Tricare Help: Where can I bring complaints? - Getting out, military health issues - Navy Times

Tricare Help: Where can I bring complaints?

Q I am very dissatisfied with the service I’m receiving from Tricare Prime. It is exceedingly slow in providing authorization for the specialty care my doctor recommends and does not respond adequately to my complaints. Who is in charge of that program, so I can register a complaint?

A You can write to Tricare Management Activity, 16401 E. Centretech Parkway, Aurora, CO, 80011-9043. Also, visit www.tricare.mil/contactus.

Tricare Management Activity is a federal agency directly under the Office of the Assistant Secretary of Defense for Health Affairs. Among other things, TMA is charged with managing contract compliance by the three Tricare Regional Managed Care Support Contractors. In your letter, provide a report of the problems you’ve had. The more details, the more quickly TMA can research the problem and work to resolve it. Include copies of related correspondence and your daytime phone number.

Other readers should note that if a problem concerns an adult patient other than the writer, Privacy Act provisions require a signed and dated statement from the adult patient authorizing TMA to discuss Tricare claims with the inquirer.

Q When I got Tricare for Life, it cost me more than I expected. I lost my enrollment in Tricare Prime and then had to pay a monthly premium for Medicare Part B. Now I find that it interferes with my use of my Tricare pharmacy insurance. I understand the first two changes, but is there any way I can get Tricare pharmacy coverage?

A You have not lost your Tricare pharmacy benefit entirely. Because Part D, the Medicare pharmacy plan, counts as other health insurance, you have lost use only of the 90-day benefit under the Tricare Mail Order Pharmacy Plan. You still can file claims with Tricare for reimbursement of much of your Part D co-payments for local, 30-day drug purchases.

Contact Express Scripts toll-free for help at (866) 363-8779.

Your letter does not say why you are enrolled in Medicare Part D. Tricare advises against it.

Some Medicare Advantage plans require Part D enrollment. Unless you have enrolled in a plan that requires Part D enrollment, you may be able to recover your Tricare pharmacy benefit entirely by withdrawing from Part D.

Your Tricare Service Center can further help you.

Write to James E. Hamby Jr. at Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or tricarehelp@atpco.com. In e-mail, include the word “Tricare” in the subject line, and do not attach files.