I wanted to treat military patients but TRICARE left me no option

[Socrates25]

I'm peds and have a lot of military families in my area. I tried to make it work for 5 years. I don't really care if Tricare reimburses less than BCBS or even United. I don't really care about the hoops for referrals that are unique to Tricare/Prime.

I want to help military families.

But the vaccine issue I just can't do it.

Tricare reimburses less than 50% of the cost of the vaccines we purchase. And I belong to a strong vaccine purchasing group where I can get vaccines for 30-40% less than the "nominal" market price.

But Tricare reimburses 50% BELOW the 30-40% discount that I get, so in reality it's an even steeper cut.

I would eat that cost if we were talking 80 or 90% but 50% is a bridge too far.

Consider that we order approx $150k in vaccines every month. If my practice were 25% Tricare, that's already a loss of almost 20k every single month just by accepting Tricare patients.

Over the years I've tried to raise this issue several times with Tricare but of course it just gets lost in the bureaucracy and apparently the higher ups don't really care that nearly all of the peds clinics in my area won't take Tricare anymore.

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[pawprint]

Meanwhile the Navy continues to cut active duty pediatrics billets because civilian medicine is supposed to cover everything that we do.....sigh

 

[armytrainingsir]

Depending on your area, keep seeing them, have them sign a letter saying vaccines are not part of your Tricare practice, and just send them to the health department for vaccines. And give them a letter explaining why.

When I was AD at DDEAMC eons ago, our private pediatrician sent our kids to the health department. That was 10x easier than going on post for either care or vaccines.

 

[HighPriest]

Email your senator. Will anything change? Probably not. But, it’s a major issue.

 

[DrMetal]

I'm peds and have a lot of military families in my area. I tried to make it work for 5 years. I don't really care if Tricare reimburses less than BCBS or even United.

I'm a little confused. There is no 'Tricare' any more, right? If you're West Coast, you're dealing with United. If you're East Coast, with Humana, right?

 

[Socrates25]

I'm a little confused. There is no 'Tricare' any more, right? If you're West Coast, you're dealing with United. If you're East Coast, with Humana, right?

All the correspondence we get from them has both the Tricare and Humana Military logo on it. I'm just used to calling it Tricare.

 

[DrMetal]

All the correspondence we get from them has both the Tricare and Humana Military logo on it. I'm just used to calling it Tricare.

Are you running your own practice? I'm still active duty, my kids got assigned to Childrens Radys here in San Diego (to one of the satellite clinics). They're in their teens, and they've never seen a military pediatrician (we've always been deferred out).

As far as I know, Radys love's to take United money, it pays much better than no insurance? I think?

 

[Brouillet2017]

Are you running your own practice? I'm still active duty, my kids got assigned to Childrens Radys here in San Diego (to one of the satellite clinics). They're in their teens, and they've never seen a military pediatrician (we've always been deferred out).

Was that your choice to defer out to civilian for your kids? Makes me wonder who the heck Navy peds residents are seeing if they aren't seeing AD families in San Diego, where there is a residency program and a large Navy presence...

 

[DrMetal]

Was that your choice to defer out to civilian for your kids? Makes me wonder who the heck Navy peds residents are seeing if they aren't seeing AD families in San Diego, where there is a residency program and a large Navy presence...

Yeah no kidding. I've been at several MTFs. Peds clinic is almost always closed for enrollment, even in the presence of a residency program. Then again, so too is the internal medicine clinic. (What the hell we're exactly doing in this enterprise is beyond me).

I had no choice in the matter. Was automatically deferred out. quite frankly I'm happy with it. My kids are healthy and they get great services from Radys.