Killeen: TRICARE changes have providers, beneficiaries concerned

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KILLEEN, Texas (KWTX) TRICARE is the main source of healthcare for military members and many veterans, but recent changes to the system have providers and members concerned.

(Photo by Kathleen Serie)

Rene Ramirez served 20 years in the U.S. Army before retiring in 2015.

Ramirez has four children, including a five-year-old daughter who has special needs and sees a speech, occupational and physical therapist each week

"She needs all the help she can get,” Ramirez said. “The more times she can go, it's obviously going to be better for her."

Since TRICARE implemented certain changes at the start of the year, Ramirez said his co-pay rates have jumped from $12 per visit, to $20 or $30 each visit.

"It's going to definitely have an effect on our finances and planning our visits,” Ramirez said.

The veteran said that means his daughter may not be able to see her specialists as often as she needs to.

"It's a little discouraging, not being able to take her the three times if we have to cut back,” he said.

Kashif Haider is Ramirez’s therapist, and a licensed professional counselor in Harker Heights.

Most of his clients are retired or medically retired veterans.

He said while these veterans are paying more for their insurance, many TRICARE providers are getting paid less due to TRICARE south merging into TRICARE East.

"I've taken a 40 percent cut in what I make every month,” Haider said.

He said it’s a harsh reality that many providers in this area have experienced since the start of the year.

"I know providers in this area that have had to close their doors because they can't afford their overhead,” he said.

As the changes affect both TRICARE veterans and providers, Haider said he is still keeping the best interest of his clients in mind.
Haider: "If something doesn't change, then yes, I may very well have to tell me clients that I'm still going to be here for you, but we're going to meet somewhere else,” Haider said.

Humana Military Chief of Staff Matthew Paynter said the co-pays, cost shares, and deductibles through TRICARE are defined by federal legislation and regulation.

“Some of the rates were established in Section 701 of the FY2017 National Defense Authorize Act (NDAA) passed by Congress and signed by President Obama,” Paynter said. “Other rates were defined by the Department of Defense (DoD) through the Interim Final Rule (IFR) process. Humana Military does not set the rates, but is responsible for implementing them under our contract.”