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TRICARE: We are in DEEP Trouble


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CardiacKid

For those of you who are using Tricare. You REALLY need to check the April 16th provider's list for Cebu. Both Cebu Doctor's Hospital and Perpetual Succour Hospital are no longer certified and one branch of Hi-Precision Diagnostics is also no longer certified. They are on the Decertified List supposedly because no one has filed claims listing them as the provider in the last two years. The list can be found here http://www.tricare.mil/tma/pacific/pacificcertifiedproviders.aspx :link:

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Smokey, I just told you the one thing you can say to the guards that will get you into the US citizen services area every time. If you don't want to use it, that's just fine with me. I guess it's a lo

"....that's the way it is" As long as you are in the U.S.. Medicare doesn't pay squat overseas. Yet we have to have it to be eligible for Tricare which doesn't pay, as for as I can tell, anything eith

Greetings! I can understand Cebu Doctors being removed. i was admitted there about 2 years ago for an angeoplastie. My cardo doctor came from the Chongwa groupe. He was just great, but the things the

Headshot

Well, that's fun. I can't file the claim for my daughter's birth from last August (at CDUH) until she is enrolled in DEERS in May, and now they have decertified the hospital? Let's see now...when Tricare was here a couple of months ago, they said they were going to make things better for us. Is this what they were talking about? What a bunch of lunatics they have running the Tricare program. BTW...it is SOS International (the Tricare contractor that "serves" the Philippines) that decertifies providers here...not Tricare themselves. Well, this will delay my payment, but according to Tricare, if you get services from a decertified provider, then Tricare will pay the claims as soon as the provider is recertified. This is fricking ridiculous.

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highwinder

Reading the current list of Medical Providers in Cebu is troubling to say the least and deadly to say the most. I have lived in Cebu going on 7 years as of August 2012 and yearly I review the Tricare Certified Medical Provider list. Over the past 6 years the list from year to year has changed very little if any. A few doctors are added a few are gone. But this year is a whole new issue. The list has gone form 20 pages in past years to just 5 pages as of April 2012. One of those 5 pages list only Rose Pharmacy. So we are looking at almost no certified providers in Cebu. Why Cebu Doctors and Perpertual Succor are decertified is a mystery or maybe not.

 

Consider this scenario. Tricare is now trying to setrup a " closed network" of which Cebu is not included. That maybe a blessing. But the facts will be this a group of certified providers and a closed network are two competing entities. In order to drive the retiree to the closed network there must be no alternative or very little alternative services available. This is where the certified provider would compete with the closed network. By limiting or removing a certified provider list the retiree has to use the closed network good or bad. Is that why the Cebu Providers are almost non existant?

 

Of course the big scam is at play here as well and that is "Decertified not used in two years" bullshit. This is built in the system to automatically limit health care. There is not a large number of retirees in the entire country. So it stands to reason you may go to a doctor today but not for years later. A colonscopy is a perfect example of a test done every 5 to 10 years. So you use your gasto this year the results are fine and you don't see him for 5 years. Surprise Surprise in 5 years you find he has been automatically decertified i.e. not used in 2 years. The certification requirement is without a doubt the major thing limiting a retirees health care in Philippines period. Remove this requirement and 95% of all our health care issues are gone. We need no closed networks, we need no 3rd party billers and fraud goes away. We pay the bill , get fairly reimbursed and don't have to suffer with necessary healthcare that is not paid because we need care and the provider was not certified.

 

Now Why 2 major hospitals go off the list is a mystery. It can't be for lack of use in 2 years crap. I just helped a retiree file a php200000 plus claim for services at Perpetual Succor. At least one hospital is still certified today, but maybe not tomorrow. Retirees had better wake up and realize that all our negotiation with Tricare and attempts at fostering a fair solution to our problerm may simply be a case of us pissing into the wind. This current Cebu Certified List certainly does not foster my goodwill towards Tricare. Unless we organize a group policy we are in deep poop. We trusted Tricare to do what is right for us. Is the current situation right for us? You look at the Cebu Providers list and answer that question.

 

Highwinder

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RogerDat

Greetings! I can understand Cebu Doctors being removed. i was admitted there about 2 years ago for an angeoplastie. My cardo doctor came from the Chongwa groupe. He was just great, but the things the CD pulled were not. Treating my diabetic condition when not authroized to, and doing a very bad job of it. They did not know how to do a blood test properly with a meter, I had to teach them. Leaving the urin bag drain open, and then taking three times to clean it up over a two day perioud. Using the fire escape stairs as storage. Feeding me potatos and bacon when on a low calire dieat. Spreading my medication out over a three hour perioud instead of all at once as prescribed.

CD and their sister Mactan Doctors are only intrested in thge money. Their doctors have NO compassion for "foringen" patients, constently complaning about how "WE" are getting such a good deal from them, and poor them have to treat us for such a low price! AVOID the CD and MD at all cost. Go to Chongwa if you want proper treatment.

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mpt1947

I received this in an email this morning from DAV in Angeles City - I am not a retiree, but it looks like Cebu is being left out

 

 

Plan to fix military retiree health care in Philippines delayed

 

By TRAVIS J. TRITTEN

Stars and Stripes

Published: April 24, 2012

 

Related

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CAMP FOSTER, Okinawa — Tricare says plans to temporarily replace its troubled retiree health insurance system in the Philippines with an experimental closed network of providers will start early next year, months later than originally announced.

 

Cities with large populations of retirees such as Angeles City and Subic Bay are slated to become the first areas served by the new network of credentialed hospitals and doctors on Jan. 1, 2013, while other areas of the country will not join until 2014, according to the agency.

 

The closed network – which had been scheduled to go online this spring – is designed to put an end to years of fraud and ballooning program costs. Tricare officials say it also should reduce health insurance red tape for thousands of aging servicemembers who have retired to the Philippines and depend on Tricare to cover treatment costs.

 

The first phase of the network will cover Manila, Angeles City, Subic Bay and Orion. The second phase will open in January 2014 in areas of Cavite, while the final phase of the network will include Iloilo City, according to Tricare spokesman Austin Camacho.

 

The agency had said the project would be up and running this spring but did not elaborate on the apparent delay. Tricare plans to continue the experiment until December 2015 when it will weigh the benefits of the changes and decide on the future of the Philippines network.

 

Tricare has said all retirees will be required to use the new network. Under the plan, participating health care providers will be required to file their insurance claims directly to the agency, meaning beneficiaries on fixed incomes no longer will have to pay for medical procedures up front and wait for reimbursement.

So far, no hospitals or doctors have agreed to participate.

 

“Recruitment is not yet under way” but the agency has hired its existing Philippines contractor, International SOS, to create the closed network and bring providers on board, Camacho said via email.

 

Last year, the Defense Department’s Inspector General criticized the contractor for not properly certifying providers or authenticating insurance claims as part of the existing Tricare system in the Philippines.

Camacho said International SOS will compile a new list of providers for the experimental network as part of its overseas contract and that list will be posted on Tricare’s website two months before the project begins.

But some retirees worry the agency will be hard-pressed to find Philippine hospitals and doctors willing to take part.

 

Bob Lowe, a retiree and cancer patient who is receiving treatment in Angeles City, said many top-tier providers may be leery of joining an experimental system in which they depend on medical care reimbursement rates decided by a foreign insurance agency.

 

“All indications are the good docs and medical institutions will have nothing to do with this program and they have no need to make room in their waiting rooms that are already full of paying patients for Tricare patients that they may or may not get paid to treat,” Lowe wrote in an email.

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RetiredNavyGuy

Headshot, I agree with your analysis. ...and in 7 months, I am supposed to start paying $115 per month for the "privilege" of being able to pay whatever fees Tricare decides to charge, as well. I am trying to work out the cost/benefit figures, but right now, its not looking good for the "Tricare for Life" program.

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Headshot

Headshot, I agree with your analysis. ...and in 7 months, I am supposed to start paying $115 per month for the "privilege" of being able to pay whatever fees Tricare decides to charge, as well. I am trying to work out the cost/benefit figures, but right now, its not looking good for the "Tricare for Life" program.

 

Just be aware that if you turn down Medicare Part B at 65, and thereby lose Tricare, you can't go back later and pick it up. Therefore, if at some point you need to go back to the US to take care of a major medical problem, neither Tricare nor Medicare will be there for you.

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RetiredNavyGuy

Medicare, alone, will be $1300+ a year, plus whatever Tricare starts charging. One of the questions in my mind is "how much is it worth to keep an option that may never get used? I have no home in the US any more, and I am not at all sure I EVER want to go back to the states the way the country is going."

 

Still thinking and considering. Also waiting for the Supreme Court decision on Obamacare...the could alter the figures, too.

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highwinder

I can totally agree on the statement about Cebu Doctors and Mactan Doctors. But what rational is there for Perpetual Succor being decertified? I would never use either one again unless they were the only alternative. They are better than nothing but not bymuch,

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Headshot

International SOS controls what happens to TRICARE in the Philippines. I think that they need to hear from us on this, so I am going to give the contact information for the head guy...

 

Chip Wilcox

General Manager

TRICARE Overseas Program, Asia Pacific

International SOS Pte Ltd

Wordwide Headquarters

331 North Bridge Road #17-00 Odeon Towers, Singapore 188720

Tel +65 6338 2311

DID +65 6631 2220

Fax +65 6338 7611

E-Mail [email protected]

Mobile +65 9119 7859

24-Hour TRICARE Overseas Call Center +65 6339 2676

www.tricare-overseas.com

 

Call, fax and email them, and voice your opinions of these changes. That is the ONLY way they will get the message that they have screwed up big time. This will only have an effect if lots of us actually take the time to contact them about this, so instead of just complaining about this, complain to the right people. Don't be rude...don't swear at them...but let him know what these changes mean to veterans here. I'm afraid that TRICARE is going totally off the tracks, and if we don't make him realize what TRICARE and International SOS are doing to us, it will just continue to get worse. He has to be made aware of how we feel about these changes unless you just want to see more of the same.

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RetiredNavyGuy

Thanks, I will write to him. Even this closed care system, which they are trying to find doctors and hospitals for, is worthless to most of us down here as in 2013 it will exist only in Manila, even though we will all "have" to use it from what I am reading. Go to the US, go to Manila. ...not sure there is much difference.

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Headshot

Greetings! I can understand Cebu Doctors being removed. i was admitted there about 2 years ago for an angeoplastie. My cardo doctor came from the Chongwa groupe. He was just great, but the things the CD pulled were not. Treating my diabetic condition when not authroized to, and doing a very bad job of it. They did not know how to do a blood test properly with a meter, I had to teach them. Leaving the urin bag drain open, and then taking three times to clean it up over a two day perioud. Using the fire escape stairs as storage. Feeding me potatos and bacon when on a low calire dieat. Spreading my medication out over a three hour perioud instead of all at once as prescribed.

CD and their sister Mactan Doctors are only intrested in thge money. Their doctors have NO compassion for "foringen" patients, constently complaning about how "WE" are getting such a good deal from them, and poor them have to treat us for such a low price! AVOID the CD and MD at all cost. Go to Chongwa if you want proper treatment.

 

I don't agree with the statements about Cebu Doctors Hospital AT ALL! My baby was born there this last year, and we receive excellent care there. I saw NONE of the problems cited by Rogerdat.

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Medicare, alone, will be $1300+ a year, plus whatever Tricare starts charging. One of the questions in my mind is "how much is it worth to keep an option that may never get used? I have no home in the US any more, and I am not at all sure I EVER want to go back to the states the way the country is going."

 

Still thinking and considering. Also waiting for the Supreme Court decision on Obamacare...the could alter the figures, too.

 

Well, for me, if I, my wife, or my daughter had anything serious that required surgery, I would be going to the US to have it done. The medical system here is good enough for the small stuff, but I don't trust them enough to have them do anything major here. I want to leave the option of going to the US for care open. I know it's a bad deal financially, but for me, it is better than the alternative. Besides, you can go to Guam for major care. You don't have to go all the way to the US to use the Medicare Part B. I see it this way. WITH Medicare Part B and TRICARE combined, ALL of my medical expenses for any major procedure will be paid for. WITHOUT those programs, I will be paying the whole thing myself. Even with reduced costs here in the Philippines, that could quickly turn into major money. To me, that is a bad bet.

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highwinder

Good idea go to Guam for major care. There is only one major flaw with that idea. If you need major care you may not be well enough to go to Guam. Then the question becomes now what? The key word here is major care. And anyway Naval Hospital in Guam most likely would have to send you to Trippler Army Hospital in Hawaii. So you have a major issue and must fly around the world when you are obviously not 100% fit.

 

I can agree with having Medicare plus Tricare to give100% US medical coverage. The problem is we must be able to aquire good medical care here. And that is where we are getting screwed. Chong Hua in Cebu being US certified by JCAHO is as good as it will get. You may need Medical City in rare instances but for the most part ChongHua should work. We must realize that medical care needs maybe necessary ASAP and flying out most likely is not a valid option.

 

Contacting ISOS is an exercise in futility. I was at the Cebu Tricare Meeting and Chip from ISOS was there saying how the closed network will help us and it is not even in Cebu. The fix is easy as I have stated many times eliminate the certified provider requirement and we can access care anywhere. Fraud will go away as care is easy to access anywhere there is a doctor. We get care pay bill file claim and get reimbursed.Just 3 simple steps to medical care. The closed network was never ment to work we know that and ISOS knows that. Just look at all the medcial providers clammering to sign up.

 

Our problem is simple by accepting a different Tricare program here in Philippines we have allowed ourselves to be discriminated against. Can you imagine Tricare pulling this on retirees in the USA? How about this for an idea. We get same benefits as Military Retirees in USA. We come under same rules for care as retirees in the USA. We have accepted the benefits of the bastard child retiree and we are getting such. Are we inferior to retirees living in the USA? YES we are. We allow our selves to be treated as such. Prove discrimination and win our case any other angle we lose. Think I am full of BS maybe. But what have we gotten here in Cebu? We like the bastard step child have not even been included in the new plan. That however, maybe a blessing in disguise unless the certified provider list dries up here in Cebu. It has gone form 20 pages to 5 pages with one page dedicated to Rose Pharmacy. Things are getting worse much worse. Anyone who thinks other wise may need his head examined. So waht do we do now becomesthe question?

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RetiredNavyGuy

Exactly what I am trying to determine. Your comments about whether or not we would be healthy enough to get on a plane is part of my concern about signing up for Medicare Part B in December.

 

Truthfully, I do NOT expect it to get better no matter how much pressure we put on them. Worse and worse. We have all been in the military for multiple years, and my experience is that contractors respond very negatively to pressure ...and that's gotten worse over the years. I am not a believer in miracles, which is why, like you, I am trying to figure out what we do now.

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