A number of beneficiaries in the Tricare West Region are off to a rocky start with the new contractor, TriWest Healthcare Alliance, citing problems with its website and customer service lines as they try to verify health care coverage and provide payment information.
“Now that it is January and TriWest is the official contractor for the West region, this has graduated from an annoyance to a major issue,” said Stevie Roach, an Air Force retiree whose son is on the Tricare Young Adults plan.
Retired Marine Paul King called the transition a “fiasco,” citing problems with TriWest’s website and the inability to get through to a customer service representative.
“We are left being unsure if we have coverage after the end of January,” King said.
On Jan. 1, two new Tricare contracts began. While the East Region contractor — Humana Military — remained the same, TriWest took over the West Region. As a result, West Region beneficiaries who make recurring payments by credit card, debit card or electronic funds transfer must provide their payment information to TriWest, except for those enrolled in Tricare for Life, a Tricare plan overseas or U.S. Family Health Plan.
Tricare officials have said that beneficiaries who don’t provide their payment information to TriWest risk losing health care coverage, with the original Dec. 31 deadline now extended to Jan. 15 for beneficiaries enrolled in Tricare Young Adult, Tricare Reserve Select and Tricare Retired Reserve plans, and Jan. 30 for Tricare Select and Tricare Prime.
However, an unknown number of beneficiaries have reported problems with setting up payments. Frustrated with the website, they’ve tried calling the customer service lines, with some telling Military Times they’ve spent hours on the phone trying to get through.
For at least one beneficiary who contacted Military Times, this issue is not simply a matter of missing an annual checkup because of possibly losing coverage. The individual, who wished to remain anonymous, said the hiccups could potentially affect two all-day appointments for critical brain and brain stem scans slated for early February.
As of Monday, about 59% of beneficiaries who need to provide their payment information have successfully done so, according to TriWest officials.
Tricare West beneficiaries granted more time for payment updates
Some beneficiaries like Roach, meanwhile, are questioning the effectiveness of the year-long transition to TriWest.
After setting up an online account well ahead of the Dec. 31 deadline, Roach tried logging in, but got repeated “error” messages.
After calling TriWest, “They told me that many users had reported this same error,” he told Military Times. “They said it was a problem with their back-end connectivity with DEERS [the Defense Enrollment Eligibility Reporting System] and that I should wait a few weeks and then try again.”
Roach did — again receiving error messages — and called TriWest. This time, TriWest updated the payment information over the phone.
However, Roach still can’t get into the website.
“I have literally tried every day, and I get the same error every day,” Roach wrote, noting the difficulty in accessing Tricare-related details as a result.
Responding to questions from Military Times, TriWest officials in an email said the contractor is “closely monitoring its customer service lines and has implemented a plan to adjust staffing levels quickly to address increases in call volumes.”
“As a result, call hold times are being addressed and we continue to see them decrease each day,” they added.
On Monday, officials implemented a change that gives callers the option — after 15 minutes on hold — to keep their place in line and receive a call back instead of continuing to hold.
Still, officials said the quickest way for a beneficiary to make a payment or view enrollment information is an online self-service portal available at www.tricare.mil/west.
“Several improvements were made recently to the portal to help enhance the beneficiary experience,” officials stated, including addressing an issue involving enrolling beneficiaries in the wrong plan.
One beneficiary told Military Times that TriWest had mistakenly enrolled them in Tricare Retired Reserve instead of their current Tricare Reserve Select, which increased their monthly premiums by over $1,200. The beneficiary said his wife had been on hold with their call center for over four hours over the previous few days, unable to talk to anyone.
TriWest officials said some letters had been mailed to beneficiaries with the wrong information “despite the beneficiary being enrolled in the correct plan.”
Corrections to those letters were emailed to affected beneficiaries Friday, and corrected letters are being sent, they added.
“With a transition of this size and scale, challenges will arise,” Tricare officials told Military Times. “Our commitment is to identify areas for improvement and execute a plan to address them expeditiously. While some issues may take time to resolve, we are confident in our ability to develop solutions and ensure a successful outcome given our 28-year history of providing excellent service to our nation’s military and veterans.”
King, the retired Marine, told Military Times that when he is logged into DEERS and selects the TriWest link, “it takes me to Tricare for Life, which I am not that age yet.”
He tried to contact the Defense Manpower Data Center’s support center for DEERS. Their “default message indicates they are aware of the problem but refer us back to TriWest to try to resolve it,” he said.
After repeated attempts to get through to TriWest’s call center, King finally got through on Monday, he said.
“I was informed that their payment system is down so they could not verify whether our payment was current in their system,” King said. “We opted to print off, complete and express ship the TriWest payment form to their Virginia address to ensure our payment data is in their system. … The office should be held accountable for the adverse impact to Tricare West beneficiaries.
“We fear the next ‘shoe to drop’ will be TriWest’s handling of claims.”
