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Home > Tricare, Medicair, and Soc Sec... Wow...
 

Tricare, Medicair, and Soc Sec... Wow...

August 27th, 2009 at 04:22 pm

No fluid around the heart, but it's making some really strange sounds that are unexplained. Working on figuring that out. 85% vein stenosis causing the blockage in her chest. Pool of fluid in her stomach where her kidney was is becoming infected. Diarrhea and vomiting all last night, despite meds. On an TNP IV feeding tube, again. At dialysis right now.

Investigating Tricare bills, found that they haven't paid anything since June 2008 and never told us. In order for the bills to be covered, Social Security has to get her put on Medicair Pt. B. Tricare has her as being on Pt. A since June of 06, Social Security has her as being on Pt. A since 94. I'm going to get stuck with past premiums to get her up to date on Pt. B, but Social Security can only go back to August of 08, a year. Problem is, the bills go back 2 months before then. So guess who is going to be left on the hook for that? Well, I'm going to write a letter to my congressmen and get my Battalion CSM in Tricare's office with me. My platoon sgt went and talked to them the other day, but there wasn't much they could do. A BN CSM can go much higher than a SFC. If I get stuck with the past premiums, it's going to an AER grant. I can't believe it's this much of a mess, and not one of the hospitals complained about it yet. Her hospital said they have been billing tricare, it getting kicked back, so they turn around and bill Medicair Pt. B, and it gets accepted. Makes no sense since Social Security has her as not being on Medicair Pt. B, and Tricare is trying to bill me for the bills they get and kick back. A huge bloody mess. And the government wants to run our nations health care? Are you kidding me?

Furthermore, this completely removes all incentive for me to not take a compassionate discharge. The only reason I've turned down the offers of it thus far is because I thought Tricare was paying the thousands of dollars in medical bills I now find out I'm on the hook for. When they do pay them, it's not Tricare paying for them, its Medicair Pt. B paying them, and Tricare paying the premiums. But they won't pay the past premiums and penalties, and the current premium is only $113 a month for my DW, so that's about the same as a high utility payment. I might as well get out and do what I want to do with my life as opposed to be put in harms way when Tricare won't even take care of it's own.

If I end up getting charged anything for this in the end, you better believe it's going to be on like donkey kong between me and DW's tricare case manager. That woman told us Pt. B was not an issue in August of 08, when it could have been back dated to the day we got married then. Really frustrated. How do you let unpaid bills go a year and not tell the beneficiary there might be problems with the account? Let alone that I talk to Tricare at least one a month about bills. And how does tricare and social security's records - both government entities - show different dates for Pt. A? What? Huge mess.

But at least there is no fluid in her heart. And Disability is expediting her payments, and backdating the application to May of 08, so she should see a $11,844 check for that if all goes well. This would cover the past premiums on Medicair, but that's not the point. So effing frustrating that I'm dealing with my wife in deteriorating health and the insurance that's been keeping me in the army, really isn't doing jack but paying $113 a month. To me, that's like telling me I've been staying in for an extra $113 a month when I could have been going to college for free this whole time and working part time. Afterall, the GI bill covers my mortgage while I'm a full time student.

So once we get this insurance crap worked out, and the disability payments start, I think I might take up that compassionate discharge. I've done my 4 yrs. I would be able to finish college full time, have my mortgage paid by the army thru the GI Bill as long as I am a full time student, and have DW's disability checks. That's without either one of us working. Our income would drop $1,000 a month, and I could work part time to make up that difference until I finish college. I'm so pissed off about all of this bullshit right now.

Creditcardfree, any advice on this being a military spouse?

4 Responses to “Tricare, Medicair, and Soc Sec... Wow... ”

  1. creditcardfree Says:

    Oh, Swanson...I wish I had some really good advice. I definitely agree with calling/writing the congressmen. I have heard that this can be a help in some instances. My husband is really the only one that has needed hospital care and he's always covered 100%. I'm also not an expert on Medicare.

    Is anyone getting paid? Your post seemed to indicate that Medicare was making some payments. I'm wondering if there is anyone at the hospital(s) that can look over your Tricare explanation of benefits to clear up what has and has not been paid and most importantly, why. The hospital may be willing to write some of this off...so don't hand over a check too quickly.

    You are under a lot of stress with your wife's illness. I'm sure this only adds to it. I don't know if it is possible to put this on the back burner or not.

    Be open to the possibility that this WILL work out, even though all evidence points otherwise. It may just take some time. Take a deep breath and keep moving forward.

    ((Hugs)) If I think of anything at all, I will write again.

  2. Joan.of.the.Arch Says:

    It is a shame to have to deal with all the crap regarding things not being paid at the same time you are dealing first and foremost with your wife's very bad situation. I wish I could kick someone's behind into getting the job done right for you. I'm having enough trouble kicking my own private insurance company's behind to get them to pay for some things for me this month. They are saying that neither myself nor my son are even insured by them, even though we've been paying them $1350 a month and have been with them about four years. Incompetence and bureaucracy is everywhere, and here we are paying people and systems to be incompetent and bureaucratic.

  3. Jerry Says:

    I don't have any good advice for you, alas, but I can commiserate. Your situation leads me to think of my own struggles with Tricare insurance (although they were less serious than your own) when I was in the military. I hope that your wife is feeling better soon, and that you contact your congressman and any other higher-ups to get the care and the funds that are rightfully yours.
    Jerry

  4. anonymous Says:

    My brother did get help when he contacted his congressional reps and senators. It was not a Tricare matter, but it was matter of the military keeping its end of the contract with him.

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