A Navy veteran, Harve Smith, along with his wife, Janice Smith, were caught off guard by a recent development involving Tricare, the military’s health care program. Tricare revoked over $100,000 in medical claims that had been previously approved and paid out several years ago. Harve, 71, first noticed something was amiss when he received a $470 bill in January for dermatologist visits in 2020. This led to the discovery that Tricare had retroactively denied 26 more claims totaling around $3,000 for services that had already been reimbursed to providers since he enrolled in Tricare For Life in 2019. Similarly, approvals for approximately $100,400 in claims for Janice were also reversed, with nine additional claims currently under review.
The Smiths, who reside in Fallon, Nevada, expressed concerns about the financial implications of this situation, mentioning the possibility of dipping into their retirement funds or remortgaging their home to settle the debt. The stress of the ordeal has taken a toll on the couple, particularly Janice, 67, who battles multiple sclerosis and fears exacerbating her autoimmune disorder due to the added anxiety.
Harve, a former lieutenant commander who served in the Navy for 15 years, admitted that the uncertainty surrounding the situation has been keeping him up at night. Questions linger about the reasons behind Tricare’s decision to reverse these payments, with legal experts pointing out that federal regulations grant Tricare the authority to recoup payments for up to 10 years in cases of overpayment or mistakes. The Defense Health Agency, overseeing Tricare, has not provided specific details on the matter, citing privacy concerns.
Amidst the confusion, the Smiths have faced difficulties seeking clarification from the involved parties, with the $470 bill already being sent to collections. The looming threat of adverse credit reporting adds to their worries. Despite these challenges, the Smiths remain determined not to shoulder the financial burden themselves.
The Smiths are facing uncertainty and stress due to issues with their Tricare benefits. They have tried reaching out to Tricare for answers, but have encountered long wait times and difficulties in getting assistance. The changes in Tricare management have led to disruptions for many service members, retirees, and healthcare providers across the country. Despite having previously been approved for various medical services, the Smiths now find themselves in a situation where they are unsure if they still have healthcare coverage and if they will be responsible for repaying claims. This has impacted their lifestyle and forced them to be more cautious with their finances. The Smiths, who were once enjoying their retirement, are now facing unexpected challenges and uncertainties regarding their healthcare coverage.
