"I'm sorry, we no longer accept ..."

Ease of appointments, little or no paperwork, just be there on-time, and no concerns about the insurance companies paying the health care providers ...  Most folks, and many spouses believe that our active duty milspouses have it made in the realm of dental and medical care -- and to be sure, I for one managed to be managed just fine thankyouverymuch for 26 years.  Then my flip to being a F/M ... the ol' D/H of yore.  But then I learned of the ease, quality and breadth of dental care available to family members.  Having trod both sides, I believe that we actually have it better than our milspouses who get the "free" care... how so, you ask?

For one thing, we get twice yearly cleanings (to their once yearly cleanings) with multiple facets of dental care available to us, all for the asking (presuming you're milspouse is having the premium taken out of the monthly pay).  So I readily jumped onto this twice yearly thing as I really want to be smiling out of my casket with all those teeth being mine.  So the uneasiness of being in a dentists office is offset by the availability of quality care ... a tedious balance at best.

But then unexpectedly, it strikes -- those dreaded words ...

We No Longer Accept United Concordia insurance ... There I was, little crab claw bib around my neck, a single bright light in my eyes, nervous sweat rolling down my back, a tray covered with all those little hooks of sharpened steel capable of nicking only the piece of gumline at the point between two teeth where all of my arteries pass, and ... it seemed I was about to have to pay for this ride.

Fortunately, just before I started baying like the hounds on the moors, the very nice dentist said, "you look surprised, didn't you get my letter?"  Ha!  That's what they ALL ask, I bet.  I sez "no" and he cut me a deal -- an inspection and a cleaning for only my first born!  Ha! Again!  My first born is a Shih Tzu whose vet bills alone will FAR exceed his charges to me!  (and yes, Shih Tzu Happens...)  but I digress ...

Lesson learned -- don't presume that any of your civilian health care providers will always accept/or continue to accept TRICARE or United Concordia or any of the other insurance providers.  Always ask when confirming the appointment and yes, ask again at check-in ... might just save you from getting into the Shih Tzu too deep. O&O, MaintenanceToadOne

Comments

[LAW]

i'm having trouble FINDING a dentist who will accept United Concordia. or if they do, they aren't accepting new patients. As for TriCare, I have been lucky that the medical group I am with is one that accepts it, but when I see the EOBs, I am not surprised that some don't.

LAW

[dizzylizzie]

here's a story for you. i was trying to find a counselor for our son and i couldnt find much under child counselors in the handy dandy tricare book so i called 'em up @ 1800tricare. nice lady on the phone gave me 9 doc's on the list. NOT A SINGLE ONE took tricare anymore, two the numbers were disconnected and one simply didnt work at that office anymore and hadnt for many years (and would i please tell tricare to take them off their list? says the cranky receptionist) so i call back good ole tricare. and got the number to the remaining 2 docs on the list. the first didnt take new patients and the second didnt take 7 year olds BUT there was another doc in there office that DID take 7 year olds AND tricare that wasnt on tricares list! so i booked the appointment. it was so far away i had to take him out of school for the entire day (the appt was at 1045, hour to get there, hour to hang around, hour to get back) anyway so i call ole tricare back up and tell them "hey none of these people are taking tricare anymore and three have vanished off the face of the planet, why dont you update your list? and remove these docs?" the answer? "well we cant. we have to have somebody there under that field" nice. isnt that kinda like false advertising or something? "yes we have 11 docs for you to choose from!" uh..hmmm...no, you dont. you have a list of names of people that do NOT take your insurnace. this is supposed to be a list of people that DO.
so anyway, thats my rant/the frustration of the week.

[Jan Wesner]

I'm very grateful for the insurance we have. Think of all the millions of people who have none at all.
But, at those times when I do get frustrated, I like to say this about the military healthcare system: You get what you pay for!
blogs.tampabay.com/standingby

[Kel]

i fortunately found a GREAT dentist for me and then a dentist for the kids all in the same building and the kids LOVE it. they keep asking when they can go back@@. but thanks for hte tip ill definitely keep in mind to ask

[Chelly]

my rant for the week? And yup, all about dental... I have two kids, possibly three that require braces, I myself need my wisdom teeth pulled, I got lucky enough to have one growing in so crooked that it is cutting into the inside of my cheek, but I can't get it taken care of because good old United Concordia doesn't help pay for any of it! So I get to sit in pain (because wonderful Tylenol or even Moterin doesn't help) until I can save up the money to get this taken care of! I even called the good ol people at health net, who I was directed to talk to, and they confirmed, they wont help out...

[RedLegMeg]

Chelly,

I have to ask why they won't pay for it. I also just found out that I need to get my wisdom teeth pulled and UC will pay for it - just not 100% - UNLESS I've already reached my catastrophic cap of $1,200 for the fiscal year. I also need a crown and that could affect how much they'd pay if it pushes me close to the $1,200 cap. Now, it's still not cheap and involves having to save for awhile. I believe it'll cost me approx. $425.00 to have all four teeth pulled.

Maybe your issue is different than mine, but having a tooth removed that is cutting into your cheek sounds like pretty necessary dental work to me. Mine aren't even bothering me at this point, but the dentist mentioned that future decay is possible with the teeth so far back in the mouth and says I should really have them removed. I was also told that there are two different fiscal year start dates. Some people start in Feb. (my case) and some in Aug. This is an important date when discussing coverage and catastrophic caps.

I wish you luck and hope that you are able to get the care you need.

[Navy Wife]

We moved here 7 mo. ago, and hadn't needed a pediatrician....until yesterday.. I went through the Tri-Care list. The only one that was listed on "Dr. Row" near our house said "not accepting new patients", but I called anyway and got a referral to a Dr. just down the road. They were great, I wish I knew how to get the new Dr. on that list! I'm sure other milmoms would like this place if they new it existed.

[Linda]

Kids need braces? Get an overseas assignment. I know a family who did just that. They didn't WANT to go overseas, but the kids needed braces, so they went...because simple orthodontia is covered overseas. Nice, huh?

I've not had a problem finding a UC dentist for me or my kids SO far. As for medical care, I opt to go on post for health care, unless THEY farm me out, in which case, THEY will find me the provider necessary. It's the easiest way. Yeah, the doctors are not always the "best" but I've not had any bad care. I had a hysterectomy recently, and I have yet to see anything from Tricare, because the facility here took care of EVERYTHING.

[Amie]

A little off subject, but I am still trying to figure it all out---Prime or Standard? I know most pick prime because it is totally free, but has anybody done standard and stayed with it? I like the freedom it offers, and even if it cost some it is still probably better than the $500 a month I was paying out in California right?

[Heather S.]

I have used standard...and not had too much trouble. I'm not near a base now, so I go to whomever will process tricare and end up with a small co-pay.

I was under the impression that if there was not a dentist/doctor within a 50 mile radius who accepted UC/tricare, you could see someone within that radius and be reimbursed. Does anybody have any more info on that?

Heather

[Molly]

Dizzylizzie--not a permanent solution, but try Military OneSource to get the counseling started. They may also be able to help you locate a counselor who will accept the insurance.

[dizzylizzie]

molly, the doc who would finally see him gave us the referral we needed, to a counselor in their office (that thankfully also takes the tricare) its just a hassle to get all the way down there.

tricare's thing was i couldnt just take him to a counselor. i had to take him to a child pyciatrist and get a referral to a counselor FIRST. their reason was, that too many people were going to counselors that needed actual pscycatrists. the doc and i both knew my son did not need medication for any mental problems, he was just angry and feeling cheated of his time with his dad (3rd deployment to iraq) so he's been really acting out at school and causing general chaos. we still have to drive all the way down there but at least i found someone who will help my boy.

[SigGal]

Linda - We're overseas and they won't give my daughtrer braces becasue her teeth are not bad enough. She has a huge gap and fangs - wont smile. But her bite is good, so she's not a candidate.
Anyway, thought I'd clear that up - your kids get braces ONLY if they qualify.

If they have braces already, they will be covered. That is the way some people get around this. They pay for the initial braces to go on in the States, and then when they get here they are covered.

TRICARE needs to do better than what some of you are explaining. PLEASE complain about this at a level higher than whoever is answering the phone. Write NMFA about this - they put pressure on Congress to make TRICARE better. I have written them recently about the dental situation overseas. They see family members space available in the dental facilities, but for over 3 months we've been shut out.

Most host nation dentists in the system require upfront payment and two kids getting evaluations and cleanings costs over $400! Then you have to apply to get reimbursed. If you want predetermination of costs so there are no surprises, it can take a month - have to mail something to the States. Get real, this is the information age.

There are no health benefits advisors for dental in our communities - no one to help with all of the claim paperwork required that I never had to deal with in the States. There is ONE office IN ALL OF EUROPE and he is supposed to help all of the military (not just Army) family members with this cumbersome process.

TRICARE has dropped the ball. Yes, healthcare is better than no healthcare, but we need the NMFA to lobby hard to get our dental care system better overseas. I want the same return for my investment as my counterparts in the States. They pay the same as I do, why do they get such better benefits?

[Christy]

I am stationed where Linda was when she was oversea's (WAVING HI..MISS YOU!) and here they pretty well do give braces to any kid it seems. One of my best friends while they were here, her son had braces and his were barely crooked! It prob. just depends on WHERE you're stationed and who the dentist and ortho is.

As far as councelors when we lived in the states, I simply opened up the yellow pages and started calling to find out who accepted Tricare, no referral was necessary either...this was 5 yrs ago, so things could have obviously changed, but personally I've never called the Tricare line, it's always been such a hassle for everything else so often!!
SIG Gal I'm not sure where here in Germany you're stationed but sounds like you're getting really poor service. Trust me when I say our medical clinic and dental have A LOT to be desired, a lot...but when it comes to paperwork, it's always been really easy and they've been good about making sure everything's easy and painless.

[SigGal]

Christy,

we're in Mannheim. They just closed the doors to family members recently in the dental facility. Haven't been able to get an appointment for 3+ months

The problem is they just have one sheet of paper that has a name and a website on it - and send you on your way. TDP is "not my job". I'm computer savvy enough, but not all military families have easy access. I'm thinking it is the right thing to do to have someone locally who speaks a little german with a computer and knowledge of the system to help family members get care in the community and to work with them on the paperwork side. The only avenue we have at this moment is to use a website and to call an office and speak to one guy and his assistant. He travels to communities (that invite him - not ours yet) to explain the TDP to the dental facility staff and to educate the community folks, so he is hard to reach sometimes. It is just too much to ask one office to handle. It just isn't enough.

I'm rambling. Any input you have on how your community handles the TDP paperwork would greatly help me understand how ours could be improved. Something is missing here - probably because the need hasn't been high with the dental facility mostly being able to handle family members. But that has changed.

Thanks!

[Renee]

Just wondering if any of you have ever had to use the civilian side of insurance or looked at what it costs a milretiree to pick up dental insurace. As ADFM we have it made in the shade for benefits. No one and I repeat no one has catatrophic caps where they pay no more out of pocket that 1000.00 for medical or 1200.00 for dental. Wake up and smell the coffee on the other side of the fence!! and yes I am a milspouse with children!!

[Renee]

Just wondering if any of you have ever had to use the civilian side of insurance or looked at what it costs a milretiree to pick up dental insurace. As ADFM we have it made in the shade for benefits. No one and I repeat no one has catatrophic caps where they pay no more out of pocket that 1000.00 for medical or 1200.00 for dental. Wake up and smell the coffee on the other side of the fence!! and yes I am a milspouse with children!!

[Amie]

Renee, I do understand totally! My family just spent the last 3 years in California before joining Army. We paid $500 (w/$45 co-pay and $2000 deductable) a month for GOOD insurance, and I still paid about $3,000 (yes, $3,000) for my pregnancy & birth of my son. And it was a natural delivery, no drugs, c-section, long stay, etc...That is why I am liking Standard, I choose who I like and what is a $300 deductable after all that?

[Rick]

Man, I gotta say... ya'll are giving me the willies. haha. My mom, retmilspouse, just moved into my neighborhood in Houston from northern Cal. and has Tricare. she just asked me yesterday to get her a list of local general practitioners but I didn't think to ask for Tricare acceptance in my search criteria. I know she told me that at her age (68), medicare pays it's share of all her health care and Tricare has been great about paying the balance. She's had 2 operations to put stints in her arteries and paid for prescriptions only. Now she needs cataract surgery and a knee replacement and swears it'll all be taken care of. I guess I'll find out. Now I have to re do my search for her a doctor WITH Tricare acceptance included.

[Deirdre]

I just wanted to thank you all for the tips and tricks of dealing with Dental....Ive had a time, DH was deployed and they LOST OUR PAPER WORK!!!!!!!! I know I know.. get used to it.. but having no dental with 2 teens and a 6 year old Bites..im getting it sorted out but its taking lots of time and hoop jumping...

[SigGal]

You are right, I do not know what dental would cost if we were not a military family. But I do know what it cost me in time and paperwork in the US, and it was a piece of cake. I just want the same benefits for the same money as my stateside sisters. Is that too much to ask?

I do like perspective. It helps me not sweat the small stuff.

I've always thought our healthcare has been a blessing. If I had too much trouble getting appointments (especially when my kids were young), I paid a supplemental and went off base. I had no problems with the paperwork for filing claims and there was always a TRICARE health benefits advisor there to assist if I needed it. I'm so happy I didn't have to worry about the costs of childbirth - and I did have a c-section once. I never had to be stressed about that.

But dental? I guess it is a shock to my spoiled system to have struggles now after 22 years. This is the first time I am a family member overseas, though. Last time I was here I was AD.

I wonder what it is like for command sponsored family members in Korea and other overseas locations. Do the dental facilities see them space available there, too? Do the family members have to get dental care off base? Just curious.

[Maint Toad1]

Rick ... grab a paper sack and breathe deeply... it's going to be an interesting ride but one that is manageable. First, Yes IN GENERAL, your mom's medicare will be the first payer w/ TRICARE being the second and/or follow-on level of payment. HOWEVER, there's a couple of things to know and remember. Just because Medicare agrees to a procedure, doesn't mean TRICARE will --you must ask both POCs if in doubt about a procedure for your mom. (I'd ask regardless each and every time.)
My MIL had to have vertebrae surgery and Medicare said "yes" and paid X %, but TRICARE disagreed as their books called the procedure "unproven" and we were left holding the bag for the balance due. YIKES! But the MIL has had cataract surgery in both eyes, totally paid for by the combined coverages. I think the knee surgery will be covered too.
Yep, rework your search criteria and I'm pretty sure that either/both Methodist or Baylor Coll of Med accept TRICARE. It's the small PLLCs that shy away from the caps placed on their work by TRICARE.
My best to you in your newest role.
(Also, don't forget to get your mom to sign the HIPAA letter to allow the Docs to talk to you.)

[shelly]

i just had that happen to me 6 months ago, by a local dentist who said they took united ordia, well the origanl dentist was out sick so his partner took over. we got billed for full dental visit. i wear dentures, not one x-ray was taken, no dentures was replaced nor realignment was done. i was only told that they dont do dentures, that was a complete wasted trip.its like hello, wake up. why bother putting me in a chair, knowing iam there for dentures.and not a tooth in my head, iam not that stupid. some dentist takes advantage of military, thank god my hubby was there as he is a corpsmen and does medical and dental billing, as to see a bill huge bill for a visit that should never been made. so for those who has had this happen to them. file a complaint with united concordia about a so called provider. thats still in the sytem that shouldnt be there if he isnt going to take our military dental plan. and for those who need specail dental services. check out the other branches of military dental some states will treat dependants.as my hubby mentioned to his dentist about how we couldnt find anyone to redo my dentures. 2 weeks later iam having x-rays, and they are doing what they call the pernant dentures, its awesome. as my hubby is active duty coastie he is been treated at a airbase and they took me as a specail case. so look into it. same goes with health as well check out what each branch or base can or cant do. hope this helps

[elizabeth]

i do not think our dental insurance pays enough for spouses and dependents. we put braces on our oldest daughter and it cost us 6000. out of pocket. and i think that is to much. we are about to have to put them on our youngest and it is really putting a rock in my shoe. i can't imagine what it cost familys who have alot of children who need dental care and for older women like me who need a lot of dental care to keep my teeth. 1500. a year is not enough with the rising cost of dental care and that is why dental offices are dropping out of ticare concordia. yes is it nice we have some kind of dental insurance but i had rather pay a little higher premium monthly and get a much better policy. i have been lucky so far in finding dentist who will work me to pay for the work they do and now days that is rare. i have trouble getting concordia to pay for a crown i needed for a broken tooth, and in fact have refused and i have had to pay all of the work out of our own pockets. i wish i knew who to complain to about our dental program to see if we could all gang up on them to get a better program for our children and our selves. we as spouses have a lot of voices and maybe if we got together on this we could get the dental program up to par!!!

[NoName]

Don't tell anybody that I'm on here, but I work for an insurance company. I hear the complaints of people every day & I do understand what you are going through, now if you're mean to me to be honest it's hard to care, but I always try to do what I can to help. I'm guessing some of you live in South Carolina. If so, basically you are out of luck. It's harsh I know. But denists are GREEDY!! & SCAMMERS. I see it every day. They know these military families need care but don't want to be restricted to the contracts of insurance companies. Its not like these families are going anywhere, so why take a lesser rate to get more customers? They need us, or at least that seems to be the mentality. Also, I've seen SICKO & I was shocked w/ how other insurance companies behave. UCCI honestly doesn't. If your crown was denied, blame your dentist for doing a crown that wasn't needed or not submitting the proper xrays. Crowns cannot be paid for w/out proof that they were the appropriate treatment via xray. If xrays are not available (which is usually an excuse), a good narrative from a trustworthy dr can sometimes work. There are so many other options before a crown is needed that xrays are required to rule out FRAUD. As for the lists of participating providers being updated, that gets tricky too. Provider relations reps try to visit & be in contact w/ the offices as much as possible, but there are only so many people to go around. It is the office's responsibility to let the insurance company know, yet they don't seem to know or care. If more provider relations reps are hired, more $ has to be paid out by the company which could result in higher premiums. It's kind of a catch 22. If you have complaints about the dental program & you are tricare, talk to the government. They picked it for you. UCCI offered them the best plan for the $ they offered, so they went w/ them. Any other insurance company wouldn't even offer what you have now. It's a joke what military men & women get w/ insurance company. The plan isn't great, but it's something. I've seen a lot of better plans in my day tho. Ortho coverage isn't very good on a lot of plans, but it's better than paying in full. Usually if something is not covered, it's b/c it's not needed. That's a general rule though. But if something is going to help you it's covered (or something comparable) or else it could lead to more problems! Yeah insurance companies suck & I wish they paid me more, but if my pay goes up, so does your premium. If a dentist gets paid more, your premium goes up. Most people have $1000 a year maximum, but most people don't pay $1000 a year for dental, some do tho. Just remember, when contracts are set up w/ dental offices it's b/c an actual dentist informs the insurance company how much a service is worth. What they can pay them to still make $ yet keep the insurance company in business. I had a dentist submit a claim the other day & charge $405 to pull a tooth, just for pulling the tooth. All the is is labor. It doesn't cost them anything but time. I'm sorry but I don't think a dentist is worth $405 per 1/2 hour.