Veterans TriCare insurance considered 'out of network'

I am a veteran and a healthy senior. As such, I rarely need to see specialists. So when the need finally arose, I was stunned to find that the specialist’s business practices required me to pay $150 in advance to have my first consult. Well, OK, it’s a first visit and they don’t know me, I said to myself, and so I paid. A second visit produced the same requirement. This time I asked why I was being subjected to this? To her credit, the administration person uncomfortably explained the charge was likely to be $90, but that this was “policy” due to my being covered by “out-of-network Veterans TriCare” insurance. She was embarrassed.

I reiterate that I was stunned. Veterans as a class — and the TriCare program in general — are unreliable risks? Further, I have learned that almost no specialists in Central Oregon are willing to be “in-network” providers to TriCare — but that is a concern and a letter for a different day.

Never in my life have I been asked to pay more than the expected doctor visit cost as insurance against me (or my insurance!) being a deadbeat. Actually it has been decades since I was even asked to pay anything in advance. My care providers bill me and I pay. Isn’t that how it works for you, dear reader?

Now with $300 pre-paid into this specialist’s coffers, and a planned minor surgery, I get a phone call requiring that I must now prepay ALL of the expected patient portion they determined after checking with TriCare or the doctor won’t do the surgery. I am told this is due to TriCare changing providers and the business office not knowing how the payment system will work in the future. Excuse me? What does this have to do with my reliability?

So now I must pay this significant new charge because I need the service, but I must share my view that this is an unreasonable class discrimination and not based on an individual’s credit worthiness or performance. Like the vast majority of veterans, I am a responsible citizen who pays my bills, has little or no debt and highly values my reputation for honesty and integrity. This business practice is an affront to me and veterans in general. It is what used to be called a “sharp and grasping” business practice and rightly angers most patients it is imposed upon. Doctors genuinely care about their patients, I believe, but have abdicated the money side to professional money raisers.

So I say, doctors, look into what your business managers are doing and decide if you agree with this kind of discriminatory policy that suggests veterans are deadbeats. I suggest you challenge them in your next business meeting to come up with a method to deal with people as individuals regardless of what insurance they have. You might even consider joining the TriCare network as a recognition of the service of our country’s veterans. And, on the rare occasion that some veteran fails to pay his or her bill, ask your manager to deal with it as any other business does, post-facto. It is the way of the rest of the world of business and would reflect your humanity and your appreciation of the fact that we veterans once put our lives on the line for you and yours, without thought of payment in advance.