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Tricare Help: Why won't Tricare talk to me about daughter's claim?

Mar. 29, 2012 - 02:25PM   |   Last Updated: Mar. 29, 2012 - 02:25PM  |  
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Q. My daughter attends college in another state. She is 20 and still covered by my Tricare. She called me recently because she was having trouble with a claim, but when I called Tricare to try to straighten it out, they refused to help me, saying the Privacy Act wouldn't allow them to talk to me about my own daughter. I tried to explain she was my dependent, and even gave them my Social Security number to prove I was who I said I was, but they wouldn't listen to reason. Who can I talk to at Tricare to make sure other parents don't go through this?

A. You may not like this answer, but for purposes of the Privacy Act, your daughter became an adult when she turned 18. She alone has the authority to grant someone else access to her Tricare claims and other personal information. That's easy to arrange, however. She simply needs to give you a signed and dated written authorization. If she agrees, contact your Tricare Service Center to learn how to proceed.

If it ever becomes necessary to file an appeal of a denied Tricare claim, and if your daughter wants you to deal with the matter on her behalf, she must provide with the appeal a signed and dated statement appointing you as her representative on the appeal.

Q. Several times I've had a doctor's office give me a blank look when I tell them my health insurance is Tricare for Life. They say they've never heard of it, and they want to see a proof-of-insurance card. Where can I get such a card?

A. Under Tricare for Life, your primary insurance is Medicare. Tricare acts as a free Medicare supplement.

Providers usually don't care which Medicare supplement you have because they will look to you to pay what Medicare does not. What you owe is your 20 percent Medicare co-payment and maybe some Medicare deductible. Whether you have a supplement to pay it for you, or whether it comes out of your own pocket, you, the patient, are responsible.

So, when asked about your health insurance, just say you have Medicare. That's the important word. If they ask about a Medicare supplement, then you can say you have Tricare.

TFL doesn't have an ID or proof-of-insurance card. Just show your Medicare card and your military ID card.

Also, any time you go to a new provider of any health care service, whether it's a doctor, a hospital, a physical therapist, or medical supply and equipment vendor, ask if the provider files Medicare claims before you incur a debt.

If a provider does not or cannot file Medicare claims, it's an indication that the provider is not an authorized Medicare provider.

That doesn't mean there is something wrong with the provider. But it does mean that neither Medicare nor Tricare will pay for any services you receive from that provider.

Write to Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or">click here to email us. In email, include the word "Tricare" in the subject line and do not attach files. Get Tricare advice anytime">on our blog.

Answers by RallyPoint

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