TRICARE CHANGES LEAD TO EVEN MORE UNPAID CLAIMS, DISRUPTIONS FOR FAMILIES
When it comes to healthcare, there’s almost no scenario that isn’t going to add a bit of stress to your life. Yet, for military families, the last several months have been a trainwreck even by comparison. TRICARE changes have led to several issues with claims, access to care, and other complications. It’s April 2025, and these issues are only getting worse for the community.
Over 16,000 Providers Have Unpaid Claims
Healthcare providers are having to drop patients and limit the healthcare services available to the military community as TRICARE issues continue to mount.
The contract changes that began when 2025 started have over 16,000 providers dealing with unpaid claims, and that’s just on the East Coast.
You’re likely aware by now that TRICARE undertook new regional contracts under TriWest and Humana Military.
Since doing so, patients, providers, and everyone in between has been dealing with the fallout.
Real Disruptions for Workers and Patients
Regardless of what business you’re operating, if you have $100,000 or more outstanding in payment, it’s going to affect your daily operations.
This is the reality clinics are living in now, which is causing some to take steps to handle these disruptions.
Some healthcare facilities are taking on debt, cutting staff members, and even refusing patients using TRICARE.
This means families who work in healthcare, as well as those who use TRICARE’s military insurance, are losing their livelihoods and access to care as a result. One notable example is Stephens Therapy Associates in San Diego.
Owned by Brenda Stephens, LPCC, LMHC, LPC, LCMHC, she has faced the unfortunate reality of taking out tens of thousands in loans, laying off staff, and halting mental healthcare services for 350 military families.
Behavioral health services are especially impacted by TRICARE’s issue, with clinics treating children, teens with autism, and Veterans with PTSD facing care gaps.
Families in Tennessee have lost access to care due to payment delays, hindering their health, and other states have reported potential closures for healthcare facilities needed by the military community.
Those With Autism Have Been Hit Hard
It’s safe to say the issues with TRICARE are affecting the military community as a whole, but those with children on the autism spectrum are facing major disruptions due to ongoing payment issues.
Treatment for kids with autism is already dicey for military families, and these disruptions only hurt their access even further.
Again, with clinics dropping clients, kids are left without essential services, including occupational or behavioral therapies that are vital to their well-being.
As a result, parents are already reporting heartbreaking regressions due to the lack of care, and even as technical issues are resolved, many providers are still unpaid, facing hard choices that affect families.
Why Are the TRICARE Issues Still Happening?
The government has had a quarter of the year to fix these issues, only to leave the healthcare industry and military community left to scramble.
There is still no clear end in sight, and the transparency has been non-existent for many.
This is causing military families to make hard choices, which could lead to a separation of service as they do what’s best for their families.
Others sell essential things, such as their vehicles, in order to cover the cost of healthcare when paying out of their own pockets.
Experts are warning that if TRICARE’s issues persist, the temporary access and payment problems involving military healthcare could get worse, limit availability to families, and force some facilities to move out of the network altogether.
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