Why do doctors not like TRICARE?

Answered by Frank Schwing

As a doctor, I can understand why some of my colleagues may not be fond of the Tricare health care program offered by the Pentagon. There are a few reasons why doctors may turn away patients with Tricare or express dissatisfaction with the program.

Firstly, it is worth noting that Tricare is a government health care program specifically designed for military personnel, veterans, and their families. While it may be a comprehensive program that offers a wide range of benefits, some doctors may simply be unfamiliar with the intricacies of the program or the specific requirements for reimbursement. This lack of familiarity can make it difficult for doctors to navigate the system and may discourage them from accepting Tricare patients.

Additionally, the compensation rates offered by Tricare may also be a factor. Doctors often compare the reimbursement rates of different insurance programs, and if they find that Tricare offers lower rates compared to other insurance plans, they may be less inclined to accept Tricare patients. This is especially true for specialists who may have higher overhead costs and need to ensure that they are adequately compensated for their services.

Another issue that doctors may face is the timeliness of reimbursement from Tricare. Like any insurance program, Tricare requires doctors to submit claims for reimbursement. However, some doctors have reported delays in receiving payment from Tricare, which can cause financial strain on their practices. This can be particularly challenging for small or independent practices that rely on a steady cash flow to cover expenses.

Moreover, some doctors may have concerns about the administrative burden associated with Tricare. Insurance claims, pre-authorizations, and paperwork can be time-consuming and detract from the time doctors spend with their patients. This administrative burden can be particularly frustrating if doctors feel that the compensation they receive from Tricare does not adequately compensate them for their time and effort.

It is important to note that not all doctors feel negatively towards Tricare. Many doctors proudly serve military personnel and their families and have positive experiences with the program. However, the challenges I mentioned earlier can certainly contribute to some doctors’ reluctance to accept Tricare patients.

The reasons why some doctors may not like Tricare can vary. From a lack of familiarity with the program to concerns about reimbursement rates and delays, these factors can play a role in doctors’ decisions to turn away Tricare patients. It is crucial for both doctors and Tricare administrators to address these concerns in order to ensure that military personnel and their families have access to quality health care.