Military reserve members across the Tricare West Region mistakenly were told they must pay monthly premiums of more than $600 to $1,500 to retain their health benefits in 2025.
TriWest Healthcare Alliance, the new Tricare contract manager for 26 states, sent letters late last month to an undisclosed number of reservists and their families with updates to their monthly health premiums for 2025.
Instead of containing information for the Tricare Reserve program, however, the letters said the service members were enrolled in the Tricare Retired Reserve program, a significantly more costly premium plan for eligible retired reservists under age 60.
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"Effective Jan. 1, 2025, the government has established new monthly premiums for the Tricare Retired Reserve program as noted below," the letter stated. "$631.26 TRR Member Only Plan; $1,513.04 TRR Member and Family Plan."
The 2025 premiums for the Tricare Reserve program are $53.80 a month for a single member and $274.48 for a family.
Beneficiaries who contacted Military.com said they had tried to update their payment information with TriWest before receiving the letters but couldn't access the portal to fix their issues.
"Whyyyyyyy did we get this?" asked an Army National Guard spouse in a message to Military.com.
"For those on Tricare Reserve Select, TriWest enrolled us in Tricare Retired Reserve, upping the monthly payment by over $1,200. ... Over the past few days, my wife, who is the beneficiary, has been on hold with their phone trees for over 4 hours now and so far [is] unable to talk to anyone," retired Air Force Lt. Col. Jeff Schneider said in an email.
TriWest officials did not provide information on the number of members who received the inaccurate information but said in a statement Monday that corrections were emailed Friday to affected beneficiaries and letters containing the right information would be mailed as well.
"The letter included wrong information despite the beneficiary being enrolled in the correct plan, which is reflected in all applicable systems," according to the statement.
The error follows a series of challenges facing roughly 4.5 million patients in the 26-state Tricare West Region following a changeover in regional contract managers on Jan. 1.
The Defense Department awarded the new Tricare contract for the West Region to TriWest in December 2022, and after a series of bid protests and a lawsuit, the company retained the contract effective Jan. 1.
In early December, shortly after TriWest published its list of network providers, patients began raising concerns that their doctors under the old contractor, Health Net Federal Services, were not in TriWest's network.
At the same time, providers reported challenges applying for the network.
Then, as the deadline approached for beneficiaries to update their payment information to TriWest, many encountered website outages and long hold times on the phone.
To accommodate the problems, TriWest and Tricare extended the deadline for patients to update their payment information by Jan. 30 for those on Tricare Prime or Tricare Select and by Jan. 15 for other programs.
According to TriWest, as of Monday, 59% of those who needed to update their recurring payment information by bank transfer or credit card had done so.
"This urgency has generated a higher volume of calls to the call center for payments," TriWest said in its statement. "TriWest is closely monitoring its customer service lines and has implemented a plan to adjust staffing levels quickly to address increase in call volume."
TriWest also said it now offers a menu option that, after 15 minutes on hold, callers can use to keep their place in line and receive a call back.
The company said, however, that the quickest way to update patient and payment information is through the beneficiaries portal.
"Caring for America's military and veteran communities has been TriWest's sole priority for nearly three decades. We believe there is no more valuable service to be performing for the nation. With a transition of this size and scale, challenges will arise," the statement read.
Complaints on Tricare's Facebook page jumped from the low hundreds across several posts before New Year's Day to more than 1,200 as of Tuesday.
Tricare has been monitoring the page and responding to complaints via direct messaging and encouraging beneficiaries to reach out directly through messaging as well.
In October, Defense Health Agency officials said TriWest would send letters or emails to beneficiaries announcing the payment update requirement and telling recipients how to do it. It appears, however, that some beneficiaries did not get the correspondence and found out about the need only from emails sent in late November.
Beneficiaries nearly immediately started reporting problems updating their information, including incorrect phone numbers and dropped transfers, no callbacks when requested and problems with the website, according to emails received by Military.com.
Health care providers also reported communications issues with TriWest, with several saying they received little to no information on applying to become part of the new network.
"TriWest has made the new contract extremely challenging for clinicians, making it hard for military members to continue seeing their provider,"Ashley Comegys, a licensed clinical social worker, said in a Facebook reel.
TriWest officials say they have a network of nearly 1 million providers. The company is allowing a 90-day network waiver, from Jan. 1 to March 31, that lets beneficiaries see their current providers.
After 90 days, if the provider has not been accepted into the network, patients may still see their providers, but there will be associated out-of-network costs.
Additionally, TriWest will honor pre-authorizations or referrals from Health Net through the pre-authorization's expiration date or June 30, 2025, whichever comes first.
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