Tricare Customer Service Issues

My daughter lived in Hawaii with her mother and stepfather but has since moved back with me to New York. She needs to switch her coverage from Tricare West to Tricare East as she injured her foot on April 2nd and requires specialist care. Unfortunately, the phone numbers I tried contacting do not offer the option to speak with a real person, and she does not have her insurance card with her as it expired before her move. I am unable to get her new insurance in NY as she is already covered by Tricare. I seek assistance in resolving this issue promptly for her to receive the necessary treatment.

I am a retired military member (USCG) on Medicare with Tricare-for-Life as my secondary insurance. I underwent surgery last year to replace a defective bicuspid aortic valve, which was a congenital defect. Leading up to the surgery, my cardiologist monitored me with regular echocardiogram checks every 2 years, then annually, and eventually every 6 months as my condition worsened. Following the successful surgery, I had a follow-up echocardiogram about 6 months after the procedure. Now, my cardiologist has scheduled another echocardiogram, blood tests, and office visit for later this month (October [redacted]). My concern is whether these tests and visit need to be scheduled more than a year after the previous echo to be covered by my Medicare and Tricare insurance. Can anyone provide guidance on this timing? Thank you.

I am having issues with the Express Scripts pharmacy site. I have contacted them multiple times over the phone and spoke with different representatives, including Janet. Despite assurances that the issue with my prescription (slidelfil script no# [redacted]59) would be resolved, nothing has been done. My doctor prescribed the medication to be taken once a day, but Express Scripts only allows it to be dispensed for a 90-day period, meaning I have to take it once every three days. Even after several attempts to get the refill before the due date of 3-01-[redacted], the medication is on delay hold. I am frustrated with the lack of service and professionalism from Express Scripts employees and the overall system. This is my second email to customer service for Tricare, and I hope this time it will be addressed properly.

I am currently in contact with US MED to obtain authorization for the Libre 2 sensors, but I am experiencing delays. I was informed that you cover 80% of the cost, which should be around $51 for 2 sensors per month. My diabetic doctor, Dr. Nissa Blochet, provided the prescription and sent my medical records to US MED. So far, I have purchased 3 sensors out of pocket for $[redacted] and already have the reader. Using the sensors has significantly improved my blood sugar levels, with an average of approximately [redacted] compared to [redacted] previously. The alarm feature has been particularly helpful in alerting me during the night about low or high blood sugar levels. My doctor strongly believes it is essential for maintaining good blood sugar control. - Donna C.

I am eagerly seeking authorization to have US Med medical supplies cover 80% of the cost for the Libe 2 sensors. My diabetic doctor has prescribed them, and I have already paid out of pocket for these necessary sensors. The alerts from the sensor have helped me during sleep when my blood sugar levels were dangerously low, waking me up at levels like 50 to 46 mg/dL. I kindly request an update via email regarding the delay in obtaining the authorization. Thank you.

I purchased a Medicare Part-D plan in December [redacted] but only started using it in December [redacted]. I recently discovered that I need to meet a $4,[redacted] deductible before the cost-sharing for my prescriptions begins. The high costs have led me to consider canceling the Part-D coverage and going back to my original Medicare with Tricare-for-Life as secondary coverage for my medical and DME needs. Once I cancel the Medicare Part-D coverage, I would like to solely rely on Tricare-for-Life for my medication coverage. I usually get my medications from Dunham Pharmacy at Carlisle Barracks, except for Empagliflozin, which is not on their formulary. I have previously used Tricare Express Scripts for Empagliflozin with a co-pay. I would appreciate guidance on the steps to take with Tricare-for-Life to remove the Other Health Insurance (OHI) with drug coverage from my records and how to notify Tricare Express Scripts of the change in my coverage. Thank you for your assistance. --F. W. Keiser

As a retired NYC employee, my health coverage is switching to a managed care plan, NYC Medicare Advantage Plus (PPO) through Empire Blue Cross/Blue Shield, Emblem Health. This change will lead to more co-pays on my end. I am unsure about the claim reimbursement process. What documentation do I need to provide if I pay the co-pay out of pocket? Additionally, does my healthcare provider have a specific number they should call to submit a claim on my behalf?