I can tell you that under Tricare in the US, at least, doctors and hospitals do refuse to “participate” and will not accept the low reimbursements. Those that do accept Tricare on a case by case basis are cautious about what cases they accept. A friend of mine from the Philippines is currently in Arizona getting chemo for his colon cancer, and will later have surgery. He spent a lot of time trying to find a doctor that would accept Tricare. The Mayo institute will not accept Tricare.
Here is an example of the Tricare reimbursement/payment for him in Arizona, (each area of the US has different payment rates based on prevailing rates and are tied to the Medicare rates);
Example——I have a PET/CT scan tomorrow and the cost is
$4,230————TRICARE will be paying $1,034——and the provider will just accept that.
I had a mobile chemo pump installed in a main artery, it was going to cost about $3k in the PI————here the bill was over $5k-——but tricare paid $1,700—————again without any moaning from the provider.
The last example is pertinent for us in the Philippines. Tricare will reimburse us the $1,700 but since this is a cash and carry society, (and almost no providers will “participate” on a Tricare claim, and can’t be forced to), we must absorb the extra $1,300 that Tricare won’t pay, but we must pay to the provider before we can have the medical care.
We have been fighting this for a long, long time. And I know, many on FR will say that we should just go back to the US. The problem with that is the US Embassy/State Department will not allow most of our wives and children to immigrate to the US because are income is too low, (most of us live on our military pension and have no other income).
Add to that that the OBAMA admin wants us to pay higher deductibles and co-pays and is threatening to veto the DOD budget bill because Congress did not approve those fee increases in the bill.
I was surprised to learn that TriCare has so many problems and shortcomings. From what I’ve heard, it seems like the VA is a better funded medicare program, but of course that doesn’t cover any family members. I’m not entirely clear on what is provided by on base medical facilities, or TriCare, and what there is families of retired career servicemen and women.
Truthfully, that sounds a bit high for the PI. Have medical prices gone up so much since I left in '05?