Military Families

Medical bankruptcy!

My son was born two months early, so he spent a month in the NICU.  My husband mailed the paperwork into Tricare immediately after he was born so he would be covered under our insurance (we weren't sure how much time we had, so we did it right away).  He also called them to inform them.  Last week, we received a letter stating that my son would not be covered under our insurance because we didn't send the paperwork in.  My husband called them and told them he sent it, and they said we couldn't prove anything.  It's a $40,000 bill from the hospital for my son, plus subsequent doctor's visits and a hernia and circumcision.  I don't know what we're going to do and I'm so angry and scared and frustrated!  Has anyone else had this happen to them?  Is there anything we can do?
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Re: Medical bankruptcy!

  • Not sure what can be done about the bill, but you need to register the baby with DEERS, not through TRICARE. Once he is in DEERS then he will be covered by TRICARE, but unless he is in DEERS he isn't listed as a dependent and isn't eligable for coverage. Essentially until you get him in DEERS he isn't recognized as a dependent, so won't get any benefits, or be recognized as such.
    TRICARE and DEERS are two completely separate entities.

    https://www.military.com/benefits/tricare/defense-enrollment-eligibility-reporting-system-deers.html

    Once you do that then start looking into getting them to cover the bills. Your son should be covered under TRICARE for the first 60 days of his life, but again you need to get him into DEERS, for any coverage after that. While enrolling him in DEERS, ask about the medical bills and who can help you with that. See if there is a military facility with a patient rep close by or try calling an ACS, they will probably know who to send you to.
    Good luck.

  • Like the pp said your husband needs to enroll the baby in DEERS. Did he do that?
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  • He is registered in DEERS.  We got the letter a few days after his two month birthday.  He won't be covered until Sept. 1 under Tricare now.
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  • I would get my tail into a Tricare office and speak with an advocate face to face.  See what they can do for you.  As long as you were in DEERS and covered, he should have been covered for the first 30 days.  
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  • Go to your TRICARE office. As long as one of you is covered, th baby is covered by Prime automatically for 60 days after birth. After that, the baby is covered by Standard for the rest of the first year, even if you do nothing. If you enrolled him in DEERS and TRICARE Prime, he is fully covered. This is fixable. Do not panic. 
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  • It's my understanding that you have 60 days after the birth to get paperwork in-everything up to then should be covered automatically. That means even if you didn't send anything in, the month in the NICU would be covered!

    Good luck! I know dealing with stuff like this is crazy stressful :/ 

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  • Just take a deep breath and relax. We've got your back. All of the pp's gave fantastic advice. Tricare is tough, and sometimes calling them is a waste of time. If you need to speak with a rep face to face, most military hospital's have a Tricare office somewhere on their campus. You should be able to speak with someone face to face at that time...as long as your LO is enrolled in DEERS.

    Good luck.  

  • This is very common with Tricare. You have to check check and double check with them and request things in writing that they have recieved everything. You have 60 days with Tricare to enroll them, and provide payment. If they are enrolled in DEERS then you should have the paperwork to prove it. DO you have any receipts from the mailings or faxing?
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