The vast majority of readers who responded to a small poll of Military.com SpouseBuzz readers say that, yup, they had to switch dentists when their previous provider left the Tricare network after the May 1 change to a new Tricare contractor.
Over 75 percent of the more than 600 people who took the poll said their dentist dropped from the Tricare network when new contractor, United Concordia, took over. About 15 percent said their dentist was staying in-network despite the change.
Before May 1, the network was managed by Metlife. But Tricare newly selected United Concordia, which had been the manager until 2012, to takeover administration of the contract after a regular rebidding period. Although the change brought expanded benefits and lower premiums for users, it also brought lower reimbursements for dentists who choose to accept the plan. For many dentists that meant choosing between leaving the Tricare network or accepting payments that, in some instances, did not meet the cost of providing coverage, dentists told me.
United Concordia and Tricare officials said early last month that all requirements for the contract continue to be met. According to the contract, 95 percent of dental plan enrollees must have an in-network general dentist within 35 driving miles of their place of residence and must be able to obtain appointments with 21 days of requesting one -- even if that means they must switch dentists from their current provider.
Military family advocates say that standard is not enough. Also concerning to them is the secrecy of the network. United Concordia officials say that the size of the network, the specific reimbursement rates and how many dentists are in each area are all “proprietary.” Although there is no network size requirement in the contract for specialized dentists, such as pediatric providers, Tricare officials said a standard is being “enforced.” What exactly those standards are, however, is “proprietary” and not available to the public, they said.
Here are the full results of the poll, which you can still take. Did you have to switch dentists? Let us know.
%embed1%
