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My daughter suffers from a misaligned jaw. Tricare refuses to pay "ANY" of the cost for surgery claiming it is not a medical problem despite numerous doctors saying it is.

Their excuse: incorrect codes, doctors not listed on their database, daughter is mentally deficient and any number of other excuses to refuse payment.

So, why do we have the insurance at such high rates if they will not do their part and resolve such issues by doing what "MEDICAL PEOPLE" are supposed to do - DO NO HARM! How are your sons and daughters with medical jaw pain enjoying their suffering while paying into an institution that "claims" to be the best medical insurance?

Review about: Tricare Health Plan.

Reason of review: Medical Assistance fraudulent.

Monetary Loss: $65000.

Preferred solution: Full refund.

I didn't like: Poor and rude customer service, Phone center confusion, Lack of good record keeping.

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Anonymous
Fresno, California, United States #1292482

Adjunctive dental is a limited specialty, unfortunately a lot of providers are not as aware of the policy (even though they get a packet with the policy). I would suggest you find a network oral & maxiofacial surgeon (if you have Prime you will need a PCM referral).

Network providers are a little more aware of the policies and procedures. Check reviews and stay on top of what's going on between the Dr's. Office and Tricare. (Via EOB's).

It will be much smoother and you can get the care you need. I suggest you call your region's customer service line number

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