Everything you need to know about the new TRICARE West Region Contractor, UnitedHealthcare Military & Veterans

Everything you need to know about the new TRICARE West Region ContractorThis month, the contractor managing the health care benefit in the TRICARE West Region changed from TriWest to UnitedHealthcare Military & Veterans (UnitedHealthcare). If you are enrolled in the TRICARE West Region, you should have received a welcome packet from UnitedHealthcare.

The TRICARE West Region includes Alaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa (excluding the Rock Island Arsenal area), Kansas, Minnesota, Missouri (excluding the St. Louis area), Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Texas (the southwestern corner, including El Paso), Utah, Washington, and Wyoming.

Continuity of care remains a top TRICARE priority, and UnitedHealthcare officials have pledged to the National Military Family Association and other beneficiary groups that it will make every effort to conduct a smooth transition. Here are some tips to help ensure your family has a smooth transition:

Keep Contact Information Handy
UnitedHealthcare Military & Veterans
1.877.988.WEST (1.877.988.9378)

Review your Primary Care Manager (PCM)
UnitedHealthcare has recruited more than 90% of the PCMs in TriWest’s network to be in their network. A searchable online directory is available on UnitedHealthcare’s website. If you do not see your current PCM listed in the directory, do not be alarmed. UnitedHealthcare is will continue to add more providers. It is recommended your ask if your provider is part of UnitedHealthcare’s network before you seek services.

Explore Enhanced Benefits
UnitedHealthcare will provide new benefits including Convenience Care Clinics, Urgent Care Centers, Centers of Excellence, and Telemedicine services. Keep checking the UnitedHealthcare website for more information about the enhanced benefits.

The National Military Family Association welcomes UnitedHealthcare to the TRICARE community. We look forward to continuing our ongoing dialogue about how to best meet the health care needs of military families in the West Region.

katiePosted by Katie Savant, Government Relations Information Manager at the National Military Family Association

38 responses to “Everything you need to know about the new TRICARE West Region Contractor, UnitedHealthcare Military & Veterans

  1. I work at a provider’s office and I am experiencing the worst hold times with United Healthcare/Tricare than I have with any other insurance company. This is not a smooth transition in my opinion as I was able to immediately speak with a customer service representative when Tricare was handling the benefits.

  2. I agree! Worst hold times ever! I waited an hour and a half yesterday just for someone to give me the wrong information. No one there knows what they are talking about. They need to hire more people and train them properly (and retrain the ones already there). The only way I was able to get the answers I needed was because I finally got a hold of someone who used to work at triwest. It should not be this hard!

  3. I never received a welcome packet nor any sort of ID card. I have doctor offices asking for them and the best I can do is offer my military ID as my children are not old enough. Another issue that I am currently having is finding a hospital/ER that is in network. We are a Prime remote Active duty family with 6 kids with NO hospital/ER, at this point.
    Also had United tell me that it was ok to pick one doc for PMC, but see another doc and bill as if the appointment was with PMC!! This is total Fraud. Thank goodness my college degree is in healthcare and insurance. The customer service rep didn’t know what to say when I said that it was fraud and illegal! Worst transition EVER! No one know anything.

    • Welcome packet from UnitedHealthcare??? What welcome packet? This unpopular transition to a new contractor reeks of political cronyism. I never had problems with TriWest!

  4. This by far has to be the worst transition in insurance company history. Hold times are ridiculous (as I type this I have been on hold for 57 minutes); I sent in an authorization request 1 week ago only to be told today the request hadn’t been processed because of no CPT codes, however the codes were listed on the form and were overlooked by whomever reviewed the request per the customer service rep I spoke to. Urgent requests are not treated as urgent. Complete lack of communication – no confirmation letters of authorizations are sent or faxed to the requesting provider. TriWest was so easy to get ahold of and work with – UHC Military/Veterans needs to make some serious changes.

  5. Your managemant of MY hard earned health care bennifits SUCKS.

  6. All,
    I have the same problems with UHC.
    I was denied heart medication today because of the poor transition. In my case I have no OHI (other health insurance) however OHC said I did. While checking with MyTricare.com it indicates I had not other health insurance which is correct.
    Also their billing is screwed up along with their online payment website. It timed out immediately without confirmation after submitting my credit card info. Fortunately the payment showed up on my bank’s website.
    What happened to quarterly or yearly payments for retirees?

    Suggest that you all write your US Congress Representatives and request and inquiry.

    On frustrated retiree.

  7. Hello,
    Triwest was outstanding in customer service, efficiency and managing the TRICARE program for ADSM, ADFM and Retirees. Since the rollout, I have experienced long hold times, which have gotten better. However, the call center in South Carolina is awful, they are simply reading off the screen and seemingly don’t understand the rules and regulations surrounding the TRICARE program. They need to be retrained and educated. I have encountered two discrepancies regarding the interpetations of physical exams and vision care. For vision care, the rules listed in the TRICARE PRIME handbook state for ADSM and ADFM, they can receive one eye exam per calendar year. In the UHCMV handbook, the rules for vision care for ADSM and ADFM state one vision exam per 12 months. I spent two hours straightening out this with them and then filed a complaint. Considering they received a enormous expensive contract, we should be receiving better customer service.


  8. In MO. I have lost my Oncologist that I have been with for over a year. I should have had a surgery two weeks ago, but because all my referrals reflects a colonoscopy and upper GI. I can’t make the appointment for what I really need which is a surgical biopsy to test my Lymph nodes. NO where on this planet has there ever been a discussion about a colonoscopy or upper GI. The codes between your Primary Care and UHCW don’t match so heads up! I have contact UHCW everyday for the past three weeks, with no success in getting what I need. Even my dermatologist referral is for a colonoscopy and upper GI . As a cancer patient I’m completely blown away as to the treatment I have endured from their customer service, I have been hung up on twice. Told “if you get the surgery, it will be at your expense”. Been put on hold for 45+plus minutes, been sent to departments that could not change a referral, been lied to by two supervisors that the referrals were changed and when I checked the website the next day and nothing was changed. I can’t make the appointments I need, so left with no answers and choice I contacted my Congress rep, signed the release and HOPE their is a resolution soon.

  9. I concur with all the statements here. Transition to UnitedHealthcare as the Tricare manager has been atrocious. Hold times in excess of an hour, customer service disconnects when transferring to a supervisor, no supervisors available, and gross mis-handling of billing and enrollment.

  10. United Healthcare Military and Veterans Services (or United Healthcare Tricare) is absolutely useless. Although I am posting here and have a lot to say, I am actually at a loss for words…so to speak. I cannot imagine how or why they have not been held accountable for their atrocious service.
    There isn’t a doubt in my mind that every posting above is true and accurate. I can’t even begin to tell you where my problem began but I can promise you that it was due to a few (maybe more) incompetent employees who work there.

    I really hope that contacting my congressman or representative helps!

  11. This is the worse insurance you can have. And to think that my husband is active military and serving his country and then his country is thanking him with this mess of an insurance really makes me wonder. It is ok for our soldier to risk their lives for their country and never have a real home cause of all the different duty stations but it is obviously not enough what they do in order for their country to thank them with good health care. Unbelievable. The system with the referrals is a nightmare and the care you get is not enough. All military personnel and their families are sacrificing a lot!!!!! And we chose to do so but the least you could get back in return is health care. We are being treated like we are nothing. I am worried for me and family with this healthcare. And very disappointed that the military would treat their soldiers health so bad with this insurance. This insurance should not even be called so. It is causing more issues and problems than it is solving. Very sad.

  12. Just spent the past 30 mins. trying to pay TRICARE annual dues on the web.

    Keep getting directed to a new page that asks me to upgrade my account- then tells me I already have an account- then asks me what page I want to go to.

    Extremely frustrating.

    If the TRICARE payment option was as easy as ordering retail products/booking travel reservations, etc. on the web- you would never hear me complain.

    Just trying to send money- that is all.

    I liked the old system- write a check once a year and mail in time to arrive prior to the end of Sept.- never had a problem.

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  14. Charmaine Carpenter

    I am so upset by this military healthcare contract change. For the first time in 25 years of military service I was turned down for a necessary surgery as determined by my doctor because UHC said it wasn’t medically necessary over and above my doctor’s advice. They have lied to me several times on the status, they advised my doctor to submit the surgery under a different classification number than what it actually was, they lost the referral altogether at one point only to find it again, and now, the most recent debacle is that because my provider submitted the referral for surgery twice in hopes the second time it would be approved, they “archived” the second one without benefit of a letter to me of denial, and it wasn’t until I called to ask where my letter was so that I could appea that I found I was supposed to do so under the first submission, of which the time was nearly up to do so. I guess its a good thing I called. But the lies are the worst. They literally have fed me lies about my provider not submitting any clinical information with the referral, about the case being re-evaluated (it wasn’t), about it being deleted, etc. But even worse, I am no longer able to speak with an authorizations and referrals rep because apparently they were getting too many calls and so they took that benefit from us. My take is they are denying military people like myself their care and the calls were overwhelming. I am truly worried. I need some serious surgeries and I am really concerned I will not receive what I need now. It is heartbreaking!

  15. I have trying to sign up my son for Tricare Young Adult since July. The incompetence combined with extreme lack of giving a @#$% by UHC is a travesty. They act as if they really do not want to serve their customers. Fortunately for them they have a government granted monopoly; if I had a choice I would run away from this company as fast as possible.

  16. I’m experiencing a terrible time with United Health Care enrollment. Right after I was approved for enrollment, our banks issued us new cards due to the Target breach. Our new card number was declined of course and our enrollment was canceled. I was originally told I can fill out another form to be re-enstated and used our direct routing and account number.That was not accepted because they said I was never enrolled. Then I was told I have to to re-enroll. So, I re-enrolled. Again.
    I called today and was told to call back again in 5 days to check my enrollment status.

  17. The contact number is dropping the call after one enters automated information. This is ridiculous! I called the other regions for assistance, but no one can help. The providers I looked up online are either no longer accepting tricare or numbers are disconnected. This is a joke!!!!

  18. I am at my wits’ end. Tricare West denied an authorization for urgent type 1 diabetes care and treatment for my daughter and tried to tell me that she should just be admitted to a mental health facility. (It took over 2 months to get an answer.) I appealed that decision in November 2013. I heard nothing, called in January multiple times and was eventually told that it was denied and that a letter was on the way. I called today, 3/5/14, only to be told that there is no record of an appeal being received and to call yet another department. I have had it with these guys. What are my options? It is useless to complain to them because they don’t care. The majority of reps are rude, incompetent and dumb. It makes me very angry that this dummies are in charge of my daughter’s health. So, so frustrating!

  19. My Tricare West claims seem to be disappearing into some strange Bermuda Triangle of health care incompetence. I have had several claims filed in the past 3 months and none show up on UHC’s website. I can’t find anyone with oversight over UHC to contact to try and get help. I have tried to get help from UHC, but they are clueless.

  20. As a military retiree, I am disgusted with the mismanagement and lack of service provided by UHC Tricare West. My wife and I are both enrolled in Tricare Prime. My wife received a referral from our PCM to see an orthopaedic surgeon regarding a dislocated shoulder, which was authorized and approved by Triwest. The surgeon determined surgery was necessary, and the procedure was also authorized and approved in advance before being performed. I followed every requirement to the letter. Here’s the upshot; Triwest has now charged me a $300 “Point of Service” deductible because I didn’t obtain a separate referral for the anesthesiologist who who was part of the doctor’s surgical team in the operating room. One would think that “approval for surgery” would include anesthesia. This is just the beginning of the pains. I have twice been assigned PCM’s who were out of practice for nine months, or didn’t exist. “And a grateful nation thanks you for your service….”

    • David Crispin, MSgt Retired

      Lowest most incompetent bidder, don’t you know! They are messing up what was a good thing. I’m still 100% they haven’t approved anything since the take-over. This is the way a proud nation treats its military, current and past.

    • I think United Health Care requires a critical re-evaluation. When I asked a representative from UHC why they have been granted the contract they informed me that their counterpart had been caught in a fraudulent scandle and lost their contract. I am embarrassed and saddened with the healthcare problems in the VA as well as United Health Care that represents our military members. This is a serious problem that needs to be addressed and we do need to contact our congressman for further action.

  21. BENEFICIARIES BEWARE – A PRE-APPROVAL DOES NOT GUARANTEE PAYMENT!!! I received a pre-authorization for a medical test. My pre-auth read… “We received a request from the health care provider noted above to provide you with health care services. A coverage review has been completed and we are very happy to let you know the requested service is eligible for coverage under TRICARE benefits.” It listed the exact billing codes that were approved. I saw the requisite provider, in the dates authorized, for the pre-authorized test under the billing code listed. When the $2,200 bill arrived, TRICARE (UHC) refused to pay the claim. In trying to rectify this over the phone with the Claims Dept, I was told – “A Pre-Authorization is not an agreement to pay.” What?????? Apparently the test is on the Government No-Pay List, and they won’t pay. NO WHERE on the pre-auth did it state this! They then gave me the links to find a very buried “Gov’t No Pay List of Codes” and said I’m always welcome to check that before having any procedure. Are you kidding?!?! I sent in an appeal – quickly denied. I’m told the Appeals Office doesn’t have a phone number. I have written the TRICARE Congressional Office – no reply. I have totally lost faith, and apparently we have no advocate.

    • We do not have any advocate, and we are all being totally screwed over by UHC. Why in the world no one at the puzzle palace is doing anything about this is beyond me. I guess the MBAs at the Pentagon don’t care. Keep writing to your Congressmen, because they are currently the only between us and the bus.

  22. David Carrier SCPO Retired

    This UnitedHealthcare company is pretty screwed up.Being retired USN, me and my wife have tricarewest through UHC.My wife has UnitedHealthcare,with me as a dependent at her work,both of them tell my doctors billing office that they are my secondary insurance only!Go figure,both are UHC and neither one want’s to be the primary.This has been going on for over a year no matter how many forms I fill out and send in or phone calls to either one.I guess I better sign up for Obama Care too.

  23. Bernadette Hisel

    I am also very frustrated with United Health Care. I am a career veteran, who served my country for 22 and a 1/2 years. I need surgery on my back for three artificial disc in the cervical and lumbar spine which is service connected. UHC originally denied the claim stating it was experimental–It isn’t. After a first appeal now their claiming they only approve 1 level artificial disc not 2 levels and the lumbar artificial disc is on the no pay list. This is a disgrace. They have denied me over the past few months one prescription that I was prescribed by my doctor, two different requests for physical therapy and now surgery. If you are a female veteran who has been denied services for service connected injuries, please contact me at RoryHisel@aol.com. I have a plan and need your help to pursue it. Thank you!

  24. It is such a shame they don’t care I have been having issue with them for over a year – I know there may be some change issues (and there were some) but this has to be corrected. I have talked to no less than 10 people just when I am told my issue is solved it is not. You can not get the same answer for anyone. I am told what to do to fix the issue and I do it to only be told that was not correct you need to do this when I tell them (insert name her from XYZ office) said to do that all I am told is “I am sorry you were given incorrect information but I can not help you” you need to do this. Well I have been doing “this” for a year.

  25. UHCM-West is Aweful. I (a spouse) currently have multiple medical conditions that have been requiring tests, therapy’s, Dr appointments, pain clinic, etc. EVERY referral I have to call repeatedly to get approved. Even the Urgent ones. About HALF get lost the first time so my clinics have to constantly resubmit! Triwest was bad, but this is worse. Today I almost narrowly missed a CT because it took me HOUNDING a supervisor for over 2 hrs before it was approved. They had the refferal and just sat on it! Don’t complain to them. Just call your local congress and complain to them. Things move MUCH faster when you log complaints that way, and if enough congress members that are on the military board of appropriations get enough complaints they WILL do something about it. I’ve been blessed at times with the aids in the offices at my state. So don’t hesitate, changes need to happen but they won’t until more people stand up and show there is major problems with this company!

    • Bernadette Hisel

      I finally got my surgery approved after putting in a third appeal through Kepro a third party company that reviews the appeals. They approved my request and reversed Tricare’s decision. United Healthcare is a disgrace and should be fired. I did notify my congressman and he is well aware of all the denials I have received from them within the past few months. Shame on United Healthcare they are a disgrace.

  26. I left USPFH Washington State, never had as many complaints that I have read on UHC program. It almost makes to go it alone with the issues and problems I have read here. I am a military retiree and civil service retiree. Total of 36 years for both services. Never any problems with Tricare and Tricare for Life.

  27. Why is it that the person can no longer make a payment with a check or money order. In this day and age when everything is stolen off the web site (Healthcare.gov included) you expect sane people to put the credit card number out there for everyone to have. You have removed the humans from the Tricare office from Luke AFB and replaced them with a machine. That is worse than the telephone, push 1, push 4. A new company took over and changed the policy and has made it WORSE. As in other business service is a thing of the past, it’s all about money. If I can get a reply from someone with a bit of knowledge about if you are going to reinstate accepting checks for payment or money orders in the near future or the possibly of reopening the Luke AFB AZ office.

  28. I have noticed that they are now approving referrals on the same day. Maybe their listening? I appreciate not having to wait two weeks to get an approval or denial.

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  30. Terrible, terrible insurance company. No customer service whatsoever, when I called to enroll a new family member they directed to me THREE websites I had to fill out stuff for just get him on. Unable to help me with ANY of my claims, it’s all on me to do by myself on the internet apparently. What is the point of them pretending to have customer service representatives when they simply direct you to do it yourself? Thanks for nothing tricare west.

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