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Gap in TRICARE Insurance Coverage Leads to Servicemembers Choosing Between Bankruptcy or Jail

Jessica Manfre, LMSW by Jessica Manfre, LMSW
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Typically, no one plans for a thirty-seven-year-old healthy adult to need to take out a long-term care policy. This is something that is usually thought about as adults age. Even if Bill had taken one out as Sarah began declining, almost every plan had a 90-day waiting period before you could utilize it which still would have led him to extreme financial hardship. Another concern is what will happen when it’s time for bill to transfer. Sarah was approved for Florida Medicaid, that will go away when he’s transferred out of state. What happens to her need for care then? 

When her condition worsened, she was told she had to leave the facility after seven weeks. TRICARE covered rehabilitation at a new facility for two weeks but then cut that benefit, saying she no longer met the criteria for it. This is because TRICARE will not cover what’s deemed as “long term care” needs. What saved this family from absolute certain financial ruin was that Sarah received a new diagnosis: terminal. The very moment she was given the diagnosis that meant her life was ending, she received services through hospice care (which is something TRICARE will cover). Medicaid is now covering her end of life care in full.

All military members deserve the peace of mind that their family will be cared for and supported while they serve the citizens of the United States. There should be no gap, no horrible choice like Bill had to make. TRICARE needs to examine its current policies and recognize this life altering gap and make a change so that no other family has to go through what Bill did. We ask our service members to risk their lives and always remain mission ready. The Coast Guard motto is semper paratus which means always ready. We owe them to be ready to hear their call.

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