For the first half of 2025, mental health providers in Hampton Roads complained that the military health insurance Tricare was not paying providers on time.
Ramsey Goshert with Mission Harbor Counseling in Virginia Beach was one of several mental health counseling services in the area who did not get paid on time for several months by the contractors hired by the Defense Health Agency to run Tricare. Payments are now arriving on time, but the billing issues put a strain on providers and patients, he said.
The larger issue is because of Tricare’s “completely insulting reimbursement rates, many providers are no longer participating,” Goshert said. “This is making it increasingly difficult for Tricare beneficiaries to find a provider, especially therapy.”
Changes in Tricare administration at the start of the year contributed to the issues. A new contractor, TriWest Healthcare Alliance, was put in place to run the western part of the country.
Humana Military, which administers Tricare in the eastern part of the country, changed the subcontractor which handles their claims. Thousands of providers were not paid on time throughout the country, said Eileen Huck with the National Military Families Association.
Mental health providers, some of which didn’t see payments for several months, were hit particularly hard, she said.
“A small mental health provider or speech therapist or physical therapist, somebody who's seeing a patient multiple times over the course of a few weeks or months,” she said. “If they’re not getting reimbursed, that's really something that they just can't sustain.”
NMFA is one of the groups that pushed Congress to place language in the new defense bill that will require DHA to report on what caused the 2025 Tricare delays.
“I don't know where the breakdown occurred, but I think that it's on DHA to make sure that they are exercising very close oversight during what is a very complicated process,” she said.
Many of the payment delays were resolved by the second half of the year, but not before causing massive disruption for the 9.4 million troops, military families and retirees around the country which use Tricare, she said.
“When I ask if they are seeing providers leave the network, they have consistently said that they are not seeing that,” Huck said. “But I think what we may see is that providers are limiting the number of Tricare patients that they'll accept, or just deciding that they won't accept new Tricare patients.”
And cost increases are coming for families as well. For 2026, most Tricare health plan costs for military families and retirees will go up between 2% and 3% next year. The price of prescription drugs will increase more than 15%. The charges are in line with what Tricare patients have seen over the last several years, Huck said.
“Certainly anytime there's a cost increase, especially when the cost of living is already so high, and we know a lot of families are struggling financially, the last thing we want to see is, you know, struggling to afford health care.”
The new rates go into effect Jan. 1.
