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A 33-year-old Vet went to the VA for help. Hours later he took his own life

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Suicidal Veterans 002

Washington (CNN)Burdened by suicidal thoughts, Justin Miller, a 33-year-old Veteran from Minnesota, reached out to the Department of Veterans Affairs in February for help, telling responders on the VA crisis line that he had access to firearms.

Miller was advised to visit his local VA emergency department, which he did immediately.

According to an inspector general report, Miller was admitted to the Minneapolis mental health unit after he described in detail symptoms of severe emotional anguish to VA clinicians.

After four days under observation, he was discharged.

Miller exited the hospital upon being released from care but never left the facility's grounds that day.

Police found him dead in his car from a self-inflicted gunshot wound less than 24 hours later.

With the permission of Miller's parents, Minnesota Democrat Rep. Tim Walz, the ranking member of the House Veterans Affairs Committee, shared this tragic story during a hearing on Capitol Hill on Thursday as lawmakers addressed the issue of suicide prevention among Veterans and former service members.

"It is infuriating to know that there is a possibility that Justin's death could have been prevented. It should outrage us all that an entire health care system failed at something so serious and that it claimed to be their highest clinical priority," Walz said.

Investigators were unable to determine "that any one, or some combination, was a causal factor" in Miller's death, despite identifying several "deficits in care provided to the patient."

However, the investigation did find that staff members at the Minnesota medical center, including the suicide prevention coordinator, did not properly follow protocol while handling Miller's case and, according to Walz, failed to utilize the three-step REACH VET process, in which a clinician can assess a Veteran's risk of suicide so that he or she receives the proper level of care.

"This is profoundly unacceptable," the Minnesota Democrat said about the inspector general's findings, which he called "deeply disturbing."

And that frustration was only compounded by the fact that this was not the first time the inspector general had investigated many of these shortcomings.

"The finding that the Minneapolis VA failed to sufficiently sustain relevant recommendations OIG made in 2012 should outrage us all," he said.

Paul Sherbo, a spokesman for the Minneapolis VA Health Care System, told CNN that their "deepest condolences go out to Justin Miller's family and loved ones" and said that in response to his suicide and the inspector general's review, they have redoubled their efforts "to ensure every Veteran receives the best possible care. This includes improving care collaboration across departments and disciplines -- from initial treatment and planning to discharge and medication management -- and engaging family members in Veterans' mental health treatment plans, whenever possible."

Sherbo added that the Minneapolis VA Health Care System has started implementing the inspector general's recommendations and would complete all but one this year. He also encouraged Veterans in crisis to visit the nearest VA health care facility, where they can receive same-day urgent primary and mental health care services, and provided the 24-hour national suicide prevention hotline: 1 (800) 273-8255.

Young Veterans at risk

The circumstances surrounding Miller's death, including his age and the use of a firearm, also seem to highlight two of the major issues related to Veteran suicide, according to data outlined in a new report released by the VA on Wednesday.

The suicide rate among younger Veterans who, like Miller, fall between the ages of 18 and 34, continues to increase, a VA analysis of suicide data from 2005 to 2016 reveals.

"Rates of suicide were highest among younger Veterans (ages 18--34) and lowest among older Veterans (ages 55 and older). However, because the older Veteran population is the largest, this group accounted for 58.1 percent of Veteran suicide deaths in 2016," the report says.

The use of firearms as a method of suicide also remains high, according to the data, as the percentage of suicide deaths that involved firearms rose from 67% in 2015 to 69.4% in 2016.

Although the overall number of suicides among Veterans decreased slightly between 2015 and 2016, the VA is bracing for an increase over the next five years as thousands of Vietnam Veterans enter mid-60s, joining what is already the largest age group.

Additionally, VA officials acknowledged that the average daily number of Veterans who take their own lives has held steady for years despite efforts to combat the problem.

"In 2016, about 20 current or former service members died by suicide each day. Of these, six had been in recent VA health care and 14 had not," VA spokesman Curtis Cashour told CNN, explaining that Wednesday's suicide prevention report defines Veterans "as those who had been activated for federal military service and were not currently serving at the time of their death."

"VA also presents the yearly suicide count of never federally activated former Guardsmen and Reservists," he said.

This report "simply reiterates what many of us have known for a long time: that our fight to end the tragic epidemic of Veteran suicide is far from over," Walz said in a statement.

"We must continue to work together to provide Veterans with immediate access to quality, culturally competent mental healthcare and make bipartisan progress toward eliminating Veteran suicide entirely," he said.

VA officials have said they would prefer to move away from using the per-day metric as an indicator of suicide rates, arguing that it does not account for changes in population size and can be misleading.

But for now, lawmakers and department officials seem to believe that number appropriately underscores the severity of the issue.

"Most of us have heard VA's staggering and heartbreaking statistic that every day, twenty Veterans end their own lives. Twenty," Republican Rep. Phil Roe, chairman of the House Committee on Veterans' Affairs, said during Thursday's hearing ahead of testimony from several suicide prevention experts.

"We also know that over the past several years VA has invested significant resources towards addressing that number which stubbornly has not changed ... We have the expertise. We have the support of the President. We can and must reduce suicide among Veterans. There is no excuse not to," he said.

Where is the money going?

President Donald Trump's recently confirmed VA Secretary Robert Wilkie told Senate lawmakers Wednesday that suicide prevention is a top priority for the department under his leadership and noted that the VA published "a comprehensive national Veteran suicide prevention strategy that encompasses a broad range of bundled prevention activities to support the Veterans who receive care in the VA health care system as well as those who do not come to us for care."

He also highlighted the executive order signed by Trump in January intended to assist service members and Veterans during their transition from uniformed service to civilian life, "focusing on the first 12 months after separation from service, a critical period marked by a high risk for suicide."

But despite a new budget of more than $200 billion, some critics argue that the VA continues to spend its money in the wrong ways.

"Senior leaders like awareness campaigns and spend millions of dollars on them. They make a big splash in the media. It is measurable in how many outputs -- "views" or "hits" websites or social media pages get --- but does not generate outcomes," according to Jacqueline Garrick of the Whistleblowers for America.

"These campaigns do not work because they cannot change behavior," she said in a statement to Congressional lawmakers.

Rajeev Ramchand, a suicide prevention expert at the Rand Corp., told CNN that "while it may make people feel good, there is very little evidence that public awareness campaigns have a significant impact on suicide rates.

"We do have evidence that public screening at emergency departments can reduce future suicide attempts," he said.

However, he did note that areas with less evidence "should not be ignored as a comprehensive view of Veteran suicide prevention requires a thorough understanding of the environment where those events are occurring."

In addition to developing and addressing the limitations around analytical tools like REACH VET, Ramchand told CNN that there are also a lot of things that "we know work," including initiatives that promote screening patients at emergency departments and then identifying those who are high-risk so that they receive the appropriate care.

"Promoting quality evidence-based care ... we know these things work, so let's get people to do them and do them more systematic way," he said.

Troubling allegations

In a written statement submitted to Congress, Garrick also said that her organization has been contacted by several VA employees who shared troubling accounts of workplace dysfunction that are having a direct impact of the quality of care provided and seem to undermine the programs currently in place.

"At one VA medical center, a suicide prevention coordinator reported that they do not have time to complete suicide assessments or write prevention plans with every Veteran who potentially needs one because of the case load and its complexity," Garrick said.

"She had 35 patients at one time. Administrators directed to note patients as 'moderate risk' for suicide so as not to raise red flags in the system. When a Veteran died by suicide on VA property, her supervisor refused to conduct a root cause analysis because that would be too time consuming," she added.

According to Garrick, this VA employee asked to remain anonymous due to fear of retaliation for speaking out.

CNN has independently contacted the employee and agreed withhold their name and place of work at the request of the individual.

When asked for comment about the broader issue raised in the whistleblower statement, VA spokesman Curtis Cashour would only say: "VA asked CNN for specific details regarding these allegations so the department could look into them, and CNN could not provide them."

"CNN's publishing of such vague allegations without any details that would allow the department to investigate them is highly irresponsible because it does nothing to help fix any issues that may exist and could actually discourage Veterans from seeking VA care," Cashour said.

Griffin Anderson, a spokesman for the Democrats on the House Veterans Affairs Committee, told CNN that lawmakers take the allegations in the Whistleblowers of America report seriously and that the statement "certainly alludes to an alarming and unacceptable trend that we are going to look into."

While the committee has not received a formal complaint pertaining to this specific allegation, Anderson said that lawmakers would work with the suicide coordinator in question to pursue an OIG investigation should they come forward.


Army observes September as Suicide Prevention Month

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Suicide Prevention Month


The Army is committed to the health, safety, and well-being of its Soldiers, Department of the Army civilians, and families. To emphasize this commitment, the Army is joining the nation in observing September as National Suicide Prevention Month.

Every person has a responsibility and commitment to reach out and help fellow Soldiers, civilians, or family members who need the strength of the Army. Together, a difference can be made by helping those who are at risk and suicides can be prevented.

Effective suicide prevention requires everyone to be aware of the risk factors for suicide and know how to respond.

If a person seems suicidal, the time to take action is now. Talk to that person before it is too late. Be direct and talk openly. Listen, and allow them to express their feelings.

Battle buddies are the front line in surveillance and detection of high-risk behavior. Be a buddy, learn the warning signs of suicide, and find out how to help someone threatening suicide.

Employ ACE

Ask, care, escort, or ACE, is an easy-to-remember acronym that any Soldier, leader, family member, or civilian can use.

  • Ask your buddy – Have the courage to ask the question, but stay calm. Ask the question directly, “Are you thinking of killing yourself?”
  • Care for your buddy – Remove any means that could be used for self-injury. Calmly control the situation; do not use force. Actively listen to produce relief.

Escort your buddy — Never leave your buddy alone. Escort to the chain of command, a chaplain, a behavioral health professional, or a primary care provider.

Know the signs

Do you know the warning signs for suicide?

If anyone you know exhibits the following signs, get help as soon as possible by contacting a mental health professional or by calling the National Suicide Prevention Lifeline at 800-273-TALK.

  • Threatening to hurt or kill oneself or talking about wanting to hurt or kill oneself.
  • Looking for ways to kill oneself by seeking access to firearms, available pills, or other means.
  • Talking or writing about death, dying, or suicide when these actions are out of the ordinary for the person.
  • Feeling hopeless.
  • Feeling rage or uncontrolled anger or seeking revenge.
  • Acting reckless or engaging in risky activities.
  • Feeling trapped.
  • Increasing alcohol or drug use.
  • Withdrawing from friends, family, and society. This includes feeling anxious or agitated, being unable to sleep, or sleeping all the time. It also includes experiencing dramatic mood changes or seeing no reason for living or having no sense of purpose in life.


Websites become tool for stopping Veteran suicides

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At 5:49 p.m. on a January day, Pvt. Jordan DuBois posted on his Facebook page: "I'm goin to kill myself this is my last post ... miss u all..."

One hour and 20 minutes later, DuBois' speeding truck slammed into a light pole and a bus bench in Colorado Springs.

Several people who saw the post in early 2012 tried to talk him out of doing anything rash. They failed. The FortCarson soldier was dead.

But in recent months, Facebook has become an important tool in tackling an alarming number of military suicides. The social networking site has helped shed light on a serious problem plaguing service members and veterans. It has acted as friend and counselor to weary soldiers and played a key role in reducing the stigma associated with post-traumatic stress, depression and mental illness.

Social media have helped blur the lines between private and public. What used to be intensely personal affairs are now out there for the world to see. That's not always a good thing, as evidenced by the August posting of a man who police say shot and killed his wife in Miami and then uploaded the shocking image to Facebook.

But mental health professionals say Facebook, which is at once deeply personal and removed enough from actual human interaction that makes it a safe place to air despondent thoughts and inclinations, can be of use in saving lives and keeping alive the memory of those who are gone. Many younger service members have grown up in the age of the Internet and are used to sharing their inner selves on social media.

With more than a billion users worldwide, the social network acknowledges its power. Public Relations Manager Brandon Lepow says that power can be used to prevent deaths. The company lists suicide hot lines and has instructions on how to report suicidal content on its help page. It has also partnered with organizations on suicide prevention and now more specifically, on military suicide prevention.

"Facebook," says Lepow, "has a tremendous responsibility and opportunity to save lives and put people in touch with those who can help them best."

Ground level

"Sweat dries. Blood clots. Bones heal. Suck it up Buttercup." Words to live by from a drill sergeant.

It's the kind of stuff Daniel Caddy posted on a Facebook page he started last year. Awesome S**t My Drill Sergeant Said is a collection of expletive-laden military jokes Caddy and his buddies sent around after basic training. Its "likes" have exploded to more than 234,000 today.

The page was meant to be funny and tells visitors lacking a sense of humor to "execute an about face and be gone." But on an October night last year, it took on dark undertones.

Veteran suicide rate may be more than 22 a day

Caddy, a National Guard staff sergeant who spent a year clearing mines in Afghanistan, was about to fall asleep at his San Francisco home when he received a disturbing message. It was from a fellow Guardsman who said a soldier friend was contemplating suicide. "I'm certain he's going to kill himself," the text message said. He sent Caddy a screen shot of his friend's Facebook post.

It sent shivers through Caddy, the kind of fluttery feeling you get when you know something terrible is about to happen. Immediately, he posted a plea for help on the drill sergeant Facebook page:

"TROOP IN TROUBLE: We just received a request for help from a troop that turned to us in desperation because it is the middle of the night and no one in the chain of command is picking up the phone and he sincerely believes his battle (buddy) is planning to take his own life tonight. I'm out of bed on full alert and am waking up our Admin staff as well as our Network. We need your help as this develops.

"If you are in or near Kingsport, TN or know a battle that is, email me ASAP at This email address is being protected from spambots. You need JavaScript enabled to view it.. Please share this s**t so as I get more details we have a large reach able to respond and hopefully intercede. If we lose one, that is one too many. Not f*****g around here."

Within minutes, the page lit up with comments, support and offers to help find the suicidal soldier. "We can't afford to lose another one," said one post.

Caddy received several hundred e-mails within the first five minutes from schools, teachers, phone company representatives and hostage negotiators who responded to the crisis as though that soldier was their own son. Some people jumped in their cars and began driving toward Kingsport.

Volunteers hit the ground. The soldier's exact location was pinged through his cell phone.

The harrowing five-hour saga unfolded on Caddy's Facebook page, with 5,000 people glued to their screens. They refused to go to bed without knowing that the soldier in distress was OK.

In the end, Caddy was able to find the soldier's unit commanders, and they connected with him, alone in his apartment in a vast complex. He felt isolated and disconnected, like so many combat veterans feel. He had been drinking heavily. But he was alive.

In his mind, Caddy heard a collective exhale. "We were able to achieve a miracle via social media," he says.

After that, Caddy learned of more cases of potential soldier suicides on Facebook. He realized the power of a medium that instantly allowed combat veterans to connect with each other. He also realized that he needed to reach soldiers long before they came to the point of wanting to end it all. Otherwise, it was like an emergency responder using a defibrillator to revive a heart attack patient but then never checking on the heart condition that caused it.

He launched Battle in Distress, a crisis response team that makes immediate contact with soldiers going through financial difficulties, marital friction, depression and other problems. They communicate resources that are available to soldiers in crisis on social media platforms and connect them with peers in their own communities.

"It's about saying, 'Hey, you got a lot going on, brother. Here are people who can help you,' " Caddy says.

Between January and April of this year, Battle in Distress intervened in 250 cases; 67 were suicidal soldiers.

But just one life saved means success for Caddy.

"Facebook has a huge potential to identify commonalities between war fighters," he says. "It also has the power to rip out the limitations of physical boundaries, like a base. Somebody can be on the other side of the country, but when the call goes out, I can reach out to them."

Caddy is convinced the only way to stem the tide of military suicides is when soldiers themselves become accountable.

"It starts," he says, "with us on the ground level."

It's in the language

Chris Poulin also wanted to use the power of Facebook to prevent military suicides. He'd always been interested in using language to predict events, from political outcomes to economic letdowns.

He points to the language of Norway mass shooter Anders Brevik, which was filled with clues that he was radicalized enough to act violently.

Poulin began thinking of a friend who had taken his own life. He had left digital breadcrumbs that he was having problems. His friends and family wished they had picked up on the signs. For them, it was too late.

How could he marry predictive linguistics with technology to identify service members and veterans at risk? Poulin approached Facebook, the Defense Department and the Veterans Administration. They are now partners in the newly launched Durkheim Project, named after pioneering French sociologist Emile Durkheim, who studied suicide. The project targets veterans, who are killing themselves at a rate of 22 a day, according to the VA.

It works this way: Veterans opt into the Durkheim Project, which installs an app on their devices and monitors their conversations and posts on Facebook, Twitter and other social media. A database at the Geisel School of Medicine at Dartmouth keeps track of locations and text messages.

Yes, it's a bit Big Brother. That's why veterans have to agree to the terms of the program.

"We are trying to push the boundaries on data privacy and get people to think about the issues," Poulin says, though he knows that may not sit well in the wake of NSA leaker Edward Snowden's NSA leaks. "There is no spying without your consent. You can opt out whenever you want.

"It's certainly true that suicide is an intensely private affair," he says. "They may not want to sign up, and we can't force them to. Or they may sign up when they feel fine, but years down, they might descend into darkness."

Poulin said monitors look for expressions of hopelessness or comments about sleeplessness or, feeling isolated. "People would be better off without me": That's a statement that will raise red flags.

At that point, a veteran's clinician will be alerted.

But a huge number of veterans do not seek counseling, so the Durkheim Project asks participants to name a buddy who can be called in an hour of need.

"If they have no one designated, we will at least say something positive to them," Poulin says.

Eventually, Poulin would like to see the Durkheim Project do interventions, but right now, he doesn't have the funding for it.

Fifty people have opted in. Poulin's target is 100,000. Facebook is participating in recruiting by reaching out to military groups and posting nonprofit ads.

"But I don't think we have to hit our target to be useful," he says.

Craig Bryan, a psychologist who advised Poulin's team for the Durkheim Project, says he expects that enough people will opt in to make it a success.

"We have found that military personnel and veterans tend to be very willing to participate," Bryan says. "The reason for that is the collectivist identity. Very distressed service members tend to volunteer for this kind of thing. Their thinking is that 'even if it doesn't help me, maybe it will help others in the future.' "

Few people actually ever say "I'm going to kill myself." In many cases, after a suicide, families and friends point to things the person wrote or said that they feel were perhaps indicators of trouble.

"But after the fact is not good enough," Bryan says.

Bryan says social media provide forums for people to talk about crisis situations and connect with people in ways that were not previously possible.

And that, says Bryan, is a great protective measure.

Soldier's suicide note goes viral; family demands better for veterans

Good and bad

Public health researcher Dr. Joseph A. Boscarino thinks Facebook posts can be therapeutic for those who are suffering. It has been proved, he says, that talking about traumatic events is a first step toward recovery, and for some, it may be easier to talk on Facebook.

But Boscarino, a Vietnam veteran, worries that the Facebook environment is so open and uncontrolled that the potential for a negative reaction is very real.

"It can go both ways, obviously," he says. "There could be a negative side if the victims are fragile. It could push them in the wrong direction."

What if someone writes a post on a suicidal soldier's page, "You signed up for war fighting, not babysitting"?

"People who are hard-core militarists or pacifists may not be that sympathetic," says Boscarino, who did a tour of Vietnam in 1965 and knows first-hand what it was like to face ugliness from the public.

"Rejection is hard to take. It was in Vietnam. And it is now," he says.

But he recognizes the potential for Facebook and says he hopes people figure out how to use it beneficially for service members and their families.

Alice Franks, who heads the National Alliance to End Veteran Suicide, calls Facebook sites for military suicides wretched but worthy clubs.

"Depending upon what a survivor is seeking, these sites can help create connectivity for a community of survivors who may not reach each other under other circumstances," she says.

The group attempts to reach survivors who have progressed in their own grief to a point where they are ready and willing to move to action.

"Any tool," says Franks, "that causes dialogue to happen around the concern of veteran/military suicide is good."

Frantic search

On July 18, Erik Jorgensen, 26, texted his mom. He said he was a "waste of oxygen on this Earth."

And then he went missing.

Cindy Crow began driving from her home in California to Boise, Idaho, where her son was stationed with the Army National Guard. Before that, he'd spent a year as an Army private clearing roads laced with makeshift bombs in Afghanistan.

Crow knew that her son suffered from post-traumatic stress. She knew that she had to get to Idaho before something terrible happened.

As people began looking for Jorgensen, his sister started a Facebook page to help.

A photo of Erik was posted; he was described as 6 feet 1 inches tall and 240 pounds. He had dark blond/light brown hair and blue eyes. He had PTSD and did not have his medication with him. No one knew what clothes he was wearing that day, but he was driving his jacked-up white Dodge Ram with black grilles and rims. License plate number: S58329.

They asked anyone who spotted Jorgensen to call the Boise police department immediately.

The post was shared instantly by people all across America. Some asked what unit he was with and where he was last seen. Others just wrote messages of support and love for Jorgensen's family.

Staff Sgt. Maggie Haswell of Boise came across the Facebook page early Saturday morning. Jorgensen had been missing for two days.

"What the hell," Haswell thought. "This is happening right here."

She didn't know Jorgensen but volunteered to be the family's point of contact and lead the search efforts. "You never leave a man behind," she says of the Army creed.

She also knew that PTSD is not always taken as seriously as it should be.

A missing soldier with PTSD, she says, should be treated like a missing child. Authorities need to act immediately.

"For all those wanting to help search ... The command center is located at the corner of Hwy 21 and Federal way in the Albertsons Parking lot," the Jorgenson family's Facebook page said. "Please we need all the help we can get. We've got some good leads just need the bodies to chase them down! Please people help us out!"

Said another: "Erik was spotted yesterday afternoon on the middle fork of BoiseRiver in the Atlanta, IDAHO area and we now need as many volunteers as available to blanket the area!"

Those who couldn't physically get out there to help wrote words of comfort for Jorgenson's family. They hoped Erik would be found alive.

He wasn't.

Jorgensen had driven to the National Guard training facility and shot himself.

The news traveled quickly via Facebook, where Crow posted a message for her son.

"It is with the greatest sadness of our life to have to share that our sweet boy spread his wings and flew to God's protective arms where the sun always shines and there is no pain. God keep my baby protected until we meet again. God bless all our soldiers who give so much and ask for nothing in return. Save them all from the pain of war and bring them home to their families. Good night my angel I'll see you soon, Mommy"

Haswell says the Facebook page helped with search efforts.

"It helped gather a lot of people. It helped get his face out there. It helped to get the word out on PTSD," she says.

And it was a great source of comfort for the family at the moment that their worries turned to utter grief.

Relationship: It's complicated

At first, Blake McAlpine's Facebook page befits an Army guy. It says he likes the movie "Black Hawk Down" and the television series "Band of Brothers." His cover photo shows him with his son, who is wearing his father's old patrol cap.

In a post, he writes that he misses his son "like crazy and Iraq sucks still." Another announces his engagement on June 8, 2009. Under information about himself, it says: "In a complicated relationship."

After February 4 this year, the posts on his page have mostly been written by his wife, Kimberly. They reflect her sorrow and will to carry on in a very public way.

McAlpine returned from Iraq with nightmares. He became addicted to drugs, alcohol. He lost his job. He watched porn on his computer. He shot the family's pet pit bull. And then in early February, he picked up his Colt .45 and tried to force Kimberly to pull the trigger. When she managed to get away, he shot himself.

She buried her husband and took to Facebook, writing on his page as a way to cope.

"I know there is no Facebook in heaven, but I feel like he knows," she says. "I love my husband. I love him with all my heart. When I talk to him daily, everything is OK."

On June 28, she posted photos of their son, Jackson, now over 2 years old.

"He's getting so big and looking more like his daddy everyday."

A few days before that, she wrote:

"All the good memories outweigh the bad.... I love u always honey."

Recently, she posted: "I wish heaven had a phone so I could hear your voice."

When she writes on his page, she says, it feels like spending time with him.

She doesn't know any of his passwords anymore -- he changed them all during his struggle with PTSD -- so she cannot turn on privacy settings to make the posts visible only to friends.

"I don't care if other people see it. Everyone knows I love my husband," she says. "People think I'm crazy for still writing to him. I'm not going to say I'm not."

Facebook helps her cope. It is like a friend who is always there.


Changes for TRICARE's ECHO Program

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DVA Logo 009


Do you have a family member who gets supplemental services through the TRICARE Extended Care Health Option (ECHO) program? If so, you need to know that beginning on Jan. 1, 2019, the ECHO benefit cap will apply to covered costs during a calendar year and not a fiscal year October 1 - September 30. The calendar year runs from Jan. 1 to Dec. 31. Due to the shift to calendar year, TRICARE adjusted the benefit cap by $9,000 to cover the remaining quarter of this year. The $36,000 limit for the costs of all ECHO benefits combined will reset on Jan. 1, 2019. For more information, visit the TRICARE ECHO webpage.


'I can be a bad ass,’ top health official says, when it comes to making sure Tricare patients get good service

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Tricare provider


Some Tricare beneficiaries still have problems trying to get medical care, and officials have taken actions to try to improve the performance of contractors, said Navy Vice Adm. Raquel Bono, director of the Defense Health Agency.

Officials are closely monitoring the performance of the two U.S. Tricare contractors, Humana Military in the East region, and Health Net Federal Services in the West region, said Bono, speaking at a family forum Monday at the 2018 AUSA annual meeting.

She said she recently was impressing upon some senior spouses that “it’s extremely important to me that we get the type of performance we need” from the contractors.

And, she told them, “While I may not look like it, I can be a bad ass.”

Defense health officials have issued several corrective action plans to the contractors, among other things. Through August, the contractors were meeting contract requirements at a level of about 80 percent.

She said there are still challenges with the accuracy of the contractors' provider directories. Defense health officials have issued corrective action plans to both contractors regarding these issues. Families have had trouble finding area doctors and other medical providers who are in the Tricare network.

Officials also issued a corrective action plan to Health Net regarding its customer call centers. Humana has corrective action plans regarding claims processing, correspondence, autism care/Applied Behavior Analysis therapy.

Tricare underwent massive changes in January, as three regions were reduced to two, and Tricare Select replaced Tricare Standard and Extra. There have also been increases in some co-pays and some pharmacy costs.

Help spread the word

Bono asked for the help of those in the audience – which included many military spouses – in getting the word out about important changes coming up.

There are new requirements for those who are retiring. To keep Tricare with no break in coverage, the service member must re-enroll within 90 days of retirement.

There are new open enrollment seasons affecting three benefits, all of which will be held Nov. 12 to Dec. 10:

  • Those in Tricare Prime or Select who like their plan don’t need to do anything. But anyone wishing to switch from Prime to Select, or vice versa, must do so during that open season. Until now, families could switch at any time. But once the open season is over, a switch can be made only for a qualifying life event. A few examples of those are moving, retiring, separating from active duty, getting married, having children, and getting divorced. (
  • The Tricare Retiree Dental Program ends Dec. 31. To have dental coverage for themselves and their family members through the government in 2019, retirees must enroll in the FEDVIP plan during that open enrollment season which starts Nov. 12. (
  • Retirees and their family members and active duty family members (not active duty) will also have access to new vision coverage under the FEDVIP, during that open enrollment season which starts Nov. 12. (


Conferees urged to reject Senate-passed Tricare fee increases

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Senate passed Tricare


The Military Coalition, a consortium of almost three dozen associations and Veterans groups, is urging House-Senate conferees, as they negotiate a final defense policy bill, to reject Senate-passed language that would impose higher Tricare enrollment fees and deductibles on more than a million retirees under age 65.

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