WASHINGTON, June 8 — A transition in the management of the TRICARE West Region contract to TriWest Healthcare Alliance in January 2025 has been marred by complaints of delayed referrals, unpaid claims, and long waits for customer service assistance, affecting millions of military families, retirees, and veterans across 26 states. The problems emerged after one of the largest healthcare administrative transitions in the federal system, with the Pentagon shifting management of the West Region under a contract reportedly valued at roughly $65 billion.
Retired Army Sgt.
First Class Guy Shoemaker, who survived throat cancer, said the promise of lifetime medical and dental care collapsed when he needed it most, after encountering disruptions in his TRICARE coverage. Lawmakers have warned that the operational failures are already impacting military readiness.
Rep. Marilyn Strickland, D-Wash., described the situation as one of “unending delays,” “inoperable or overloaded websites,” and canceled appointments and surgeries tied to the transition. The Defense Health Agency implemented temporary referral waivers to stabilize patient access, but the breakdowns reflect deeper structural flaws inside the TRICARE system itself, according to healthcare executives familiar with federal contracting.
Healthcare executives say the breakdowns are a result of deeper structural flaws.
Joanne M. Frederick, CEO of GMS, said the issues are a reflection of the system’s underlying problems, although her full statement was not available.
The transition has had a significant impact on patients, with some postponing therapy sessions or critical follow-up care because providers could not confirm authorization or payment.
This has raised concerns about the ability of the military healthcare system to fulfill its commitments to those who have served. As the situation continues to unfold, it remains to be seen how the Defense Health Agency will address the issues and ensure that military families, retirees, and veterans receive the care they need.
Shoemaker’s experience is a stark reminder of the importance of a functioning healthcare system for those who have served.
He had often told prospective recruits that they would have medical and dental care for the rest of their life, but his own experience has shown that this promise is not always kept. As the Pentagon works to address the problems with the TRICARE West Region contract, lawmakers and healthcare executives will be watching closely to see how the situation is resolved.
The ability of the military healthcare system to provide timely and effective care to those who have served will be a key indicator of its success, and one that will have significant implications for military readiness and the well-being of millions of military families, retirees, and veterans.
