Nearly every day for months, Lorelei Evans, a major in the U.S. Army Reserve, received a call or text from a doctor’s office trying to collect on some of her family’s $86,000 in unpaid medical bills.
Almost weekly, she said, a bill showed up in the mail at her home in San Antonio, Texas.
Some of the notices were “friendly” reminders, but some were more ominous.
“This is your final notice,” one of the letters warned, in big, red block font.
One of the notices, for a $911 charge for her daughter’s pediatrician, revealed the problem: Evans’ insurance company had denied the claim because it needed more information about other insurance.
But Evans and her daughters do not have other health insurance besides the Tricare Reserve Select plan she gets through her military service.
“Seventeen different providers, emailing us, calling us, texting us,” Evans said. “It’s time, it’s energy.”
David Kraklow, a retired Marine Corps major in Temecula, California, understands her pain.
“I’ve got 6 inches of bills totaling near $700,000 and not one of them is paid,” Kraklow told The War Horse in February after urging the insurer since last summer to pay for the surgery it approved to fuse his thoracic spine. He said he was also erroneously flagged for having “other health insurance.”
Kraklow and Evans are among many active-duty and retired service members who have been trapped in a bureaucratic meltdown that first surfaced more than a year ago with the rollout of the new contracts for Tricare, the health care program for active-duty service members, National Guard and Reserve members, and their families.
The system is administered through regional contractors that build provider networks and process claims. TriWest Healthcare Alliance took over a $65 billion, nine-year contract at the start of 2025 to administer the Department of Defense’s health care program across 26 states, mostly in the western half of the country. Humana Military continued to administer the Tricare plan for the east region, starting a new $70 million contract in 2025.
Complaints Pile Up on Social Media
Patient frustrations with Tricare claims continue to mount in Reddit threads and TikTok posts, with military family members and veterans swapping outrage over stalled claims, scheduling troubles, unpaid bills, and little explanation.
One Facebook group focused on TriWest claims boasts about 1,300 members, with fresh complaints piling up about bills going unpaid because the system believes people have “other health insurance.”
The troubles persist even after several medical associations and advocacy groups complained about “unprecedented barriers” for Tricare patients back in July 2025 in a letter to the U.S. Senate Committee on Armed Services and the House Armed Services Committee, and some lawmakers raised the alarm.
“After over a year, I continue to hear about payment and reimbursement frustrations from constituents,” Rep. Marilyn Strickland, a Democrat who represents Washington’s 10th Congressional district, told The War Horse in March. “My office regularly checks in with TriWest, but improvement is too slow. Servicemembers, families, and retirees deserve uninterrupted access to high-quality health care—even in the aftermath of this poorly executed transition.”
Pentagon Gives Contractors Clean Bill of Health
The Pentagon acknowledged the widespread problems last year after the new contracts began, but in an email last month to The War Horse, the Defense Health Agency is now giving the contractor a clean bill of health.
Peter Graves, a spokesperson for the Defense Health Agency, said TriWest and Humana have met all claims processing “timeliness requirements” since July 2025.
In early 2025, both Humana Military and TriWest experienced issues with “loading of provider files in their databases and claims systems,” Graves said, leading to a backlog of more than a million claims in the early part of the year.
But he insisted that from July 2025 to March 2026, the contractors have met their contractually required standards, which include processing 98% of claims within 30 days of receipt and 100% of all claims within 90 days.
For Evans and many others still complaining in message groups, that was not the case. She was left pleading with medical offices that were sending her bills for almost 13 months, despite regular calls, forms, and letters she sent to TriWest to confirm that she hasn’t had any other health insurance for at least seven years. She paid about $1,200 of the bills directly to avoid a hit on her credit report.
”Every phone call I’ve had with Tricare lasts about 30 to 45 minutes to try to resolve a simple issue,” she said. “And so yeah, I’m beyond frustrated.”
Finally, on March 10, after Evans reached out to her Congress member Chip Roy’s office for help and The War Horse began inquiring with the company about payment holdups and erroneous “other health insurance” designations, Evans got an email from TriWest with a glimmer of hope: It said the “OHI” designation was removed and that payments were “in process.”
But, two days later, a pharmacist told her that a prescription for her daughter wasn’t covered because her Tricare account was still flagged for “other health insurance.”
Kraklow recently got a notice that TriWest was correcting his “other health insurance” label and started paying his bills. But he said while many of the bills have been paid, he will have to resubmit some of the claims to be completely freed from the nightmare.
Problems with Previous Contracts
A TriWest spokesperson said in an email that the company is committed to the 4.2 million members of the military community it serves and it is working “diligently to ensure they receive the care they have earned.”
She noted that since January 2025, TriWest has processed more than 30 million claims, and on average has processed those within eight days.
This isn’t the first time the company has run into issues with a military contract. TriWest Healthcare Alliance Corporation managed Tricare contracts for 17 years from 1996 to 2013. In 2011, TriWest agreed to pay $10 million to resolve a whistleblower lawsuit that alleged it was overbilling.
Humana Military, a subsidiary of larger health care company Humana, Inc., was also first awarded a Tricare contract in 1996. In 2012, it paid $45 million to settle a legal dispute claiming it violated reimbursement agreements with hospitals in its network.
After TriWest and Humana won the bids in 2022 for the current contracts, a competing bidder—Health Net Federal Services—filed legal claims to stop the deal, challenging the Defense Health Agency’s evaluation process for both contracts. A federal judge rejected the claims, allowing the contracts to move forward for 2025.
Tricare patients across the country reported a number of problems after the new contracts began.
In February 2025, U.S. Rep. Jen Kiggans of Virginia warned the Defense Health Agency that the rollout was causing issues in the East region.
Humana Military spokesperson Nan Frient told The War Horse in an email last month that it had resolved those issues, which stemmed from the “input of incorrect provider data,” and was working with providers to resolve issues with claims.
But Brian Allen, a senior specialist of congressional affairs for the American Physical Therapy Association, said his organization’s members continue to report problems with Tricare claims processing on both sides of the country. In March, at least 19 members reported difficulties getting claims paid or encountered other processing issues.
The House Armed Services Committee had originally asked for a report from the Department of Defense on Tricare’s claims processing problems, but the Government Accountability Office is evaluating the program, with plans to report back by the end of 2026.
“DHA continues to closely monitor contractor performance to ensure that beneficiaries and providers receive the timely, accurate service they deserve,” Graves, the agency’s spokesman, told The War Horse in March.
No ‘Other Health Insurance’
But the complaints persist, along with patients’ stress levels.
After Kraklow’s initial surgery, he landed back in the hospital in the summer when an infection stemming from his procedure went septic. Between the hospital stays and the home health care he needed for intravenous treatment, the bills piled up.
“Everything got approved with them throughout the whole process,” Kraklow said. “I mean all the referrals were approved and everything that I needed, and then I found out that they set my account, ‘OHI.’”
He said multiple calls to the company yielded no explanations for why he was being denied or how an “other health insurance” designation was placed on his account.
He entered the Marine Corps at age 19 in 1987, retired in 2016, and has not had any other insurance, he said.
While many have reported “other health insurance” issues similar to Evans and Kraklow, others describe perplexing problems that are delaying them from seeing a doctor until billing issues are resolved or care can no longer wait.
Tatiana Andjus, 64, who is married to a Navy veteran and lives in the San Diego area, is facing three months of physical therapy to help heal after she broke her foot and ankle in a hiking accident in December. But she said she has been hesitant to start the treatment until she resolves the more than $100,000 in claims that TriWest has not processed.
Andjus calls the company regularly to sort out the unpaid claims, but she is often told to call back and continues to get conflicting information about whether they have her paperwork. She has sent faxes, certified mail, and emails to the company, with no fix in sight.
“It’s incredibly stressful,” she said, adding that she and her husband are trying to figure out what to do. “We had a talk the other night, like, ‘Do we sell the house to pay for this?’”
Evans in San Antonio, said she, too, struggled to figure out how to provide medical care for her three daughters, ages 10, 14, and 15, when the payment issues started appearing.
She knew she would “bite the bullet” and pay for medication that Tricare had been covering for her daughter for five years, even though the pharmacist told her the copay was $750 without insurance.
“This has got to get fixed,” Evans said.
This War Horse story was edited by Mike Frankel, fact-checked by Jess Rohan, and copy-edited by Mitchell Hansen-Dewar. Hrisanthi Pickett wrote the headlines.
