Military Significant Others and Spouse Support - MilitarySOS.com
Page 1 of 2 12 LastLast
Results 1 to 10 of 20

Thread: Tricare fraud?

  1. Fresh Newbie
    California's Avatar
    California is offline
    Fresh Newbie
    Join Date
    Aug 2017
    Posts
    3
    #1

    Tricare fraud?

    Advertisements
    Hello, trying to help a friend. He divorced in 2009 and submitted all the paperwork once finalized. His ex wife was never removed as a dependent for whatever reason and continued using benefits until 2015 when he was honorably discharged. He recently was reviewing old paperwork and realized this. she was getting free insurance and $1400 a month in child/ spousal support so why would she say something. He called DEERS and notified them and is going through the proper channels of reporting this, but I read he can be liable (https://health.mil/Reference-Center/...d-Abuse-Report page 14 Case study: U.S. V. Inman). So the dilemma is, should he continue going through the proper channels of reporting as DEERS advised him or leave it alone? He turned in his divorce paperwork and insurance was deducted automatically so he had no idea she was still using the insurance, but it seems he may still be liable. And to clairify, she was not entitled to benefits, he did not serve 20 years and the marriage in question was only 4 years long from date of marriage to finalized divorce. Any advice would be appreciated!
  2. Senior Member
    villanelle's Avatar
    villanelle is offline
    Senior Member
    Join Date
    Aug 2009
    Posts
    14,790
    #2
    It sounds like they have a child together, in which case the child likely was entitled to Tricare. Is he sure she was using the Tricare herself, and not just for their child? Does he have any proof that he submitted the paperwork for the divorce? (If he stopped getting BAH and had to move into single housing, or if his BAH went down to the w/o dependent rate, I'd say that qualifies.) We he getting separation pay or any other pay associated with having a wife? There are other benefits associated with being married besides Tricare, and they should have been somewhat obvious to him, if he was still getting them, as they would have been on his pay stub, any orders he got during that time, etc.

    Yes, he should definitely tell someone, as it's the right thing to do. If he truly made the effort to disenroll her and she knew she wasn't supposed to have insurance and kept using it anyway, then if he's asked to pay back those costs, it seems like he should be able to get her to have to pay for them, though that might require a lawyer. (I am not a lawyer and that's not legal advice; just a guess based on logic.) He can contact his divorce attorney for more info on that, if it becomes necessary.
    Science always wins over bullshit. ~Dick Rutkowski
  3. "If you don't like my attitude, quit talking to me"
    TrishAFSpouse's Avatar
    TrishAFSpouse is offline
    "If you don't like my attitude, quit talking to me"
    Join Date
    Jan 2011
    Location
    VA
    Posts
    12,308
    #3
    Insurance isn't deducted from pay for active duty .. so to say "He turned in his divorce paperwork and insurance was deducted automatically..." isn't even a true statement.
    It sounds like he didn't update DEERS at the time of divorce. He had to do that himself, it isn't automatic. So long as she was in DEERS then it wasn't 'illegal' per se because he never updated. There are times when divorced that the spouse can still have tricare even if not married anymore, DEERS wouldn't know that unless told.

    There are 10 types of people in the world, those that understand binary and those that don't
  4. Fresh Newbie
    California's Avatar
    California is offline
    Fresh Newbie
    Join Date
    Aug 2017
    Posts
    3
    #4
    My apologies, I'm just trying to help gets some answers and I obviously relayed the information wrong or understood the deductible portion incorrectly. I know the child is not the issue, it's the ex wife. The child was covered with no issues, however tricare verified the ex wife had been using the insurance for 6 years post divorance. I know after the divorce his pay decreased and that's about it. He's not the most responsible adult when it comes to paperwork so who knows why he wouldn't have noticed this sooner other than he's an idiot. But the problem is, can he be held liable for his ignorance and ex wife's taking advantage?
  5. Senior Member
    Medic2Doula's Avatar
    Medic2Doula is offline
    Senior Member
    Join Date
    Mar 2017
    Location
    San Diego, CA
    Posts
    1,330
    #5
    I don't think he would get in trouble unless he tries to take her to task for it.
    Honestly, I would drop it. What's done is done.
  6. "If you don't like my attitude, quit talking to me"
    TrishAFSpouse's Avatar
    TrishAFSpouse is offline
    "If you don't like my attitude, quit talking to me"
    Join Date
    Jan 2011
    Location
    VA
    Posts
    12,308
    #6
    Unless Tricare is coming after him for some money I wouldn't worry about it.
    As far as his pay getting deducted, this likely wasn't for insurance, but rather the reduction in BAH, which would have been reduced due to him not being married and only having a child dependent. Plus there could have been other things in his pay he was getting that changed after divorce.. such as separation pay, BAS, etc

    There are 10 types of people in the world, those that understand binary and those that don't
  7. Fresh Newbie
    California's Avatar
    California is offline
    Fresh Newbie
    Join Date
    Aug 2017
    Posts
    3
    #7
    Quote Originally Posted by Medic2Doula View Post
    I don't think he would get in trouble unless he tries to take her to task for it.
    Honestly, I would drop it. What's done is done.
    I think the issue, once he realized what happened is, 1) will they audit it in the future 2) since he now knows is it fraudulent on his part 3) should he continue to notify them of the error 4) if he should notify them is he liable
    And as far as the ex wife goes, she is not the nicest person to say the least and she was aware of the fact she was not supposed to have insurance, but used it anyways. If he didn't fill out proper paperwork I doubt this would fall back on her.
  8. Senior Member
    Guynavywife's Avatar
    Guynavywife is offline
    Senior Member
    Join Date
    Aug 2007
    Location
    Maryland
    Posts
    19,310
    Blog Entries
    2
    #8
    1) listen to no one who isn't an attorney AND deals with this on a regular basis.
    2) he needs to gather up all his paperwork showing that he filed the proper divorce paperwork, plus LES statements for the few months after, and the last few months.
    3) he needs to go talk to an attorney who deals with this, and bring all the paperwork.
    4) the case you cited is not relevant if he filed the proper paperwork, or thought he did.
    5) ignorance of his wife using the insurance may not be an excuse. Ignorance of the proper procedures to file the paperwork and remove her from deers is not an excuse for liability. It may be for fraud.
    6) I AM an attorney, but I do not deal with this stuff. If he had come to me, I would tell him to go see legal on base, and before he gives them any facts, ask them what topics of information is privileged and confidential. Then talk to them.


    A general question for all though..
    As a divorced wife with a dependant child, would she still be allowed to keep her ID? Or would one just be issued for the child?
    Because if she was not entitled to her own, after 8 years, she would have had to renew it, right? Which she couldn't do without him or his signature?
    What about the child's ID? Has to be renewed or not?
    If you want my opinion on your relationship or life issues, just ask Villanelle!
    Quote Originally Posted by LittleMsSunshine View Post
    I think it's really funny when people come on here, and automatically assume that everyone here is a gung-ho, hoo-rah, i-bleed-red-white-and-blue, kiss-my-military-ass, people-in-uniform-can-do-no-wrong, and i'm-entitled-to-everything bitch.
    "RIP Blackie, and Whitey, New Whitey. Goodbye Poopers and Momma Beige and Lady Grey. New Blackie and the Whitey Sisters rule the roost now!"
  9. Senior Member
    Guynavywife's Avatar
    Guynavywife is offline
    Senior Member
    Join Date
    Aug 2007
    Location
    Maryland
    Posts
    19,310
    Blog Entries
    2
    #9
    Oh yeah, one more thing in response to some of the others suggestions:
    If he does nothing, NOW he may be guilty of fraud, among other charges of dishonesty. He knows of ongoing criminal/fraudulent activity against the military.
    Whether reporting it to Tricare alone is enough,I don't know. He may also need to report it to DEERS.
    He needs to, everyone say it along with me: TALK TO AN ATTORNEY!!!
    If you want my opinion on your relationship or life issues, just ask Villanelle!
    Quote Originally Posted by LittleMsSunshine View Post
    I think it's really funny when people come on here, and automatically assume that everyone here is a gung-ho, hoo-rah, i-bleed-red-white-and-blue, kiss-my-military-ass, people-in-uniform-can-do-no-wrong, and i'm-entitled-to-everything bitch.
    "RIP Blackie, and Whitey, New Whitey. Goodbye Poopers and Momma Beige and Lady Grey. New Blackie and the Whitey Sisters rule the roost now!"
  10. "If you don't like my attitude, quit talking to me"
    TrishAFSpouse's Avatar
    TrishAFSpouse is offline
    "If you don't like my attitude, quit talking to me"
    Join Date
    Jan 2011
    Location
    VA
    Posts
    12,308
    #10
    guy is correct, talk to an attorney.
    At the very least he should verify with Tricare and DEERS that she is no longer on the insurance. If she is not in DEERS she will not be able to use Tricare.

    to answer your question, guy, the child gets issued the ID card, and that child can let whomever is taking them onto the base. The divorced spouse doesn't get an ID card, ID cards are usually confiscated or requested to be turned in at time of divorce.

    There are 10 types of people in the world, those that understand binary and those that don't
Page 1 of 2 12 LastLast

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •