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Maui Medical Group reopens for Maui vets and families

Tricare health insurance had been on hold

Maui veterans and their families who rely on Tricare for health insurance can return to Maui Medical Group after a nearly five-month hiatus, a company administrator said Thursday.

The health care provider temporarily put a hold on seeing patients with Tricare from April to August because of questions over a new management contract with the federal program. Tricare is a health care program under the U.S. Department of Defense Military Health System. The program serves military personnel, retirees and their dependents.

Maui Medical Administrator Cliff Alakai said via email that Health Net Federal Services was awarded management of the Tricare program at the beginning of 2018. Health Net honored the previous contract until April, and then issued a new one to Maui Medical, he said.

“There were certain terms in HNFS’s new agreement that we wanted modified, but it took time to reach HNFS’s representatives,” Alakai said. “Without an active agreement in place, we are paid non-participating rates, which are much lower than participating rates and new health care providers not credentialed by HNFS will not be paid for their services.

“Fortunately, we made contact with HNFS representatives, and we have worked out the agreement so that patients covered under this program can be seen by our health care providers,” Alakai added. “HNFS and our scheduling department have been informing patients covered under this Tricare program that we are now able to continue with their care.”

The temporary hold frightened many veterans and their families for at least the past several weeks with many wondering where to go for care.

Brad Juliano, outreach specialist at Maui Vet Center in Kahului, said Friday that about 20 veterans contacted him about the lost health coverage. He said his family also has Tricare and found out about the issue when he was trying to make an appointment for his 11-month-old son, sick with pneumonia.

“I called them to make an appointment, and they looked me up and said we can’t see you because of your insurance,” Juliano said. “I had my wife call hoping to get someone else on the line, but they said the same thing. I’ve been going there for 10 years now, and I’ve always had Tricare so I was kind of shocked they couldn’t take me anymore. I thought, ‘What about my kids and other veterans?’ “

Juliano said he took his son to the community clinic Malama I Ke Ola Health Center, which treated his son. The retired Army veteran said it was the only clinic that he could find that would take his insurance and had a pediatrician.

“I took my son three times to Malama this month,” he said. “They said I would be covered so I’m hoping that’s the case.”

Juliano said many of the veterans who contacted him served in Vietnam and were getting checkups, but some had major health issues. He said a lot of them had future appointments, and there were at least five families with children.

“They were shocked and didn’t know where to go,” he said. “It’s very important for the older veteran retirees with diabetes and cancer, and those major health issues. Several went to their appointments and were turned away because of their insurance.”

Wailuku resident Ilyn Kleinsasser said she found that Maui Medical was no longer accepting Tricare on July 31 when she tried to make an appointment. She said she spent the next few days calling other clinics, including Kaiser, but found no success.

Kleinsasser and her daughter rely on the insurance through her husband, a retired Navy chief with 24 years of service. Her husband could still receive care, though, at the veterans clinic.

“Where do we go? What do we do?” she said. “I don’t think that’s right because I’m not the only veteran’s family here, and they won’t even tell us why they’re not accepting.”

Alakai said Maui Medical is a longtime participant with various military health care programs, including the Tricare program. He did not know how many Tricare patients the group covers, but he assured veterans and their families that “there should be no problems.”

“We try our best to care for our active military personnel, veterans and their dependents,” he said.

Juliano said the news of Maui Medical covering Tricare is a “sigh of relief,” especially for veterans’ children. He said he hopes that patients with future appointments will be able to keep them scheduled with their doctors.

“It was just kind of scary because doctors are so scarce on Maui, especially pediatricians and specialty,” he said. “I think a lot of families were experiencing the same thing.”

Kleinsasser was speechless recently when she heard the news while traveling back from New York with her husband.

“That’s amazing,” she said of the returning health care provider. “I’m just overwhelmed. This was big; this was not just one person affected by this. I’m speechless. As soon as I get back tomorrow I will call them.”

* Chris Sugidono can be reached at csugidono@mauinews.com.