When it comes to being covered by your insurance company, years of dedicated service in the Army and all the Purple Hearts in the world don't mean squat. At least that's what one decorated Iraq War serviceman says he's finding out.
According to a lawsuit recently filed in Houston federal court, Major Jonathan, whose last name is omitted, is suing the Department of Defense and their insurance provider, Tricare Management, for not reimbursing him for medical expenses the soldier claims should be covered.
During his career as an army chaplain, Jonathan received numerous commendations, including the Bronze Star, the Meritorious Service Medal, the Iraq Medal, the Global War on Terrorism Medal, the Combat Action Badge, and the Purple Heart for injuries he sustained in Iraq when a bomb exploded near his chapel.
Jonathan is a family man; his wife and two children, ages 14 and 16, live in Katy.
Years ago, when the family was stationed in Germany, Jonathan claims both his children were traumatized after they were sexually abused by other children at school and were physically abused by their teachers. Both of his children have also been diagnosed with Asperger's Disorder, a type of autism, and require an intensive therapy-driven scholastic atmosphere.
When the family moved to Texas, they began researching schools and decided that Houston's Monarch School was the only one in the state that offered the therapeutic support Jonathan's children needed. Wanting the best for his kids, Jonathan enrolled them and began paying the costly tuition himself, according to the lawsuit.
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Jonathan was counting on his medical insurance provided to him through the U.S. Department of Defense to help with the costs of the special school. So far, the Army chaplain is still holding his breath.
At first, Jonathan claims, Tricare refused to reimburse him, saying the services were not covered. Then, according to the lawsuit, Tricare conceded that the services were covered but that the service providers were "not authorized" under the regulations. Finally, Tricare told Jonathan that even if the service provider was authorized, the company would still refuse to reimburse him.
"Tricare's rationale is nonsensical," states the complaint, "and particularly troublesome in light of the fact that both children received their medically necessary services while their father was stationed" outside the continental U.S.
Jonathan claims that he has gone broke paying for the school all by himself and runs the risk of having to withdraw his children from the program if he is not reimbursed, which would be catastrophic to his children.