Tricare Question

[Genuine]

I'm trying to figure out this whole insurance stuff. Tricare Prime, Tricare Standard, and Tricare Extra... Who has what? On my husband's DEERS site I'm listed as having Tricare Standard. What's that mean? Help!

 

[StephanStrategy]

My understanding is that the servicemember has TriCare Prime. The families are automatically enrolled in TriCare Standard.

The basic difference are the copays (Prime does not have any) and who you can have as your Primary Care Physician.

Take a look at www.tricareonline.com. It should cover the basics.

Mike (not an expert in TriCare)

 

[daveleau]

Main differences:

Tricare Standard- you go to whatever doc whenever you want and Tricare pays a percentage of (usually) 80%.

Tricare Prime- you go to the doc Tricare pulls from a list, and Tricare pays 100%

Tricare extra- This option works with Standard. If you want to lower your doctor fees, you can choose from a list of Tricare suggested doctors. Works with Standard to give you the option of swapping to a Prime-like option when you feel it is needed.




I am Tricare Prime as I am active duty.
My wife is Tricare Standard, and we did not switch to Prime because we did not want to go through the referral system and be limited on what doctors to see.

 

[3girls2dogs]

Do you live on base? Is your husband AD or Activated Reservist? Do you live in a different zone than your husbands duty station? and by duty station, I mean where your husband is attached to his unit, not if he is in Iraq or deployed elsewhere.

If you are an AD dependent, living in the same area as your spouse's duty station, you would normally have TriCare Prime. You would use a MTF first, if they cannot accomodate you, you would use a doctor they refer you to.

Tricare Standard has co-pays and works as a kind of PCM type thing. You must, MUST, make sure they are a TriCare accepting physician, though, or it will be a fight to the death.

We are TriCare Prime. I hate it on this particular base, because their clinic bites, but every other base I have been on has had a full-service clinic, so it has always been good for us. If something here happens that they can't handle, they are great about letting us use Urgent care centers and the ER, as our clinic closes at 4, and TBH, they have been really helpful about some health issues I have had recently.

I prefer Prime.

 

[3girls2dogs]

And I wanted to add that a new thing they have is that Behavioral Health and Substance issues (in the normal world known as mental health) is now a self-referral thing. They give you a list, and you can make the appointments and go immediately. If you need more than your 10 yearly visits, you simply need to go to your doc and ask for a referral. This is with Prime.

 

[Genuine]

My husband is on base right now, and I'm in the middle of nowhere. But starting next month we both will be living on base together (thank God!). Sounds like we'll both be on Tricare Prime then... Thank you so much! You've been very helpful!