Monday, September 2, 2013
#MilitaryMonday - What's the Deal with TriCare?
Happy Monday everyone! I usually do a 'Military Monday type post, but today is my first time linking up with Ashley over at Eights on the Move. I'm super excited to have found Ashley's blog because I've been thinking about an officially 'Military Monday' Link-up and low and behold there it was! I'm thinking about re-visiting some of her previous topics and playing catch up, but first thing's first. This week's topic is TriCare - dun dun duuuunnnnn! Did you hear the creepy music?
As with all things in life there are multiple experiences. Truth be told we've had an almost impeccable experience with Tri-Care and United Concordia one could have in an eleven year career. The only problems that we've had was something that I don't know that they necessarily had control over, and was mostly due to the oddity that is my husband's job. The other unique experience that we have had is the fact that we were remote. Because of that we had TriCare Prime Remote. TriCare Prime is the standard plan that most active duty people receive. Prime Remote meant that standard of care was received by all civilian doctors since we weren't anywhere near an MTF. There is no cost for TriCare prime and we never had to pay a co-pay. Our prescriptions were dirt cheap; and I had three babies, a wrist surgery and several specialty visits and paid not one cent! The one thing that did cost us a bit was when there wasn't a generic prescription for something, but then compared to what someone else might pay for name brand meds, it was nothing.
When we moved here to Virginia and my husband took a civilian contract we first took the insurance available through his work. After one year we were like forget this nonsense! A part of the decision to take the civilian insurance was because of our location. There are about five military bases within a stone's throw of us. For us, personally, MTFs and military health care was not for us. However, we had other options! Currently we have TriCare Reserve Select, which other than the annual fee has been a seemless transition from active to traditional guard.
Here they are broken down for you:
TriCare Standard and Extra - This plan provides so much flexibility to its users. You are allowed to see any authorized provider whether they are in your network or not. When you see a non-network provider (standard option) you will pay a little bit out of pocket. You will not need a referral but some appointments might need prior-authorization. For example when I decided to see someone for my depression I called and made an initial appointment and the doctor submitted the paperwork. I then received a letter from TriCare stating that I was approved to see this doctor for a certain number of visits. There is a small deductible based on your rank.. This plan is available to all the eligible beneficiaries except the active-duty service member. ** if your sponsor is National Guard or Reserve, the deductible is waived if they were activated in support of a contingency operation.
TriCare Standard and Extra info page
US Family Health Plan - This is an additional Prime option. It is available through networks of community-based, not for profit health care providers. There are designated areas that this option is available, and it is available for a wide variety of people including the following - active duty, retired families, active guard and reserve families, non-activated guard and reserve families who qualify for Transitional Assistance Management Program, survivors, Medal of Honor recipients and their families, and qualified former spouses. Like I mentioned before this plan is available only in certain areas, mostly on the East Coast. You can view the areas and the areas on the TriCare info page. There is no enrollment fee for active duty families and transitional survivors. Other families pay an enrollment fee of of a little over $500.00 (which can be paid quarterly or monthly). There are no other fees as long as you see an approved provider.
TriCare Prime - Here's a great article about Prime from Military.com
TriCare Reserve Select - This is for my National Guard and Reserve peeps! This is very similar to the Standard and Extra plan. When you see a network provider it costs less, then if you see a non-network provider. There is a small enrollment fee of just under $200.00 for a family. Deductibles vary based on the sponsor's rank. After the deductible is met there is a percentage that is paid for outpatient visits. Learn more by visiting the info page for TRS.
When you visit the TriCare main page you can answer questions about who you are, where you live and your service member's status. It will pull up available plans for you and break them down even further. I have to say the TriCare website has come a long way in being way more user friendly. It is explained clearly and is very easy to navigate.
I guess the final question would be "how do I get this insurance?" In order to receive this you must be enrolled in DEERS. Service members are automatically enrolled in DEERS. In order for family members to be enrolled you have to go on your base or armory. The service member will take his/her spouse to the local ID office to get your ID as well. You will a birth certificate and/or marriage certificate. You can locate the nearest office here. Unfortunately our guard/reserve families may have to travel further to get this done if you are not near your unit. The good part about those that are far (and close as well) is that if you can't make it with your service member that's okay. My husband enrolled me right after we were married without me being there. He just took my birth certificate and our marriage certificate with him. And all children can be enrolled without you lugging them out to the office. The service member will just take the birth certificate to the office to get them officially enrolled. TriCare does make allowances for new births and the initial pediatrician visits before you have the official birth certificate, just make sure you have your information (tricare card and the id) when you go to the office.
We are huge fans of TriCare in the Cammo Style Love house. Do you use TriCare? What's been your experience?
If you have any other questions please ask here or email me!!