Tricare Select or Prime and how to transition to Medicare?

[stephenson]

Hi All,

Got out of touch traveling and missed upcoming changes to Tricare - I'm retired military.

While traveling a friend noted they used Prime vice Standard ("Standard" is Changing to "Select" in 2018). Started me thinking, then I began researching and found there are changes I have to sign up for by 20 Nov IF I wanted to change from Select to Prime.

Apparently, most medical providers in our area (Pensacola, FL) accept Tricare and are "in network" ... good news, I guess.

We have 18 months till 65, but then will get more complicated as our medical costs will increase as we are required to purchase Medicare Part B in order to have Tricare provide secondary coverage?

Waaaaay more complicated than I thought

Thoughts or recommendations - figure there are many of you out there who have been through this.

Thanks!!

 

[razztazz]

Thanx for mentioning this little bit of TriCare trivia. I hadn't heard a peep! I just went to the main Tricare site and saw a lot of stuff going on behind The Green Door

 

[braumeister]

You'll find it pretty seamless (I did).
When you sign up for Medicare (which you can do easily online even before you turn 65), you're all set.

Medicare automatically bills TFL for what they don't cover so you really don't have to do anything.

 

[Huston55]

You'll find it pretty seamless (I did).
When you sign up for Medicare (which you can do easily online even before you turn 65), you're all set.

Medicare automatically bills TFL for what they don't cover so you really don't have to do anything.

Thx for that; not there yet (only 62) & was curious how easy/complicated it might be.

Regarding the OP’s question, we’ve used TriCare Select since turning 60 & are very pleased with it; especially compared to other choices. We live in the SF Bay Area & virtually all providers take TriCare, with most of them in network. We chose ‘Select’ because the ability to choose our own Doc’s is very important to us. However, both choices are so good IMO, and comparatively inexpensive, that you’ll likely do well with either.

 

[mickeyd]

Contact your local DEERS office and they will give you the proper (easy) guidance that you seek regarding TFL.

 

[stephenson]

OK - quick follow-up ...

We decided changing from Tricare Standard (soon to be called Select) to Tricare Prime would work better for us. (Note: we already have a GP provider and have used services of several specialists)

However, when I checked with the management system for Tricare, they explained we would be required to go to Naval Hospital Pensacola (closest military facility - about 15 miles from our house), where we would be assigned a Primary Care Manager from the staff there (many are "doctors for hire" or "contract doctors" - my names).

This is quite a bit different than our expectations - trying to understand it all now.

 

[braumeister]

That's right.
Prime is what would be called an HMO operation - you are restricted to the doctors they send you to.
Standard is the old PPO operation where you can go where you like.
Surprised you didn't realize that.

 

[stephenson]

Yeah - knew the referral part, just didn't think it would be required to be seen by a "military doctor" at a military facility in order to get the referral.

 

[ExFlyBoy5]

Yeah - knew the referral part, just didn't think it would be required to be seen by a "military doctor" at a military facility in order to get the referral.

Yep. If you are close to a mil hospital (and they have openings), then you will most likely have to go there. It *is* possible that you *may* be able to request a PCM change through the Humana website, but there aren't any guarantees of that. Or...you could move farther away from the base!

 

[Nords]

Yeah - knew the referral part, just didn't think it would be required to be seen by a "military doctor" at a military facility in order to get the referral.

You could apply to the Tricare contractor for a waiver to use your current GP as your primary care manager. Your current GP would have to accept Tricare (and be in the Tricare database for that).

Tricare (or the contractor) might still disapprove the request, but in general Tricare is happy to get retirees out of the military clinics in areas with a high military population.

https://tricare.mil/primeaccess