Tricare - Active Duty

[Fireup2020]

I know there are a few active duty folks on this board. What is your experience dealing with Tricare? It seems that in a non-military area, it is basically insurance (almost makes me want to be attached to a regular military base with a decent-sized hospital!) The 72 hour referrals are what are really irking me now. Discovered I was registered neither for TC Prime or TC Remote today. Hopefully things will be fixed - just frustrating to have spent 20-40 minutes of my Tues, Wed, Thu, and more calls tomorrow coming up...(to verify my online activity this evening and double check the referral business!)

Once the necessary registration here in the area is complete, and my PCM has a clue who I am will things settle down? I hope it becomes less of a maze...

 

[Nords]

Once the necessary registration here in the area is complete, and my PCM has a clue who I am will things settle down? I hope it becomes less of a maze...

Let's see, you've been commissioned, mobilized, and possibly (by this time) promoted. You've changed your ID card at least twice. It sounds like you've also moved outside your former Tricare service area? No wonder DEERS is confused, not that it takes much effort to achieve that distinction.

Once DEERS gets its act together, and you're registered for Tricare, then things should settle down... as long as you put your monthly premiums on autopay!

When we need a Tricare referral it takes 48-72 hours, and even after approving it Tripler is likely to change their mind.

The good news is that our civilian clinic is staffed by a bunch of interns/residents, and their appointments people are pretty good about getting us in at short notice within 24-48 hours. The younger docs don't hesitate to admit their ignorance, and they're so new that they actually discuss their thoughts with the patients before they go check with their supervising doc.

If I had an emergency (concussion, serious bleeding) then I'd have to start at the Makalapa Clinic. Any ol' corpsman would happily stitch me up, but if it involved X-rays or a CAT scan then I might as well take a sleeping bag with me to Tripler. I'm not sure that emergency care is any better/faster at a civilian clinic/hospital.

 

[heardoc]

Once DEERS gets its act together, and you're registered for Tricare, then things should settle down... as long as you put your monthly premiums on autopay!

W.

I thought all retirees were automatically enrolled in Tricare for life. Do you have to enroll?

 

[Nords]

I thought all retirees were automatically enrolled in Tricare for life. Do you have to enroll?

Your DEERS record is updated when you retire, but you have to keep updating it when you move because you may cross the borders from one Tricare contractor's area to another.

Then after you retire (whether or not you relocate) you have to sign up with your local Tricare contractor and either put them on autopay or send them an annual check. For Tricare Prime, those steps are usually part of choosing a primary care manager.

I retired in place and so the process was mostly invisible to me... until my daughter moved to Houston for college and we had to change her Tricare enrollment to a new area/contractor. I had to start all over again with DEERS and work my way down through both contractors.

I'm not old enough for TFL yet, but my retiree ID card expires the day before my 65th birthday-- expressly to force me to report to a military ID card facility to sign up for Medicare and TFL.

 

[heardoc]

I might be wrong but again I thought that TFL was at no cost. I have no
plan to use Tricare until I'm 65 because my wife's insurance is a much better,cheaper plan and then only as a secondary insurer. I'm not going to pay for a plan I don't intend to use (might change my plans depending on where government mandated changes take us, as no one seems to know).
Am I incorrect on the no cost option?

 

[Rustic23]

Presently TFL has no cost, however, you have to be signed up for Medicare, and that does have a cost. These numbers are not exactly right but close. Under Tricare Prime we paid about $600 a year for insurance (I think been a while) Now we pay $200 a month for Medicare. TFL picks up most of what Medicare does not pay, including the co-pay.

 

[braumeister]

Actually, your retiree ID card doesn't expire.
It should have something like "Expiration Date INDEF" on the front.
On the back of the card you should have another expiration date, which merely refers to the expiration of Tricare coverage (not the same thing as Tricare For Life (TFL).

I'm sure you know all this, but I thought I'd comment for anyone else who might be confused.

 

[heardoc]

Since we are on the subject of TFL and there seems to be a real depth of knowledge here, let me ask:
If I use my wife's insurance does TFL automatically become MY primary, wife's secondary ? I'd rather not let anyone including Tricare mess up the excellent service I'm getting with only one "known" insurer. Having worked with Tricare from the provider end years ago (when it was CHAMPUS ) I don't want to deal with the headaches or bureaucratic nonsense if I don't need to.
Once I use it, even for the first time, I figure they have me by the you know what.

 

[Rustic23]

How does your wife's insurance treat Medicare? TFL is Medicare secondary, and I think it is in third place behind private insurance. Under TFL you see your doctor, your doctor bills Medicare. Medicare pays what they pay, and passes the rest to TFL. TFL pays what it pays, and the medical community accepts this as full payment. So it depends on where your wife's insurance fits into this arrangement.

 

[heardoc]

Not on medicare. Just turned 60. In five years I figure I'll have a whole new set of problems, although too much low cost medical insurance seems not to be something people will sympathize with me

 

[braumeister]

I think I keep seeing a bit of confusion here.

Just to clarify:
These are completely separate programs.

Tricare is for those under 65 (whether you're active duty or early retiree).
There are different flavors (Prime, Standard, ...)

Tricare For Life (TFL) is a different program that only begins at age 65.
You have to buy Medicare Part B, which then becomes your primary, and TFL is secondary to it.

 

[heardoc]

I think I keep seeing a bit of confusion here.

Just to clarify:
These are completely separate programs.

Tricare is for those under 65 (whether you're active duty or early retiree).
There are different flavors (Prime, Standard, ...)

Tricare For Life (TFL) is a different program that only begins at age 65.
You have to buy Medicare Part B, which then becomes your primary, and TFL is secondary to it.

Well that explains my confusion. Thanks
Which one of the under 65 Tricares is no cost ? or am I dreaming....

 

[Rustic23]

I believe it is tricare standard. Tricare prime works somewhat like an hmo. I know in Houston there use to be a hospital that took you $600 a year, a really cheap price for the entire family, and provided you health care.

 

[braumeister]

There is no cost for Tricare.
With Tricare Prime, you have to choose a primary doctor who is a gateway to all other services (basically an HMO system).

With Tricare Standard, you can go to any doctor you want for any reason (with certain conditions), but your coverage is less than with Prime.

Go to mytricare.com and you'll find a good overview of all the various options.
While there, click on the Tricare Handbook link and you can get a customized edition of the book that focuses on your situation (active, retired, tricare option, location, etc.)

As a military retiree living a good distance away from a military base, I've been using Tricare for many years, and I'm very happy with it. When I see a doctor, I show my ID card, and they take care of the billing.
No paperwork for me.
I also have a supplemental policy (Mediplus) through MOAA, which pays some of what Tricare doesn't cover.
But overall, my medical costs have been low enough that I don't ever think about it.

 

[Rustic23]

There is no enrollment fee for Tricare Prime for active duty and family. There is for retired.

Humana Military Healthcare Services TRICARE Prime Summary of Beneficiary Costs

 

[martyb]

Since I retired from the AF reserves instead of active duty, I have to wait till I'm 60 for Tricare. At that time, I'll suspend my federal employee FEHB coverage under BCBS, and go on either Tricare standard or prime. Then at 65, I'll do the Medicare thing. Right now, under BCBS, I'm paying $4810 this year for premiums alone. Next year, it will be over $5100. So....federal employees don't get such cheap health care as some people believe. In addition to the premiums, I have, I believe, $500 worth of family deductibles, and then $20 copays for our regular Dr, and $30 for specialist, for the office visit, and then also whatever's left over after they settle up with the ins. co. If it's a network provider, it'll still cost some, but it's much worse if you happen to get an out of network pathologist, or anesthesiologist etc. that you weren't expecting. Also...I've recently learned than many ER physicians are contracted out to the hospital and don't fall under the network. Just found that out the hard way....

 

[Rustic23]

MartyB,
I have had both Tricare Standard and Prime. If there is a good doctor near you that accepts Prime, I recommend it.

 

[WM]

Re: the original question, we've only lived outside a regular service area once, and it was a pain. Fortunately I only needed to go in for checkups, but even that was a hassle because then the doc's office did the billing incorrectly and then I had to spend extra time calling Tricare and finding out which codes they needed to use because they refused to call and do it themselves.

 

[martyb]

MartyB,
I have had both Tricare Standard and Prime. If there is a good doctor near you that accepts Prime, I recommend it.

Where I plan to retire, Barksdale AFB being there pretty much assures plenty of access to Drs. & hospitals that work with Tricare, so accessibility shouldn't be a problem. I was pretty much figuring on Tricare Prime already, but you know how things can change over the years. I'll take another look when the time gets closer. Thanks!

 

[lets-retire]

I know there are a few active duty folks on this board. What is your experience dealing with Tricare? It seems that in a non-military area, it is basically insurance (almost makes me want to be attached to a regular military base with a decent-sized hospital!) The 72 hour referrals are what are really irking me now. Discovered I was registered neither for TC Prime or TC Remote today. Hopefully things will be fixed - just frustrating to have spent 20-40 minutes of my Tues, Wed, Thu, and more calls tomorrow coming up...(to verify my online activity this evening and double check the referral business!)

Once the necessary registration here in the area is complete, and my PCM has a clue who I am will things settle down? I hope it becomes less of a maze...

Welcome to the wonderful world of government health care. I've seen twice in the last three years people have serious issues with Tricare. One was a Seaman who had to go to a downtown hospital for an emergency (the clinic on base was closed after hours). Tricare didn't think they should pay and refused. Of course the guy fought it (all the way up to writing the critters in Congress) and a few years later won. Unfortunately the bill had been referred to a collection agency and he had a black mark on his credit report because of the issue and he couldn't get it off his credit report. I also saw a person go to a local podiatrist on a referral from the military hospital. After treatment the initial treatment she went in for a follow up. She was told by the doctor that Tricare refused to pay because the military hospital supposedly had the ability to provide the treatment. She told the doctor she had been referred BY the military hospital because they didn't have the ability to provide treatment. The doctor said he knew that, but was just letting her know what was going on. He also advised her that she would be receiving mailings from the insurance, but not to get too worried he was working on getting everything straightened out and the issue was far from over.

It does typically all get worked out, it just takes a long time and a lot of Tums.