Military Health Care

[packrat44]

mberg501,

I am retired. DW and I are on Tricare Prime ($460/yr for family). Service has been excellent at the AF clinic we go to. When we needed medical procedures or operations, we were sent to doctors downtown. Highly recommend Tricare Prime.

 

[OAG]

Just a quick question here I’m about to be medically retired after 15yrs in the Navy. My wife and I are concerned about how or what kind of care her and the kids will receive. As far as I know and read they will all still be covered under tricare prime we just have to pay a little more. All of us have monthly meds that we pick up at our local pharmacy and they have said we are lucky to be active duty since they would be so much more expensive. Are any of you already dealing with this? Any info you could share would be great thanks.

If you are retired and remain in the same area you should still be able to get your medications at the same place. If you move near another Military Treatment Facility the same thing should apply. Short of that (the one we use now) you can get them from Express Scripts, Pharmacy Benefit Management (PBM), Order Prescriptions, Workers' Compensation. They are not free but they are inexpensive (example: my HBP medication cost me $3 for a 90 day supply).

As far as Tricare Prime on the outside (if you cannot get treatment at a MTF) you would have to find a local facility that accepts TRICARE (it was no problem for us). Depending on where you are going to be living you should be able to find referrals pretty easily through VFW, American Legion, and other Internet Forums.

Good luck and I hope all works out well for you and your family.

 

[FinallyRetired]

As far as Tricare Prime on the outside (if you cannot get treatment at a MTF) you would have to find a local facility that accepts TRICARE (it was no problem for us). Depending on where you are going to be living you should be able to find referrals pretty easily through VFW, American Legion, and other Internet Forums.

This is a little tricky. I've been both Prime and standard, and am currently Prime in the greater DC area (VA, MD, DC). Because I'm Prime, I must use a MTF unless I get a nonavailability certificate, which only happens if I can't be seen within 30 days (for nonemergency) or I need a specialist that they don't have, which is pretty rare for the DC area. Bottom line, oftentimes I have to wait nearly 30 days to see anyone other than a GP, and drive 40 miles and sometimes 2+ hours to get to Walter Reed. So I'm thinking of switching to standard, at somewhat higher cost, to get faster and closer service. However, in our area many specialists don't accept standard, so it's not an easy choice to make. Maybe this is just a DC thing, I don't know.

 

[OAG]

This is a little tricky. I've been both Prime and standard, and am currently Prime in the greater DC area (VA, MD, DC). Because I'm Prime, I must use a MTF unless I get a nonavailability certificate, which only happens if I can't be seen within 30 days (for nonemergency) or I need a specialist that they don't have, which is pretty rare for the DC area. Bottom line, oftentimes I have to wait nearly 30 days to see anyone other than a GP, and drive 40 miles and sometimes 2+ hours to get to Walter Reed. So I'm thinking of switching to standard, at somewhat higher cost, to get faster and closer service. However, in our area many specialists don't accept standard, so it's not an easy choice to make. Maybe this is just a DC thing, I don't know.

I should have pointed out we are using TFL (Tricare for Live) in conjunction with MEDICARE maybe that makes it easier for the Dr to take us. When I was on Tricare (prior to age 65) I always used TRICARE Prime.

 

[FinallyRetired]

I should have pointed out we are using TFL (Tricare for Live) in conjunction with MEDICARE maybe that makes it easier for the Dr to take us. When I was on Tricare (prior to age 65) I always used TRICARE Prime.

Oh, OK, that makes a big difference. TFL is basically Medicare with Tricare as a secondary. I've noticed some specialists in my area take TFL only, no Prime or standard. When you were Prime, did you experience the delays and distance issues I mentioned? As I said, this may be mainly a DC problem because of the number of retirees compared with the limited MTFs and their need to care for those wounded in Iraq.

 

[OAG]

Oh, OK, that makes a big difference. TFL is basically Medicare with Tricare as a secondary. I've noticed some specialists in my area take TFL only, no Prime or standard. When you were Prime, did you experience the delays and distance issues I mentioned? As I said, this may be mainly a DC problem because of the number of retirees compared with the limited MTFs and their need to care for those wounded in Iraq.

This must be unique to DC area. I experienced no problems where I was at in FL (very close to NAS Jacksonville). IMO we got very good and timely care (I got next day appointments when I called in on a Sunday). In one case I got same day care for what I thought was minor problem and could have waited. Referrals were pretty easy to attain in the couple in the instances they could not treat the problem or felt they had done all they could (unknown skin problem and a foot problem). However, at the time I was going to go on MEDICARE I did get a letter that said I may have to find outside routine care because is was going on MC and TFL. We moved before I actually went on MC/TFL so I don't know if we would have had a problem finding care in FL (I really doubt it would have been a problem).

 

[mberg501]

man thanks a bunch as im sure you all know it has been brutal the last month finding out that for sure i will be retired. ive have been pretty successful so far holding it all together but its unraviling for sure. we should be moving to houston tx as we have friends and family there and a good possibility for jobs as Im an IT with lots of network security and such under my belt. thanks again for all of your help out there

 

[mickeyd]

Are any of you already dealing with this? Any info you could share would be great thanks.

I'm retired with Tricare Prime (TP) with DW. If receive my care at a local Army medical clinic and receive all meds at no cost. I could opt to get meds via mail, but there is a copay to deal with if you receive meds in the mail. I am a big fan of TP and have no complaints at all, nor does DW.

I suggest that you get all of your Tricare Qs together and visit the local Tricare office to get them answered. They are very helpful.

 

[Nords]

man thanks a bunch as im sure you all know it has been brutal the last month finding out that for sure i will be retired. ive have been pretty successful so far holding it all together but its unraviling for sure. we should be moving to houston tx as we have friends and family there and a good possibility for jobs as Im an IT with lots of network security and such under my belt. thanks again for all of your help out there

Well, MBerg, I'm sorry the military chose not to work with you. Considerign today's retention numbers and their investment to get you to this point, it seems kinda shortsighted.

It'll be interesting to see how your health changes once you're clear of your current hassles & stressors.

A couple suggestions:

We've found Tricare to be a great way to experience life outside the military clinic. I much prefer a physician/resident's clinic 10 minutes away from the house to going up to Schofield Barracks (20 minutes) or down to Pearl Harbor (25 minutes). The clinic doctors are a lot more interested in a pony-tailed surfer dude than a military doctor (or contractor) would be, and they tend to have more experience in after-the-military medicine like your condition. The residents in particular are enthusiastic, cheerfully willing to admit ignorance, and extremely persistent in their follow-through. Civilian clinic appointments have also been much easier/more convenient than the military system. I've had better civilian care in six years than I got from the military in 24.

While meds are free at the military clinics, my time is still worth money to me. I'd much rather pay $3-$12 at Long's Drugs (and get my shopping done) than be "Priority C" at the active-duty clinic pharmacy. It avoids the bureaucracy, the base security issues, and the nagging feeling that I'm wasting the time of an active-duty guy who needs to get back to work.

Even in Houston you might want to check in to the Tricare mail-order pharmacy. I don't use it (no maintenance meds) but DoD really pushes it hard as a money-saving measure (for DoD) and using it may make it easier to get what you want.

You might also want to contact BigMoneyJim about the IT market in Houston. He's not very close to there but he's very knowledgable. You might also want to check in with REWahoo! to update your list of Texas' lethal hazards. There've been a few innovations during your absence...

And finally, you might want to contact Lucas Group to see if they still have their enlisted technician head-hunter's branch. They were quite successful with that a few years ago and they'd be more than happy to have a company pay them to hire you. They do a good job of translating your skills and helping you crack the civilian code. If you get to talk to Dave Mauerman, a submariner shipmate, tell him I said "Hey".

 

[oma]

After being treated by civilian Docs for about 20 years, I returned to military medicine almost 3 years ago.

I can say with no hesitancy that the medical care that I have received in that time from on-base military (Tricare) medicine has been superb. They have ferreted out several medical issues that my civilian doc never even checked on. I feel that my treatment has added many years to my life.

I had a Q today about the results of a recent lab test and called the clinic for further clarification. I was on the phone for 15-20 minutes with the nurse who thoroughly responded to every question that I had in great detail. Can not ask for more than that.

My wife (recently retired) is also just getting on the same program and has had no negative comments, but time will tell.

Its nice to read about good military health care. I've been in the Army for 20 yrs and have nothing more than a sore throat, thankfully, so I haven't been on the receiving end, much. But as a provider, let me tell you, we are facing so much bureaucracy that takes away from our ability to care for patients. Also, you probably wouldn't be surprised about how many patients enter the health care system not needing to see an MD - taking time away patients that do. Free health care does that.

 

[Average Joe]

Retired a few months now – have Tricare Prime. So far so good for wife, kids, and me. We were dissatisfied with the first pediatrician we selected from the list, but swapping for another was no problem. I’ve seen my civilian doctor once and was happy with the visit - he seemed to listen more and hurry less than military doctors have in my recent experience.

There are some great people in serving as primary care Doctors, PAs, Nurses, Techs, and other support staff in the military system. But my experience over the last few years gives me the impression of a trend to squeeze more and more medical care out of fewer and fewer human resources in the area of primary care – to the detriment of doctors and patients. Maybe it was specific to where I was. The primary care clinic at my last assignment smelled like stress. Physicians, and PAs seemed especially harried to me. Is someone applying fast-food restaurant management principles to medicine?

Military surgeons have repaired me using the best techniques available and with good results. And convalescent leave when needed, was granted without question, without cost to me, and without hard feeling or repercussions.

 

[packrat44]

But as a provider, let me tell you, we are facing so much bureaucracy that takes away from our ability to care for patients.

Same on the civilian side.

Also, you probably wouldn't be surprised about how many patients enter the health care system not needing to see an MD - taking time away patients that do. Free health care does that.

In the civilian world the most rude and demanding of patients are those who are on welfare.

But my experience over the last few years gives me the impression of a trend to squeeze more and more medical care out of fewer and fewer human resources in the area of primary care – to the detriment of doctors and patients. Maybe it was specific to where I was. The primary care clinic at my last assignment smelled like stress. Physicians, and PAs seemed especially harried to me. Is someone applying fast-food restaurant management principles to medicine?

Same in the civilian world. The CEOs "need" their mega-bucks at the expense of the health workers and patients.

 

[oma]

Retired a few months now – have Tricare Prime. So far so good for wife, kids, and me. We were dissatisfied with the first pediatrician we selected from the list, but swapping for another was no problem. I’ve seen my civilian doctor once and was happy with the visit - he seemed to listen more and hurry less than military doctors have in my recent experience.

There are some great people in serving as primary care Doctors, PAs, Nurses, Techs, and other support staff in the military system. But my experience over the last few years gives me the impression of a trend to squeeze more and more medical care out of fewer and fewer human resources in the area of primary care – to the detriment of doctors and patients. Maybe it was specific to where I was. The primary care clinic at my last assignment smelled like stress. Physicians, and PAs seemed especially harried to me. Is someone applying fast-food restaurant management principles to medicine?

Military surgeons have repaired me using the best techniques available and with good results. And convalescent leave when needed, was granted without question, without cost to me, and without hard feeling or repercussions.

You hit the nail on the head. I've worked in the various medical settings over the last 20 yrs, and now I'm in charge of a primary care clinic. We're strapped for physician/physician assistant staff. Two of our staff are deployed to Iraq - making access to care very poor, imo. Definitely no fun going to work every day. The stress that you describe for the providers is definitely there. A harried work environment is exactly how things feel at work. Of course, the patients should never feel our stress, but it is difficult.