Tricare Reserve Select

[Trey]

What are the copays on this? How similiar is it to Tricare?

[CoffeeGirl]

[Trey]

Thanks Dawna!

[CoffeeGirl]

Originally Posted by Rileysmom Thanks Dawna!

Your welcome

[AG2Wife]

ok.. let me see if i can explain this correctly..
There are no copays..
You have a $150 individual and a $300 family deductible - you have to meet those deductibles yearly. I believe the cost of the deductible is up to the doctor- some doctors will only charge you some of it, some will make you pay the full amount. Once you have met that deductible, cost sharing begins. Cost sharing is when you pay 15% (for in network) or 20% (out of network) of tricare "allowable charges"...

"cost share"
The percentage of the allowable charges a beneficiary will pay under TRICARE Standard and Extra. The cost share depends on the sponsor's status—active duty or retired.


Make sense?

[Trey]

Originally Posted by AG2Wife ok.. let me see if i can explain this correctly.. There are no copays.. You have a $150 individual and a $300 family deductible - you have to meet those deductibles yearly. I believe the cost of the deductible is up to the doctor- some doctors will only charge you some of it, some will make you pay the full amount. Once you have met that deductible, cost sharing begins. Cost sharing is when you pay 15% (for in network) or 20% (out of network) of tricare "allowable charges"... "cost share" The percentage of the allowable charges a beneficiary will pay under TRICARE Standard and Extra. The cost share depends on the sponsor's status—active duty or retired. Make sense?

So basically we pay $300 as we go, and then after that, if an appointment is $200, and Tricare pays $100 we pay $15?

Is there a yearly or monthly fee aside from the deductible and cost sharing?

Thanks for the help!!

[AG2Wife]

Originally Posted by Rileysmom So basically we pay $300 as we go, and then after that, if an appointment is $200, and Tricare pays $100 we pay $15? Is there a yearly or monthly fee aside from the deductible and cost sharing? Thanks for the help!!

no problem

Yes... I'm not sure how they work the $300 family deductible.. DH & DD haven't seen a Doc yet this fiscal year... and some of my family deductible has already been added to by my appointments.

Tricare does "allowable charges" -- for example, my dr's office billed them $350, they only approved $111.23 -- but I only had to pay $16.68!

here's the costs page: http://tricare.mil/mybenefit/home/Medical/Costs

Monthly Premiums
(amount due per month)
Member-Only: $47.51
Member-and-Family: $180.17


Annual Deductible
Sponsor's rank is E-4 and below:
Individual: $50
Family: $100

Sponsor's rank is E-5 and above:
Individual: $150
Family: $300

[Heather]

John just recently looked it into it. For us it would end up being more expensive then the insurance we have now.

He was told its around $200 a month just for health care. No perscriptions, no vision and no dental care

for us there would be a $900 deductable per year

we'd still have copays and it would vary depending on how much the visit cost. It'd be 80/20

It really wasn't anything like tricare at all. With the health insurance we have now we pay $300 a month for medical, vision, dental and limited perscriptions. We have an 80/20 plan with a $1000 yearly deductable.

Being here in WY we aren't exactly swimming in active duty Navy personel. The Navy people that are here aren't the brightest crayons in the box (to put in politly) So the information he got might not be the most reliable. I encourage you to look into it before you decide on your health care though.

[AG2Wife]

Originally Posted by Heather John just recently looked it into it. For us it would end up being more expensive then the insurance we have now. He was told its around $200 a month just for health care. No perscriptions, no vision and no dental care for us there would be a $900 deductable per year we'd still have copays and it would vary depending on how much the visit cost. It'd be 80/20 It really wasn't anything like tricare at all. With the health insurance we have now we pay $300 a month for medical, vision, dental and limited perscriptions. We have an 80/20 plan with a $1000 yearly deductable. Being here in WY we aren't exactly swimming in active duty Navy personel. The Navy people that are here aren't the brightest crayons in the box (to put in politly) So the information he got might not be the most reliable. I encourage you to look into it before you decide on your health care though.

that doesn't sound like Tricare Reserve Select.... Read their website.
It's $180 for a family - it used to be $253, but went down in January. It's 80/20 for non network docs & 85/15 for network docs. It's a PPO plan (no referrals needed)
Prescriptions are either $3, $9 or $22 - depending on the formula (generic, etc). Vision is either 80/20 or 85/15 .. dental isn't included..

Deductibles aren't anywhere close to $900 . .. the catastrophic yearly cap is $1000 if that is what you are thinking about...

There aren't copays (atleast I've never had one) - I just have to pay deductibles/ cost shares..

[LauranwithanA]

im really late on finding this but im going to have to show it to df. he currently has 65% covereage and $4000 out of pocket! and he pays $250 per month. leaving ellies hospital bill at about $3300 out of pocket!

glad i found this maybe it'd be a better option