Tricare Prime vs. Standard - Military Benefits

Jo · 08-23-2006, 01:16 PM

I just recieved my letter in the mail from Tricare Prime for renewal. I'm seriously considering going standard because it's so hard to get an appointment at the Tricare Offices here. I called the other day at 8:00 a.m. because Chanae had strep throat and they couldn't give me an appointment until 4:00 the next day. I hate the turn around time. Also, I called for a physical/pelvic exam in July and my appointment is in the middle of Sept.

So, my question is.................

What are the disadvantages to going standard, besides the co-pay? What is your experience if you have tricare standard?

I really don't mind the copayment because we rarely go to the doctor. I think it would be worth it to switch for the convenience factor, however I'm leary because we'd been Prime for years.

So, give me all your opinions on Standard vs. Prime. Any help would be greatly appreciated.

Jo · 08-23-2006, 01:22 PM

Oh, I forgot to add that I'm headed out to the beach. I'll be ready for all my answers and problems solved when I get home tonight!!!

Amber V · 08-23-2006, 01:27 PM

I have only ever had Tri-care Prime. Good luck.

Cat · 08-23-2006, 01:31 PM

lol well as much as prime can be a hassle i still like having it. no co pays and i have been to the drs several times so its nice not having to pay co pays. but if you dont go to the drs to much and with standard cant you make your own appointments without referrals? thats the good part. i hate waiting for referrals but down here getting referrals only takes 2 days at the most so thats not bad.

Caimbrie · 08-23-2006, 01:33 PM

If I could afford stabdard I would most definitely use it! With the 3 boys always going to the doc and my health issues I can't afford the copays. I hate how hard it is to get an appointment here though. BUT the boys have a civilian pedi since they had no room for them before

CoffeeGirl · 08-23-2006, 02:06 PM

We are Tricare Prime & really like it

Victoria · 08-23-2006, 02:15 PM

I'm on Prime as well! I was going to switch to Standard when I was preggo with Ethan due to wanting to give birth at some place other than the MTF here.
Couldn't you get a referral to a place out in town if the OB/GYN is that booked? The person I am would call/e-mail the head the Tricare office immediately...LOL!!! That's what I had to do when the midwife program at Tripler was "supposedly" booked until October and I was due in Sept.

~~Kristin~~ · 08-23-2006, 02:16 PM

The 2 oldest kiddos are on prime (xh is still in the Navy) and since he wouldn't get his butt in gear to get the base stuff taken care of as far as paperwork for the kids ID's and me an "agent ID" I was unable to get on base(Scott AF base) so I called the tricare office and told them what was going on and so they get to see a doc of my choice out in town and we got to keep prime, so still no co-pays and only 3 or 9.00 for prescriptions.
Maybe you can talk to someone and see if you can get a doc out in town and keep prime.

Kaymara · 08-23-2006, 02:18 PM

The biggest con is the co-pay. That and the fact that there is a deductible.here is off the site

Costs: Standard requires that you satisfy a yearly deductible before TRICARE cost sharing begins, and you will be required to pay co-payments or cost shares for outpatient care, medications, and inpatient care.

here is a good table of the differences on their site
http://www.tricare.osd.mil/tricarecost.cfm

I have always had Prime but looked into switching to standard when I was getting the care I wanted. At the time the cost was just too high for me...

G'luck

BLBnJVB3 · 08-23-2006, 02:23 PM

Honestly I don't know much about standard. We've only ever had Prime and I've never had a problem with it. When I call for an appt. I get right in. In FL. we actually got to see civilian drs. the whole 4 years we were there. They won't let me here unless we lived so many miles away. I forget how many but with John's hours it isn't worth it. I just got referred to Gyno. here and all I did after my appt. was walk upstairs and they already had my referral so I could schedule my appt. With them it is taking longer to get in but I can understand how they are busier than my family practice dr. I do know with my 2 little ones I wouldn't want the co-pays. But since your youngest is the same age as my oldest you could probably get away with not many appts. a year so the co-pay part my not be that bad. And if you want to have more control over you referrals then again maybe standard would be better for you. For me, in 5 years, I've only been reffered out of my family practice dr's. office twice. And one of them was for my pregnancy. Neither of my kids have been reffered out. I guess just examine what your family's habit of going to the dr's. is and then see what each Prime and Standard do and don't cover so that you can see which would be better for your family. Good Luck with whichever one you decide is best.

08-23-2006, 01:16 PM	#1 (permalink)
Jo MilitarySOS Jewel Join Date: Dec 2005 Location: Oceana-Virginia Beach, Va. Posts: 6,084 Classifieds: (0) Activity: 6% Longevity: 67%	Tricare Prime vs. Standard I just recieved my letter in the mail from Tricare Prime for renewal. I'm seriously considering going standard because it's so hard to get an appointment at the Tricare Offices here. I called the other day at 8:00 a.m. because Chanae had strep throat and they couldn't give me an appointment until 4:00 the next day. I hate the turn around time. Also, I called for a physical/pelvic exam in July and my appointment is in the middle of Sept. So, my question is................. What are the disadvantages to going standard, besides the co-pay? What is your experience if you have tricare standard? I really don't mind the copayment because we rarely go to the doctor. I think it would be worth it to switch for the convenience factor, however I'm leary because we'd been Prime for years. So, give me all your opinions on Standard vs. Prime. Any help would be greatly appreciated. __________________ Allen and I I'm a Squadron Wife I'm 40!!!!!

08-23-2006, 01:22 PM	#2 (permalink)
Jo MilitarySOS Jewel Join Date: Dec 2005 Location: Oceana-Virginia Beach, Va. Posts: 6,084 Classifieds: (0) Activity: 6% Longevity: 67%	Oh, I forgot to add that I'm headed out to the beach. I'll be ready for all my answers and problems solved when I get home tonight!!! __________________ Allen and I I'm a Squadron Wife I'm 40!!!!!

08-23-2006, 01:27 PM	#3 (permalink)
Amber V Senior Member Join Date: May 2006 Location: Everett, Wa Posts: 12,304 Classifieds: (0) Activity: 0% Longevity: 60%	I have only ever had Tri-care Prime. Good luck. __________________ blinkies by Britt

08-23-2006, 01:31 PM	#4 (permalink)
Cat wife2Rob mom2Robbie Join Date: Jan 2004 Location: Williamsburg, VA Posts: 21,167 Classifieds: (0) Activity: 0% Longevity: 98%	lol well as much as prime can be a hassle i still like having it. no co pays and i have been to the drs several times so its nice not having to pay co pays. but if you dont go to the drs to much and with standard cant you make your own appointments without referrals? thats the good part. i hate waiting for referrals but down here getting referrals only takes 2 days at the most so thats not bad. __________________ www.beautipage.com/cdiesta My wifeys are Kris, Jessica and Fireflys Girl.

08-23-2006, 01:33 PM	#5 (permalink)
Caimbrie MilitarySOS Jewel Join Date: Oct 2005 Location: Goose Creek, SC Posts: 40,117 Classifieds: (0) Activity: 74% Longevity: 69%	If I could afford stabdard I would most definitely use it! With the 3 boys always going to the doc and my health issues I can't afford the copays. I hate how hard it is to get an appointment here though. BUT the boys have a civilian pedi since they had no room for them before __________________

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08-23-2006, 02:06 PM	#6 (permalink)
CoffeeGirl Java Queen Extraordinaire Join Date: Jan 2005 Location: Arizona Posts: 56,461 Classifieds: (0) Activity: 20% Longevity: 82%	We are Tricare Prime & really like it __________________ When my time comes, forget the wrong that I've done, help me leave behind some reasons to be missed. Don't resent me when your feeling empty,Keep me in your memory, leave out all the rest leave out all the rest

08-23-2006, 02:15 PM	#7 (permalink)
Victoria Senior Member Join Date: Aug 2006 Posts: 34,202 Classifieds: (1) Activity: 98% Longevity: 55%	I'm on Prime as well! I was going to switch to Standard when I was preggo with Ethan due to wanting to give birth at some place other than the MTF here. Couldn't you get a referral to a place out in town if the OB/GYN is that booked? The person I am would call/e-mail the head the Tricare office immediately...LOL!!! That's what I had to do when the midwife program at Tripler was "supposedly" booked until October and I was due in Sept.

08-23-2006, 02:16 PM	#8 (permalink)
~~Kristin~~ Banned Join Date: Jun 2006 Location: Mt.Olive, Illinois Posts: 3,956 Classifieds: (0) Activity: 0% Longevity: 57%	The 2 oldest kiddos are on prime (xh is still in the Navy) and since he wouldn't get his butt in gear to get the base stuff taken care of as far as paperwork for the kids ID's and me an "agent ID" I was unable to get on base(Scott AF base) so I called the tricare office and told them what was going on and so they get to see a doc of my choice out in town and we got to keep prime, so still no co-pays and only 3 or 9.00 for prescriptions. Maybe you can talk to someone and see if you can get a doc out in town and keep prime.

08-23-2006, 02:18 PM	#9 (permalink)
Kaymara Behind every keystroke is a real person Join Date: Jan 2004 Location: Somewhere over the rainbow Posts: 27,350 Classifieds: (7) Activity: 40% Longevity: 99%	The biggest con is the co-pay. That and the fact that there is a deductible.here is off the site Costs: Standard requires that you satisfy a yearly deductible before TRICARE cost sharing begins, and you will be required to pay co-payments or cost shares for outpatient care, medications, and inpatient care. here is a good table of the differences on their site http://www.tricare.osd.mil/tricarecost.cfm I have always had Prime but looked into switching to standard when I was getting the care I wanted. At the time the cost was just too high for me... G'luck __________________ Surviving deployment #5

08-23-2006, 02:23 PM	#10 (permalink)
BLBnJVB3 Senior Member Join Date: Feb 2006 Location: Virginia Beach Posts: 7,345 Classifieds: (0) Activity: 16% Longevity: 64%	Honestly I don't know much about standard. We've only ever had Prime and I've never had a problem with it. When I call for an appt. I get right in. In FL. we actually got to see civilian drs. the whole 4 years we were there. They won't let me here unless we lived so many miles away. I forget how many but with John's hours it isn't worth it. I just got referred to Gyno. here and all I did after my appt. was walk upstairs and they already had my referral so I could schedule my appt. With them it is taking longer to get in but I can understand how they are busier than my family practice dr. I do know with my 2 little ones I wouldn't want the co-pays. But since your youngest is the same age as my oldest you could probably get away with not many appts. a year so the co-pay part my not be that bad. And if you want to have more control over you referrals then again maybe standard would be better for you. For me, in 5 years, I've only been reffered out of my family practice dr's. office twice. And one of them was for my pregnancy. Neither of my kids have been reffered out. I guess just examine what your family's habit of going to the dr's. is and then see what each Prime and Standard do and don't cover so that you can see which would be better for your family. Good Luck with whichever one you decide is best. __________________ September 16, 2009 We made it!!!!