Tricare Question

[cptsgirl2108]

I just have some questions:
If you have standard you can see a civi doctor without a referral? am i understanding that right? Can a civi doc be your PCP?
with standard you have to pay copays and whatnot?
with Prime no copays but you HAVE to see a doc on base? thats how im understanding it. if im wrong please correct me.

im getting married end of this year and totally need help figuring out which one is best. TIA.

ETA: i dont have any major medical problems. Just migraines which i take a daily pill for and will get my meds refilled for 3 months prior to PCS'ing to Gordon in December so i wont have to see a PCP right away. otherwise i just saw my gyno and im healthy.

[steph23]

my pcp told me i didnt need a referal but i asked for one just in case. tricare will pay if its medical problem.
i had to go see two specialist for my eyes, and they paid for it.

you do have a copay, expecially if you dont meet your deductable.
yea
yes a cici dr can be your pcp as long as they except tricare..
hope this helps.

[Southern-momma]

Originally Posted by cptsgirl2108 I just have some questions: If you have standard you can see a civi doctor without a referral? am i understanding that right? Can a civi doc be your PCP? with standard you have to pay copays and whatnot? with Prime no copays but you HAVE to see a doc on base? thats how im understanding it. if im wrong please correct me. im getting married end of this year and totally need help figuring out which one is best. TIA. ETA: i dont have any major medical problems. Just migraines which i take a daily pill for and will get my meds refilled for 3 months prior to PCS'ing to Gordon in December so i wont have to see a PCP right away. otherwise i just saw my gyno and im healthy.

Yes, with standard you choose your dr (as long as they accept tricare) and than you pay your co-pays.

With prime tricare assigns your dr. Generally it is a military dr at a military hospital but there are times when they are not. And there are no co-pays unless you are getting prescriptions filled off base.

[BubMunkeyBles]

Your doctor doesn't have to accept tricare to use standard, when a doctor accepts tricare and you use it, it is considered Extra. I try to use Extra because its cheaper, 15% coshares vs. 20% with what they call Standard. You don't technically need a PCM with Standard, but I like to have one anyways. You can self refer.

Prime, some people have civi PCMs (who take tricare). Some people HAVE to be seen on base. Just depends. Everyone HAS to have a referral. It's always free though.

[Pickels]

we have prime.. and depending upon how close you live to a military facility depends on if they assign you a pcm there (unless all of the pcm's are going on full caseloads they can and will assign you out in town) we live over the regulated distance (30 miles or 1h drive) so have to sign a "release" every year to cont. to be seen on base (we are willing to drive, for non-emergency).

the meds are the best part... they are free if you get them on a base... or if you get them out in town... i think the most we have paid was 9.00 for "name brand" and 3.00 for generic.

have fun with the pcs... i think if you are going overseas..you don't really have a choice you will be prime with a military pcm though.. i could be wrong.

[jttigerbaby]

At Gordon I had a Dr on base, and I saw a specialist for my migraines at MCG. Here at Hood I have a civilian Dr.

[cptsgirl2108]

Thank you everyone!

im just worried about leaving my really good doctor up here who is controlling my migraines really well and getting assigned a doctor who...well...doesnt. KWIM? im already expecting cluster migraines from the PCS anyway. anytime we go on vaca or move i get migraines for the first 2-3 days. sometimes longer depending on the weather at the place we are at.

My DF is no help with this either. he just always see the doctors on base and doesnt think about seeing anyone else. im picky and would rather see a doctor who will treat my condition the way it needs to be treated rather than just going through the motions.

[settles]

Just wanted to add I have Prime and have a civilian doctor off base

[ArtsyBelle]

Originally Posted by BubMunkeyBles Your doctor doesn't have to accept tricare to use standard, when a doctor accepts tricare and you use it, it is considered Extra. I try to use Extra because its cheaper, 15% coshares vs. 20% with what they call Standard. You don't technically need a PCM with Standard, but I like to have one anyways. You can self refer. Prime, some people have civi PCMs (who take tricare). Some people HAVE to be seen on base. Just depends. Everyone HAS to have a referral. It's always free though.

What she said. I have Standard/Extra and I don't have a PCM. I just look up a doctor on the Tricare website whenever I need to go. Co-pays are pretty small, but you do have to meet a deductible ($50 for E-4 and below, $150 for E-5 and above).

[Victoria]

I have Prime. My PCM is at the military clinic, but my ophthalmologist is a civilian. When I was in San Diego, my PCM was civilian, because the military clinic was full and wasn't accepting any new patients.