Tricare - Military Benefits

PrOuDaRmYWiFe08 · 10-10-2009, 11:39 AM

I have Tricare Standard and have yet to ever have to use it. But I need to see a Dr. Its my understanding that I can see a non-military Dr.? As long as they accept Tricare right? Also I dont know if this is going to sound stupid but are we supposed to have an insurance card? Or do you just tell them you have tricare? Thanks.

*skittles* · 10-10-2009, 11:41 AM

with standard you just need to meet your deductibles and then I believe its 20-25% after tricare pays. It works mostly like a civilian PPO in that you do not need referrals and can see civilian doctors.

I've never had a tricare card. Usually they just ask for my spouse ID.

Germanchick · 10-10-2009, 11:41 AM

Are you on Tricare Prime or standard?

PrOuDaRmYWiFe08 · 10-10-2009, 11:47 AM

Originally Posted by Germanchick

Are you on Tricare Prime or standard?

Standard. *skittles* -How do I go about meeting my deductables? Sorry I have never had to deal with Drs. and Insurance before. Do I have to meet them before or after I go see the Dr.

aceradcat · 10-10-2009, 01:58 PM

You go to the doctor and you will be responsible for paying the fees until you have met the deductable. Check with the doctor about the billing policies (Some bill insurance and then bill you and some will make you pay up front. ) Why are you not using prime. It doesn't necessarily mean going to a military doctor. You can choose your own primary care doctor and use them for most things. It's only if you need a referal that you will be sent to the base.

PrOuDaRmYWiFe08 · 10-10-2009, 06:10 PM

Originally Posted by aceradcat

You go to the doctor and you will be responsible for paying the fees until you have met the deductable. Check with the doctor about the billing policies (Some bill insurance and then bill you and some will make you pay up front. ) Why are you not using prime. It doesn't necessarily mean going to a military doctor. You can choose your own primary care doctor and use them for most things. It's only if you need a referal that you will be sent to the base.

Thanks! Well I always meant to take DH and get me Prime but time ran out and he deployed. So I guess I will have to wait. Unless I can do it without him present? I would rather have Prime.

*skittles* · 10-10-2009, 06:18 PM

Originally Posted by PrOuDaRmYWiFe08

Thanks! Well I always meant to take DH and get me Prime but time ran out and he deployed. So I guess I will have to wait. Unless I can do it without him present? I would rather have Prime.

There are enrollment periods. If you've never enrolled, I believe you still can but it takes about a month to be active. If your sponsor is an e-4 or below you can disenroll and reenroll in prime at any time. I'm not sure if you would need any paperwork to enroll, but I'd just call the tricare office at your nearest military post.

I personally just got off of prime. I hated prime, but I am the pickiest person when it comes to doctors and I have a lot of specialists, and refuse to be forced to get treated at a military hospital. So I'd rather pay out of pocket. You can find deductibles on tricares website. I believe the deductible is different for e-4's and below...it might be $50 for one person and I think $150 for one person for e-5 and above (but you can find all that stuff online). There's also a cap of how much you'll have to spend out of pocket. I believe our cap is one grand and then everything after that is 100%

Jenn026 · 10-10-2009, 06:27 PM

I had tricare standard for a while. You need to go to the tricare website and search for a tricare provider in your area. Just because the Dr says he accepts tricare does not mean that tricare will cover him because it doesn't mean that they consider that Dr a "tricare provider". I learned this the hard way. I never had anyone make me pay anything up front. Usually what happens is they submit the bill to tricare. Tricare covers what they will, usually 85%, and tricare will send you a letter telling you how much is covered and the maximum amount the Dr can charge you for your visit. Wait for the Dr to actually bill you to pay, or call, because the Dr may not always charge you the maximum amount. Your military ID is your insurance card. Many receptionists will not understand this. Your Dh's social security number is your Policy number. If you ever get a letter from tricare saying that they will not cover a bill and you know the Dr is a tricare provider call the Dr and make sure they have all the info right. If they don't, have them resubmit it with the correct info. I miss standard honestly, i hate the way this works with the military hospital. I just want a regular Dr!

Del · 10-10-2009, 08:17 PM

My standard deductible is $150. Once that is met, tricare pays a certain percentage of my bills (usually like 80%).

I just phone the Dr. and ask if they take tricare. If they do you just go in and bring your military ID card.

I haven't used mine yet, but I have had to ask about it before, and that's what tricare told me.

~KittyKat~ · 10-14-2009, 01:43 AM

I had standard for a little while. I didn't have to pay a copay or anything, but I had to pay a portion of lab work done.

10-10-2009, 11:39 AM	#1 (permalink)
PrOuDaRmYWiFe08 Currently surviving Deployment # 1 Join Date: May 2008 Location: Me: Back in Texas, My love: Hell which is Afghanistan Posts: 1,740 Classifieds: (0) Activity: 33% Longevity: 25%	Tricare I have Tricare Standard and have yet to ever have to use it. But I need to see a Dr. Its my understanding that I can see a non-military Dr.? As long as they accept Tricare right? Also I dont know if this is going to sound stupid but are we supposed to have an insurance card? Or do you just tell them you have tricare? Thanks. __________________

10-10-2009, 01:58 PM	#5 (permalink)
aceradcat Member Join Date: Jul 2009 Posts: 60 Classifieds: (0) Activity: 20% Longevity: 5%	Tricare You go to the doctor and you will be responsible for paying the fees until you have met the deductable. Check with the doctor about the billing policies (Some bill insurance and then bill you and some will make you pay up front. ) Why are you not using prime. It doesn't necessarily mean going to a military doctor. You can choose your own primary care doctor and use them for most things. It's only if you need a referal that you will be sent to the base.

10-10-2009, 06:27 PM	#8 (permalink)
Jenn026 Senior Member Join Date: Mar 2008 Location: Seymour Johnson AFB Posts: 2,488 Classifieds: (0) Activity: 97% Longevity: 29%	I had tricare standard for a while. You need to go to the tricare website and search for a tricare provider in your area. Just because the Dr says he accepts tricare does not mean that tricare will cover him because it doesn't mean that they consider that Dr a "tricare provider". I learned this the hard way. I never had anyone make me pay anything up front. Usually what happens is they submit the bill to tricare. Tricare covers what they will, usually 85%, and tricare will send you a letter telling you how much is covered and the maximum amount the Dr can charge you for your visit. Wait for the Dr to actually bill you to pay, or call, because the Dr may not always charge you the maximum amount. Your military ID is your insurance card. Many receptionists will not understand this. Your Dh's social security number is your Policy number. If you ever get a letter from tricare saying that they will not cover a bill and you know the Dr is a tricare provider call the Dr and make sure they have all the info right. If they don't, have them resubmit it with the correct info. I miss standard honestly, i hate the way this works with the military hospital. I just want a regular Dr! __________________ Plan for the worst, hope for the best, and let your fears hibernate. ~Jacey Eckhart I my wifeys, Twilliams and CubLub63!

10-10-2009, 08:17 PM	#9 (permalink)
Del solve problems with a little time and lots of vodka Join Date: Jan 2007 Location: Seattle Posts: 9,224 Classifieds: (1) Activity: 80% Longevity: 48%	My standard deductible is $150. Once that is met, tricare pays a certain percentage of my bills (usually like 80%). I just phone the Dr. and ask if they take tricare. If they do you just go in and bring your military ID card. I haven't used mine yet, but I have had to ask about it before, and that's what tricare told me. __________________ BrentsCrystal=fabulous!

10-14-2009, 01:43 AM	#10 (permalink)
~KittyKat~ Incubating... Join Date: Dec 2008 Location: Ft Campbell, KY (Clarksville) Posts: 6,011 Blog Entries: 4 Classifieds: (1) Activity: 82% Longevity: 16%	I had standard for a little while. I didn't have to pay a copay or anything, but I had to pay a portion of lab work done. __________________ Wifey to Ash029, Jen0201, CincoAF, KitKat78, SammaJamma, army mommy, Brighteyes1406, Melanie. & Twilliams

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10-10-2009, 11:41 AM	#2 (permalink)
skittles MilitarySOS Jewel Join Date: Mar 2009 Location: Savannah, GA Posts: 2,495 Classifieds: (0) Activity: 92% Longevity: 11%	with standard you just need to meet your deductibles and then I believe its 20-25% after tricare pays. It works mostly like a civilian PPO in that you do not need referrals and can see civilian doctors. I've never had a tricare card. Usually they just ask for my spouse ID.

10-10-2009, 11:41 AM	#3 (permalink)
Germanchick MilitarySOS Jewel Join Date: Apr 2004 Posts: 36,613 Blog Entries: 4 Classifieds: (3) Activity: 46% Longevity: 94%	Are you on Tricare Prime or standard?