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Thread: Tricare Prime or Standard?

  1. eres el amor de mi vida <33
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    eres el amor de mi vida <33
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    #1

    Tricare Prime or Standard?

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    Okay so I want ya'lls experience with both health care options.
    I live about an hour away from a base. I think I am going to go with the 80% covered and i pay 20% option which is standard I think.

    Basically i just want to know more on how it works and the benefits of both options.
  2. Senior Member
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    #2
    I now have Prime but had Standard up until I actually moved here with DH.

    Before I moved here to Bragg, I had to pay for a dermatologist appointment and the prescriptions out-of-pocket. I called Tricare because I was of course clueless and was told with Standard I had to pay a deductible.

    This is just my experience of course, maybe it's different with others

    But I found this on military.com:

    Standard's Pros - Advantages
    Broadest choice of providers
    Widely available
    No enrollment fee
    You may also use TRICARE Extra

    Standard's Cons - Disadvantages
    No Primary Care Manager
    Patient pays Deductible and Co-payment
    Patient pays balance if bill exceeds allowable charge and provider is non-participating (up to 15% additional)
    Nonavailability statement may be required for civilian inpatient care for areas surrounding MTFs
    Beneficiaries may have to do their own paperwork and file their own claims

    Important Note: The Point of Service annual deductible and cost-share amounts do not count toward your enrollment-year maximum out-of-pocket expense, but instead are credited to your fiscal year maximum. There is no limit to the amount of a patient’s responsibility under the POS option.
    Last edited by Nicole!; 08-25-2010 at 04:20 PM. Reason: Addition
  3. Fresh Newbie
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    #3
    Tricare Prime is a complete and affordable health insurance plan for permanent military retires and their families. Tricare Standard is a fee-for service health insurance plan offered through the Tricare is more costs out-of-pocket copayments for relief of Tricare Prime.
  4. Regular Member
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    #4
    When dh and I married I was put on standard until Prime kicked in in August. I didn't like standard personally.. I was always dishing out money to see doctors and get the meds they'd prescribed me. When I got on prime I looked at standard like no go.. with prime everything is to your closest hospital and considering I live on base I go to the naval hospital for everything. Normally ppl don't see their PCM (which tricare provides you when your on prime) at all but I'm lucky enough to have a captain as my PCM now so she's always there. I have no problems with Prime other than the fact I have to call the hotline to set up an appt and then wait a day or two to see my doctor depending on the situation at hand but mostly if I call tricare that morning they can schedule the same day......
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  5. Senior Member
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    #5
    we have had tricare prime for 6 yrs and we have had the option of seeing our main doctor but we had always chose to see whomever had an opening.. but my son sees his pcm for his add/adhd.. LOVE LOVE tricare prime you can chose if you want a female or male and you can chose which doc you want.. granted they can always change cause the doctors move around so much... but i know some people who are on tricare standard only cause they don't want to see military doctors
  6. Feelin' fly like a Cheesestick
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    #6
    You may be able to see a civilian provider since you live so far from base. We don't live far from base, but I was assigned to a civilian provider because they didn't have enough space available at the military treatment facilities (for my primary care, that is). I would call the Tricare office at the base where you're stationed.
    Beth, Mama to Emmalee (12), Evan (9), and Ella (4 on May 7) (I really REALLY need to update my picture!)
  7. Senior Member
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    #7
    I prefer Prime and have been on Prime for 13 years. Even when I saw doctors on base only, not all of them were military, many were civilian docs employed by the military.
  8. Old Newbie
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    #8
    I have Prime and I like not having co-pays and deductibles. My son is on Tricare Prime, we don't pay anything out of pocket for his doctor visits either. The thing that sucks about Prime though is when I moved home during deployment to have my son, I had to jump through hoops to get a new OB/GYN in the area that was approved. There was one pretty close to my house, and 2 more that were about 18 miles away, and the hospitals they were affiliated with were too far to be driving to when I would go into labor. (Luckily, the close OB/GYN practice, which I chose, was wonderful and the hospital was close, although it was in the ghetto of Trenton.) First, though, I had to change my address with Tricare, select a Primary Care Manager and make an appointment to be seen, and get a referral from him. I hated the care from the office staff, and never wish to go back there again should I ever need to. My main issue with Prime is the limitations, especially since I'm living in an area where there are no military bases or facilities close by. Like, what if the only approved provider in your area is a crappy doctor, or has bad hours, you are still forced to go there unless you want to use your point-of-sale option.

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