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Thread: Because I still don't understand Tricare.

  1. i request the highest of fives!
    lorem_ipsum's Avatar
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    #1

    Because I still don't understand Tricare.

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    So, being the dumbass I am, I ran around the block in Crocs with my dog two weeks ago and managed to seriously damage my knee in the process. I was hoping it was going to go away on it's own after some icing and time—yeah, not so much.
    Here's the thing. I don't feel like dealing with a bazillion specialists and bills just for some stupid accident. And although we're raking in hazard pay, I'm not ready to plunk down a ton of money for someone to scan and poke my knee and say here are some painkillers (which I won't take), stop running, see ya.

    I know that there is a max out-of-pocket of like $1,000 per year, yes? So, if I go and it costs $2,000 to have everything looked at, does that mean I pay $1,000 on the spot? Or is it just like a normal appt/copay and the rest of my costs for anything else I do this year go up afterward?

    I don't know if this makes sense Halp!
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    #2
    Tricare has always just been straight free whenever I've gone
  3. Don't ever settle for less than you deserve.
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    #3
    Quote Originally Posted by OutlawWoman. View Post
    Tricare has always just been straight free whenever I've gone
    This took DD to the ER twice, got x-rays and all that jazz done, and took her primary care twice within a week. It was all free to me insurance fully covered it all.


    So hope someone can help!
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    #4
    Are you on Standard, Prime, or Prime Remote>
  5. Ummmmm...........
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    #5
    DO you have prime or standard?

    If its prime you shouldn't have a co-pay if its standard you will most likely have to pay a percentage.
  6. i request the highest of fives!
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    #6
    standard.
    i'm cool with free though
  7. Senior Member
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    #7
    I don't think you'll have to pay $1000 for one visit, no matter what the costs. I have standard, and get billed pretty regularly. I am more than positive that some of my visits have exceeded over $2000- and the most ive been billed at one time is $92. So, I wouldn't worry much.

    Definitely contact tricare, and see which doctors/practices they cover 100%. Your health is far more important than money! I hope everything is ok!

    I have tricare standard.
  8. Ummmmm...........
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    #8
    I have standard and I went to the ER for my first use of tri-care and it cost me $300. You wont have to pay the entire catastrophic cap at the first use of the year. They will pay for most and you just have to pay something. I don't know how much something but if its for an x-ray and some medicine I doubt it will be very much.
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    #9
    I screwed up my knee last August, due to a huge freak accident walking my dog.

    I've had shots, X-rays, 2 MRIs, 3 different braces, and a big knee surgery 7.5 weeks ago for a knee scope, meniscus repair, and complete patellar realignment. Now, I'm in PT 3x a week.

    Tricare Prime has covered it all, even the MRIs that weren't done at my MTF and the braces that were fitted at a specialty shop. I've always followed the rule of thumb to get the referral from my PCM and go from there.

    Please don't let the knee pain just go though. Please get it checked out.

    *crap, just saw you have Standard. I have no idea on the copay cost. I'm sorry!!
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    #10
    I didn't even hit my $1000 the year I had cancer (I hit like $900ish, haha). My CT scans were about $100/piece, primary care $50, specialty $70... x-rays were way less, like $20 or so. Then after I hit my $300 deductible (for our family over E-5) it was way less, like $15 max for an appointment and then just the coshare on the CT's which was still a lot. The amount you pay is the Tricare allowed amount which is much less than what it would normally cost someone out of pocket or even with other insurance. You will possibly pay your deductible in full (so 50, 100, 150 or 300 depending on your family status and rank).
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