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Thread: I don't understand Tricare

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    #1

    I don't understand Tricare

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    I'm just really confused about the whole process.

    We got married Jan 5th and I was enrolled in DEERS and such about 3 weeks later. After a very confusing process, I was told I would be enrolled in Tricare Prime effective March 1st (I enrolled before Feb 20th). Well, I got a letter around that time but it said I wouldn't be enrolled until April 1st. Between that and TriWest no longer being the insurance so I can't create an account online, I'm totally lost. Can anybody explain how everything works? My main question is: do I get an insurance card for health/dental? And in general how do I go about setting up a primary doctor, a gynecologist, and a dentist? Also- how do I know when I'm actually enrolled!?
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    #2
    You will use your Dependent ID as your health insurance card. Dental is a whole different ball field. You're DH will have to enroll you in that and they have a fee. I think I pay like $15 bucks a month for just myself. Dental is through Metlife. I think you can enroll on Metlifes website. You should get a card from them but you don't need it. Anytime I have been to the dentist they only ask for DH's SS number and my DL.

    As for health care, I'm not familiar with Prime as I have always used Standard, but I think you just call the base PCM and make an appointment. I think it should be effective as soon as you got enrolled.
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    #3
    Quote Originally Posted by OfficerPickle View Post
    I'm just really confused about the whole process.

    We got married Jan 5th and I was enrolled in DEERS and such about 3 weeks later. After a very confusing process, I was told I would be enrolled in Tricare Prime effective March 1st (I enrolled before Feb 20th). Well, I got a letter around that time but it said I wouldn't be enrolled until April 1st. Between that and TriWest no longer being the insurance so I can't create an account online, I'm totally lost. Can anybody explain how everything works? My main question is: do I get an insurance card for health/dental? And in general how do I go about setting up a primary doctor, a gynecologist, and a dentist? Also- how do I know when I'm actually enrolled!?
    -TriWest is out, effective April 1st United Healthcare is in.
    -Yes, you should get in the regular mail an Insurance Card. I think dental, too. (I still have my old Concordia Dental Card as I never got a new one since they've been out-bidden by the other contractor, I think. )
    -If they have enough space on base, Tricare assigns you an MTF physician or NP. If they don't have enough slots open at the MTF clinic, you will be sent to an off base PCM even if on Prime. Your PCM will always have to give you referrals for OB/GYN, PT, etc.
    -When you get the letter from Tricare? Your spouse should be able to confirm this info.

    For those on Standard there is a co-pay depending on the provider and referrals are not required unless exceptions like Bariatrics, reconstructive surgery for example.

    If you go on base, they have manuals, as well as PDFs online.
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    #4
    Quote Originally Posted by shape shifter View Post
    -TriWest is out, effective April 1st United Healthcare is in.
    -Yes, you should get in the regular mail an Insurance Card. I think dental, too. (I still have my old Concordia Dental Card as I never got a new one since they've been out-bidden by the other contractor, I think. )
    You got a health insurance card in the mail? I always had to use my dependent ID, which I did not get in the mail.
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    #5
    Quote Originally Posted by Abbynormal View Post
    You got a health insurance card in the mail? I always had to use my dependent ID, which I did not get in the mail.
    Yes. So did my daughter.

    Second sentence: I would hope not.
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    #6
    Looks kind of like this:

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    #7
    So when I am enrolled, to go to the gyno to get a new birth control I will have to visit a primary care doctor first to get a referral?
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    #8
    Quote Originally Posted by roxieluvs View Post
    So when I am enrolled, to go to the gyno to get a new birth control I will have to visit a primary care doctor first to get a referral?
    I believe if you enroll in Prime, you will need a referral from your PCM. Tricare Standard doesn't require a PCM or referrals.

    this thread since I'lll be in Hawaii soon and will be in the Tricare West region.

    From when I had Tricare through my father and even now with DH as my sponsor, I've always used my ID card as my insurance card. My parents use their ID cards since my father is retired and they still have Tricare.


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    #9
    Usually your gunna see your PCM for everything, he'll write you bc scripts and all. I know here its hard to go see an ob/gyn unless your pregnant or having abnormal issues.
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    #10
    Quote Originally Posted by shape shifter View Post
    Looks kind of like this:

    Oh wow. I've never heard of anyone using anything else other then a dependent ID.
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