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Old 10-01-2010, 12:10 PM   #1
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Default You know what I need? "Tricare for Dummies".

Okay. So.

DH is an E4. I am currently enrolled in Tricare Standard. According to this little booklet the TriWest office gave me, my Annual Deductible is $50.

So if I go to the doctor next week, does that mean theoretically I would be paying $50 for my visit and that's my co-pay and then the next time I go back I only have to pay 15% of my visit cost like it also says in this little booklet?

This is all very confusing for a civilian who has been paying $20 co-pays for most of her adult life. And the guy at the TriWest office didn't answer any of my questions in a way that I could understand.
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Old 10-01-2010, 12:52 PM   #2
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Default Re: You know what I need? "Tricare for Dummies".

why dont you go Tricare Prime? You dont have to pay anything then.

here is a link explaining it a bit ....
http://www.military.com/benefits/tri...are-benefits#2

on the site it also says 20% of allowed charges for covered service for outpatient visits.. not that I know what that means though... sorry I wasn't much help.

ETA- so with the 20% thing, it means that you will pay 20% of the negotiated price for the price and Tri-Care picks up the remaining 80%, supposedly.

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Old 10-01-2010, 01:12 PM   #3
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Default Re: You know what I need? "Tricare for Dummies".

Don't you have to go to a base with Tricare Prime? The gal who did my military ID on Monday suggested Tricare Prime Remote because Oregon doesn't have any military bases in the Portland area which is where I live.

The guy at the Triwest office didn't seem to think it was a good idea for some reason. He was like "Are you suuuuuuuuuuure you want to do that?"
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Old 10-01-2010, 01:14 PM   #4
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Default Re: You know what I need? "Tricare for Dummies".

I think Tricare needs "Tricare for Dummies."
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Old 10-01-2010, 01:15 PM   #5
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Default Re: You know what I need? "Tricare for Dummies".

I have Tricare Prime and I live 2 hours from base.

I go on the Tricare website to find a doc in the area that accepts it, make a phone call...bam...done.

They also assign you a Primary Care Manager when you sign up for Prime.

I pay nada, zip, ziltch.
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Old 10-01-2010, 01:23 PM   #6
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Default Re: You know what I need? "Tricare for Dummies".

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Originally Posted by MarineHusband View Post
I think Tricare needs "Tricare for Dummies."

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Old 10-01-2010, 01:42 PM   #7
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Default Re: You know what I need? "Tricare for Dummies".

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Originally Posted by devilwhiterose View Post
They also assign you a Primary Care Manager when you sign up for Prime.
I just looked up my regular doctor (whom I absolutely adore) and she's listed as a PCM. So I'm pretty sure I could just designate her when I enroll. Also, every other doctor I've visited for anything in the last year or so is one of their providers. So it seems silly for me not to go ahead and enroll.

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Originally Posted by devilwhiterose View Post

I pay nada, zip, ziltch.

That would be ideal.
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Old 10-01-2010, 07:08 PM   #8
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Default Re: You know what I need? "Tricare for Dummies".

I live 30 miles from post, we are all on prime and we see civilian doctors. I pay nothing except drug copays at cvs.
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Old 10-01-2010, 07:34 PM   #9
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Default Re: You know what I need? "Tricare for Dummies".

Quote:
Originally Posted by white_star10 View Post
Don't you have to go to a base with Tricare Prime? The gal who did my military ID on Monday suggested Tricare Prime Remote because Oregon doesn't have any military bases in the Portland area which is where I live.

The guy at the Triwest office didn't seem to think it was a good idea for some reason. He was like "Are you suuuuuuuuuuure you want to do that?"
As someone with prime already mentioned, I live 45 min away from base and because of that don't have to go through the base. I get a civ dr and don't pay a dime for anything. The only thing I pay for are prescriptions which run me $3 unless I make DH get the prescription filled on base then it's free.
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Old 10-01-2010, 08:54 PM   #10
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Default Re: You know what I need? "Tricare for Dummies".

I printed off the application for Prime Remote and mailed it in this afternoon. I was just so frustrated that the guy at the TriWest office was so unhelpful.
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Old 10-02-2010, 04:09 AM   #11
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Default Re: You know what I need? "Tricare for Dummies".

I wish I read this earlier. Your deductible is $50 so as soon as that is met then you get to the co insurance part. That lasts until you reach $1000 out of pocket for the fiscal year (Oct.1-Sep 30) after which you dont have any more co insurance to pay until the next fiscal year. So the most you pay out of pocket whether you have one family member on Standard or 20 is $1000 per fiscal year as an ADFM. That includes your deductible.

Since you are so far from a base you should be eligible for Prime Remote which gives you the option of a civilian PCM but not the other advantages of Standard.
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