Tricare

grizz13

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Another thing not talked about on this site...

Yet again, something I was blindsided by at my pre-retirement briefing today... duhn-duh-duh............................... TRICARE!

Okies, another stupidly confusing subject that has to be waded through...:eek:

I don't have the mental capacity to go over these three options, but will continue on tomorrow I think...

Tricare Prime, Tricare Life, Tricare Standard with Tricare Extra

What in the hell do we choose? "Well Bob, that's a good question!":confused:

Ok... starting with the basic run through and will get complicated in later posts...

1. Everyone seperating receives Tricare Prime for free for 180 days after seperation, common knowledge.

2. Everyone MEB gets automatically enrolled into Tricare Standard when they get their blue i.d. card... Shocked!?!?! I was because no one has told us this! BTW, it's free until you go see doc, then pay co-pays.... deductables at $3000 per year.

3. Those enrolled into Tricare Standard can upgrade to Tricare Extra, and get better co-pays on certain things.

4. If your spouse has Medicare, they HAVE to have both Part A and Part B for Tricare for Life, if you want that. Can switch to Tricare Prime from what they said...

5. Tricare Prime- If you live with-in a 30 minute radius of a major Army hospital, you have to have Prime... Don't ask me why, this is what they said...

6. Tricare Prime- Even though it is around $520 yearly premium (goes up every year) it is WAY better than Standard and Extra in my opinion.

7. Tricare Prime- You have to enroll while still on active duty before you seperate, why? I don't understand their thought...

Input would be greatly appreciated!!!
 

nwlivewire

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Another thing not talked about on this site...

Yet again, something I was blindsided by at my pre-retirement briefing today... duhn-duh-duh............................... TRICARE!

Okies, another stupidly confusing subject that has to be waded through...:eek:

I don't have the mental capacity to go over these three options, but will continue on tomorrow I think...

Tricare Prime, Tricare Life, Tricare Standard with Tricare Extra

What in the hell do we choose? "Well Bob, that's a good question!":confused:

Ok... starting with the basic run through and will get complicated in later posts...

1. Everyone seperating receives Tricare Prime for free for 180 days after seperation, common knowledge.

2. Everyone MEB gets automatically enrolled into Tricare Standard when they get their blue i.d. card... Shocked!?!?! I was because no one has told us this! BTW, it's free until you go see doc, then pay co-pays.... deductables at $3000 per year.

3. Those enrolled into Tricare Standard can upgrade to Tricare Extra, and get better co-pays on certain things.

4. If your spouse has Medicare, they HAVE to have both Part A and Part B for Tricare for Life, if you want that. Can switch to Tricare Prime from what they said...

5. Tricare Prime- If you live with-in a 30 minute radius of a major Army hospital, you have to have Prime... Don't ask me why, this is what they said...

6. Tricare Prime- Even though it is around $520 yearly premium (goes up every year) it is WAY better than Standard and Extra in my opinion.

7. Tricare Prime- You have to enroll while still on active duty before you seperate, why? I don't understand their thought...

Input would be greatly appreciated!!!


WOW!

I was told by the TRICARE REP lady up at JBLM last March, and when I was up there doing my out-processing for PDRL, that I DIDN'T have to enroll in Prime before discharge! I live 140 miles from the nearest Army hospital, but TRICARE has an office here in Portland, Oregon (my HOR at the moment).

I'll go see them next week and get back to you on that issue. I'll be pissed if I got told wrong by the TRICARE REP lady up at JBLM last March.

I'm still in that post-discharge 180 day window and it expires in early OCTOBER.

Let me know if you get more intel on this grizz13.

(I do have Medi-care part A and B, and soon have VA health care, too).

Thank-you again for keeping all of us posted. Your posts are much appreciated!

V/r,
nwlivewire
 

grizz13

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Thoughts of the moment... If we already have Tricare Prime free for 180 days, why are we given Standard automatically? Does being enrolled into Stanard break into and over-rule the free Prime benefits we are getting already? :eek::confused::mad: (Yes, these are my emotions at the moment...)
 

pittpan2005

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Grizz,
I fight with Tricare and the VA weekly so I am chiming in not as any expert, but I help 150 military families navigate the MTF, Tricare, Medicare and VA for complex medical problems that often result in denial of care.
Another thing not talked about on this site...

Yet again, something I was blindsided by at my pre-retirement briefing today... duhn-duh-duh............................... TRICARE!

Okies, another stupidly confusing subject that has to be waded through...:eek:

I don't have the mental capacity to go over these three options, but will continue on tomorrow I think...

Tricare Prime, Tricare Life, Tricare Standard with Tricare Extra

What in the hell do we choose? "Well Bob, that's a good question!":confused:

Ok... starting with the basic run through and will get complicated in later posts...

1. Everyone seperating receives Tricare Prime for free for 180 days after seperation, common knowledge. It's called TAMP
What is the Transitional Assistance Management Program (TAMP)?
The Transitional Assistance Management Program (TAMP) establishes TRICARE eligibility for specific categories of beneficiaries. The sponsors and their family members are eligible for continued TRICARE medical benefits including TRICARE Standard, TRICARE Extra, enrollment/re-enrollment in TRICARE Prime, services and supplies provided under the Extended Care Health Option (ECHO), and MTF care on a space-available basis. TAMP eligibility is available for 180 days beginning on the date on which the member is separated from active duty.
2. Everyone MEB gets automatically enrolled into Tricare Standard when they get their blue i.d. card... Shocked!?!?! I was because no one has told us this! BTW, it's free until you go see doc, then pay co-pays.... deductables at $3000 per year. You are auto enrolled in Standard unless you enroll in Prime. If already enrolled in Prime(prior to separation), you might have to re-enroll, but there shouldn't be a lose of benefit if you stay on top of Tricare. Keep in mind you can switch between Standard and Prime within 24 hours. It's an easy process.

3. Those enrolled into Tricare Standard can upgrade to Tricare Extra, and get better co-pays on certain things. Tricare standard is more expensive with out of pocket costs(co-pays), but you don't need referrals. You choose your doctors from a larger "pool" and are better able to manage your own care. There are also no monthly fees.

4. If your spouse has Medicare, they HAVE to have both Part A and Part B for Tricare for Life, if you want that. Can switch to Tricare Prime from what they said...Your family can use Standard or Prime, but if you have Medicare A/B must stay Tricare 4 Life. Under Tricare 4 Life, Medicare is primary payer and Tricare is secondary. Personally I find them easy to use. I go to any doctor who accepts Medicare or Tricare; pretty easy. The claims are automatically sent to both for payment so if Medicare denies payment, Tricare picks the tab up.

5. Tricare Prime- If you live with-in a 30 minute radius of a major Army hospital, you have to have Prime... Don't ask me why, this is what they said...You choose Prime if you want it. You are never required to pay into Prime if you choose not to. I live 10 minutes from an MTF, but we use Standard and Tricare 4 Life.

6. Tricare Prime- Even though it is around $520 yearly premium (goes up every year) it is WAY better than Standard and Extra in my opinion. That's debatable. Each family has different needs. After spending 5 years with military doctors trying to mandate care, I stay as far away from the MTF as possible. Therefore, we will never use Prime or the MTF.

7. Tricare Prime- You have to enroll while still on active duty before you seperate, why? I don't understand their thought... Not true.

Input would be greatly appreciated!!!
 

grizz13

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Thanks Pitt, alot of the stuff they were saying seemed like b.s. that is why I am posting this and putting it out there!
 

pittpan2005

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Thanks Pitt, alot of the stuff they were saying seemed like b.s. that is why I am posting this and putting it out there!
They do the best they can with the briefs; at least they have TAPS classes now. Tricare would be a full day of classes just in itself. Like any other institution, whomever you talk with could relay different info.
 

7LVL

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I opted for Tricare Prime and the local MTF cannot keep up with retirees so we had to choose from a list of doctors in the local area. We haven't had to see that doctor yet, thankfully. I don't think the $43.33/m we have to pay along with $12 co-pays is bad, am I misinterpreting something?
 

pittpan2005

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I opted for Tricare Prime and the local MTF cannot keep up with retirees so we had to choose from a list of doctors in the local area. We haven't had to see that doctor yet, thankfully. I don't think the $43.33/m we have to pay along with $12 co-pays is bad, am I misinterpreting something?
The costs are great, especially compared with other insurance policies. It's just a personal preference of Prime or Standard. If you approach a doctor's office who accepts Tricare they will ask whether you have Standard or Prime because the Prime "pool" is smaller. This will depend on the area you live in. The best example I can give is my experience with Standard with our child being born this year. We are an anti-vaccine and natural birth family and live a few miles from the MTF. When we moved here we stayed Standard because of the increased options with personal choice. We spent about 1k out of pocket on delivery costs associated with using Standard. Had we used Prime they would have been minimal, but we wouldn't have had access to the Midwife we wanted and the hospital we wanted to labor and deliver at. In the end more money spent using Standard, but better care for what we wanted.
 

rebelblue

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Tricare Standard can get expensive quick. You can be stuck making large payments (at least for a family getting by on retirement/disability and MGIB pay/part time jobs). We are still making payments to local hospitals for last fiscal year because we ran up to our cap in January 2012. The nice thing, no more copays for that year once cap is reached. The crappy thing, bills. BUT since we live more than 100 miles away from a tricare prime area, it will do. Certainly better than nothing, and more than willing to pay on those bills until they are gone. Other nice thing. Tricare standard is not copay, (which would be due at time of being seen by doc) but cost share, which is due after billing is completed through both Tricare and clinic.
 

JBrown58

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I have a question: What if you are guard or reserve do you qualify for TRICARE coverage or not?
 

rebelblue

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Note that whether you can have Prime or Standard once you are separated ALSO depends upon where you live. I live out in the boonies....further than 100 miles from the nearest Tricare Prime eligible site so I am stuck with Standard whether I like it or not. I've been stuck with it for about four years now, and it helps, alot. Its way better than no insurance, and comparable to if not better than most other people I know with insurance through their jobs or through Obama care...I'd say it's better than the O-care stuff cost/benefit wise overall.

The co pays generally are not terrible, and we qualify for medical assistance on top of that....but it's a bit tedious keeping track of everything. At least once every few months something gets submitted wrong for one family member or another and we have to contact several different offices to get it fixed...
 

AEmedic

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One thing to note from my recent TAP class. The $520 yearly premium, or whatever that cost at the time that you "medically retire", is locked in and does not increase. This is only the case if you are medically retired.
 

T-man

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TRICARE PRIME & more:
To continue tricare prime coverages when you retire you must enroll as a retiree, you and eligible retiree dependents.

-if you retired on the 1st of the month, you have to submit your enrollment application prior to that date
-if you retired on any other date of the month, you can submit your enrollment application 30 days after that date
-If none of the above actions were taken, you will have a break in tricare prime coverage and you can reenroll by the 20th of the current month.

for more info: click on link for Tricare continuation and enrollment timing prior/post retirement:

http://www.tricare.mil/~/media/Files/TRICARE/Publications/FactSheets/AD_to_Ret_FS.pdf
 
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jeffb

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Well Im glad I found this forum. I just go to the Navy Hospital . Everything is still free for my family and myself . no fees at all.
 

ordie4life

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What is the difference between Tricare 4 life and the others?
 

gsfowler

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What is the difference between Tricare 4 life and the others?

As far as medically retired service members are concerned, there are two types of Tricare, the first is Tricare for Retirees, there are a few options to choose from, but you will need to enroll you and your family once you get your DD-214. If you do not make a choice, you are automatically enrolled in standard.

Tricare for life is for retired service members who also have medicare part B eligibility. If you are eligible for medicare part B, then you must enroll in it to also use Tricare for life. Tricare for life is a supplemental insurance in which medicare part B is the primary payer and TFL is second.

There may be situations in which you must be enrolled in both, this is something my family has to do. I get SSDI so I qualify for TFL, so I am enrolled in it (the premiums are deducted from my monthly SSDI award, it costs me $105.00 per month).

I also have my family enrolled in Tricare Prime which costs and additional $47.10 per month and there is a $12 co pay each time they receive a service.
 

Hawkeye99

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There may be situations in which you must be enrolled in both, this is something my family has to do. I get SSDI so I qualify for TFL, so I am enrolled in it (the premiums are deducted from my monthly SSDI award, it costs me $105.00 per month).
Do you know how they determine that? I'm in a similar situation with Part B, but it costs me $121.80. Just hope they're not charging me more than they should....
 

gsfowler

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I'm not sure, when you look at the medicare website it states that the Part B premium starts at $121.80, however my charge is $104.90, maybe it has to do with the year the coverage was started?

I did a quick search and the premium cost for coverage started in 2014 was $104.90.
 

Hawkeye99

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I'm not sure, when you look at the medicare website it states that the Part B premium starts at $121.80, however my charge is $104.90, maybe it has to do with the year the coverage was started?

I did a quick search and the premium cost for coverage started in 2014 was $104.90.
Interesting. Mine just started 1 Feb 2016. Of course, the letter stated that this amount would be taken out in the last payment and it wasn't, so who knows....
 

gsfowler

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Interesting. Mine just started 1 Feb 2016. Of course, the letter stated that this amount would be taken out in the last payment and it wasn't, so who knows....

By what I researched, your premium should be $121.80 this is based upon the rates for 2016. If you have Tricare for Retirees, you must contact them ASAP and get yourself enrolled in Tricare for Life and you family put back on prime if that is your choice.

I had a lapse in Tricare coverage for a month because I missed the Part B enrollment and it cost me something like $400 for visits that were not covered.
 
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