question for Tricare knowledgeable

[wyliec]

http://www.military.com/military-report/171k-may-soon-lose-tricare-prime?ESRC=miltrep.nl

I live within 10 miles of a VA Hospital. I have a primary care physician at the VA; but,I also see a primary care physician in private practice. I do have Tricare Prime. Would what is stated in the above article affect me?

 

[pickelhead]

I use Tricare Standard by choice. I researched this and it seems DOD is Testing the waters to see if Congress tells them no. I really do not pay more for standard verses prime, because I get the option to choose my own doctor and specialists. Also this runs contrary to the National Healthcare that will go completely into effect over the next few years.

 

[DR Buck]

http://www.military.com/military-report/171k-may-soon-lose-tricare-prime?ESRC=miltrep.nl

I live within 10 miles of a VA Hospital. I have a primary care physician at the VA; but,I also see a primary care physician in private practice. I do have Tricare Prime. Would what is stated in the above article affect me?

Tricare Prime is free for active duty. Others qualified must pay a fee. If you don't know what you have, it's probably Tricare Standard. The attached pdf presentation explains it all.



View attachment Introduction_to_TRICARE_Pt1.pdfView attachment Introduction_to_TRICARE_Pt2.pdfView attachment Introduction_to_TRICARE_Pt3.pdf

 

[grumpybob]

http://www.military.com/military-report/171k-may-soon-lose-tricare-prime?ESRC=miltrep.nl

I live within 10 miles of a VA Hospital. I have a primary care physician at the VA; but,I also see a primary care physician in private practice. I do have Tricare Prime. Would what is stated in the above article affect me?

Defense officials are expected to announce that military retirees and their dependents that live more than 40 miles from a military treatment facility or BRAC (base closure) site will lose access to TRICARE Prime as early as next April. This move could force as many as 171,000 retirees to shift to TRICARE Standard,


States more than 40 miles from a military treatment or a base closure. Don't see why you wouldn't be okay. I'm taking it that you are retired and not a disabled vet with a rating. The Admin office should be able to ans. your question right off. I go thru the Order of The Purple Heart, Shelly or Debbie should be able to also answer you quickly.

 

[SpyderAnn01]

I was under the impression that Prime had never been available if you lived more than 40 miles from a facility. When my husband retired in 99 we moved to an area that was not covered by Prime and so we had Standard. We also had insurance through his employer so Tricare would not have covered us anyway. Now that we are "retired" and living 10 miles from Nellis AFB we just switched to Prime.

You say that you have a private physician that you see using Prime. When you enrolled in Prime did they give you a list of physicians that you could go to? Do you have to see them to get referrals? If yes then it seems that you are in a Prime coverage area even though you don't see physicians on a military installation. So I would think that your coverage would stay the same.

If I had enrolled in Prime when we lived in Michigan I would have to have traveled more than 40 miles to get care so I would have been forced to use Standard under the new plan. I think so anyway.

 

[wyliec]

You say that you have a private physician that you see using Prime. When you enrolled in Prime did they give you a list of physicians that you could go to? Do you have to see them to get referrals? If yes then it seems that you are in a Prime coverage area even though you don't see physicians on a military installation. So I would think that your coverage would stay the same.

Yes, my private physician is on the list and I have to go through him for referrals. That link is a little ambiguous. I thought it was trying to say, in a roundabout way, that you would have to use a military facility.

 

[SpyderAnn01]

Yes, my private physician is on the list and I have to go through him for referrals. That link is a little ambiguous. I thought it was trying to say, in a roundabout way, that you would have to use a military facility.

I see what you mean " that live more than 40 miles from a military treatment facility or BRAC (base closure) site will lose access to TRICARE Prime" if they don't consider your network which I believe is Health Net Federal as a "military treatment facility" it looks like you may lose Prime. The good news for you would be that you have a year to figure it out.

 

[bruiser]

We also had insurance through his employer so Tricare would not have covered us anyway.

Sorry but that's not correct. I've had Prime for years and insurance through my employer and Tri Care has paid some of the costs of care. Granted, the employers insurance was primary. My wife is on disability and has Tri Care for life, Medicare and is on my employers insurance and all three have paid for care.

 

[Wiredux]

So I have prime as well (Since wife is still active duty), and we are going to continue on Prime. The facility we are going to be using is about 10 miles away. What I would do if I were to is call TriCare. They can answer any questions that you have I am sure. They have always been helpful when we have had questions. If you need the number I am sure I can locate it for you.