TRICARE Sucks ...
- Thread starter crabcake
- Start date
Christy said:We switched from Tricare Prime to Tricare standard when Zoe had lyme disease. It cost us much more in deductables and we did have a yearly deductable, but it allowed us to use any doctor of our choosing. Money well spent.
The switch is a personal preference. I've been using Tricare Prime ever since I retired. The cost in minimal in my case and all I have is the copays. If I switched to Tricare Standard I would be left with at least 20% of all allowable costs every time my wife or I went to the hospital which, in my case, would be considerable. With Tricare Prime I only pay $25 for the emergency room visit and $12 / day if either one of us is admitted.
While we are near Pax River the cost is even less because I don't pay for routine visits to my PCP or copays for prescriptions.
In your case, if you can't find a qualified specialist for Zoe that is in the Tricare network, you may be saving money by not being in Tricare Prime.
Chasey_Lane
Salt Life
I like your attitude!itsbob said:
IMO, I feel that a lot of people who are covered under Tricare have no idea how expensive health insurance can be.
itsbob
I bowl overhand
Who's your supplement with, and how much?Pete said:
My daughters been hospitalized three times this year for pancreatitis, and I haven't seen the bills, which tells me they were VERY cheap or nothing, or I'm sure I woud have heard about them.
I've thought about a supplement many times in the past, but there are so many to chose from, it's tough to figure out who has the best deal.
ShyGirl
Active Member
TriCare / BCBS
I recently switched from TriCare Prime to BlueCross BlueShield.
For TriCare, there is an Enrollment Fee for retirees - I think it is based on rank at retirement.
I was able to breeze in and out of TriCare appointments by paying attention to who I selected as my Primary Care Physician and what department they practiced in. For example, most people look for a general practitioner, I chose someone in Internal Medicine.
I found better care at Bethesda (Dr Baksh in Internal Medicine) than I did at Malcolm Growe, Fort Belvoir, Pax River or Fort Meyer. (Dealing with severe allergies for years.)
At one point when they switched the companies that processed claims, there was no mechanism to handle referrals... or they were giving me a really hard time about it. A little research and a threat to contact the head honcho at the hospital, Mr. So-And-So at the Pentagon and Mr. So-And-So on Capitol Hill resolved that problem pretty quickly (I received a conciliatory letter two days later) and my claims finally started being paid. Sometimes, no matter what insurance company you have, you need to push a little.... or bully a lot!
If you decide to provide coverage under BlueCross BlueShield, keep in mind that BCBS will probably become primary coverage and TriCare secondary coverage. Any out-of-pocket expenses not paid by BCBS can be submitted to TriCare. And you should still be able to fill prescriptions using TriCare.
I have BCBS PPO and am finding it to be expensive compared to TriCare. I find that there are less administrative-type hassles and a bit more freedom of choice.
Just a side note: The new Consumer Directed Health Plan options are mega-expensive, though you would never catch on reading the literature about it. Consider, low enrollment fee, high deductible, and you have to be really careful because I've heard that not all charges that you pay out of pocket are applied toward the deductible, so it takes a long time to meet the high deductible.
PM me if you have specific questions.
I recently switched from TriCare Prime to BlueCross BlueShield.
For TriCare, there is an Enrollment Fee for retirees - I think it is based on rank at retirement.
I was able to breeze in and out of TriCare appointments by paying attention to who I selected as my Primary Care Physician and what department they practiced in. For example, most people look for a general practitioner, I chose someone in Internal Medicine.
I found better care at Bethesda (Dr Baksh in Internal Medicine) than I did at Malcolm Growe, Fort Belvoir, Pax River or Fort Meyer. (Dealing with severe allergies for years.)
At one point when they switched the companies that processed claims, there was no mechanism to handle referrals... or they were giving me a really hard time about it. A little research and a threat to contact the head honcho at the hospital, Mr. So-And-So at the Pentagon and Mr. So-And-So on Capitol Hill resolved that problem pretty quickly (I received a conciliatory letter two days later) and my claims finally started being paid. Sometimes, no matter what insurance company you have, you need to push a little.... or bully a lot!
If you decide to provide coverage under BlueCross BlueShield, keep in mind that BCBS will probably become primary coverage and TriCare secondary coverage. Any out-of-pocket expenses not paid by BCBS can be submitted to TriCare. And you should still be able to fill prescriptions using TriCare.
I have BCBS PPO and am finding it to be expensive compared to TriCare. I find that there are less administrative-type hassles and a bit more freedom of choice.
Just a side note: The new Consumer Directed Health Plan options are mega-expensive, though you would never catch on reading the literature about it. Consider, low enrollment fee, high deductible, and you have to be really careful because I've heard that not all charges that you pay out of pocket are applied toward the deductible, so it takes a long time to meet the high deductible.
PM me if you have specific questions.
crabcake
But wait, there's more...
I talked with another chic this morning at Tricare, and much to my surprise -- she was *gulp* helpful! 
She actually walked me through some areas of the site to help me understand their process, and make it easier to do the transitions from now on.
They're lucky, I almost gave my money to another HMO!
She actually walked me through some areas of the site to help me understand their process, and make it easier to do the transitions from now on.
They're lucky, I almost gave my money to another HMO!
Pete
Repete
Like tricare carescrabcake said:I talked with another chic this morning at Tricare, and much to my surprise -- she was *gulp* helpful!
She actually walked me through some areas of the site to help me understand their process, and make it easier to do the transitions from now on.
They're lucky, I almost gave my money to another HMO!
They probably want people to go private.All those who want socialized medicine take heed.
N
nitwhit3286
Guest
I should print my patient complaint on here. I hate/hated Tricare Prime. It was miserable. Switched to tricare standard and it suits me just fine. Ridiculous the base doctors at pax. Never again! I actually saw the guy I was writing the patient complaint at work the other day..I almost screamed! Bad experience, bad health care....Tricare is just horrible. I would give you the reasons...but if I posted that letter it might be slanderous to certain folks reputations...and I wouldn't want to do that now would I?? 
itsbob
I bowl overhand
Nope, you chose to pay for Tri-Care prime.. Retiress don't pay SQUAT for tricare standard.. I get to see to whatever docotr I want, I never have to call anyone for "permission" and don't have to worry about premium payments to Blue Cross Blue Shield.ShyGirl said:
Did ya sign up for the Survivor Benefits plan when (whoever) retired??
P
PelyKat
Guest
We've been tricare Prime since it was created. And I love it. When we moved here in Apr, there were no openings anywhere for retiree spouses in any military hosp. So I chose a local doc. And all is good. I use the local pharmacy in my grocery store. $3 for generic, $9 for name brand. Not worth the hassel of driving down to Pax River. $12 for office visit, easy to get referals. And when I needed one to Ortho, they even had an opening in Andrews-Malcom Grow. Not a problem, and a faster appt than I could get otherwise.
I do all my paperwork on-line. They have taken care of various in-patient and out-patient hospital visits, with minimal charges. With both of us covered for under $500 per year. We don't complain.
My husband is on a second career, and every year when he brings home the open enrollment info. I read it carefully, and then we stay with Tri-care Prime. It just works best for us.
I do all my paperwork on-line. They have taken care of various in-patient and out-patient hospital visits, with minimal charges. With both of us covered for under $500 per year. We don't complain.
My husband is on a second career, and every year when he brings home the open enrollment info. I read it carefully, and then we stay with Tri-care Prime. It just works best for us.
Chasey_Lane
Salt Life
Neither would I!PelyKat said:
A friend of mine complained that she had to pay $300 year until I told her what I pay per month. She shut right up!
crabcake
But wait, there's more...
Again, I am NOT complaining about the costs associated with Tricare. Those couldn't be better. I'm talking about the fact that yesterday, when I was trying to avoid the unnecessary costs of an ER visit (which Tricare would be paying -- and ultimately the taxpayers -- not me), they were of no help in clearing up a minor mistake on their part that would have made it possible for me to take DQ to an urgent care facility or other physician for a non-emergency situation. Instead, they chose to give me a run-around for several hours with the end result being us hanging out in the ER for the better part of the day. In other words, I was trying to be "frugal" (for lack of a better word) with the benefit rather than wasteful.
I have no idea what the costs for that ER visit are, but I have to think they're going to be at least twice the cost of a routine or urgent-care center visit.
I have no idea what the costs for that ER visit are, but I have to think they're going to be at least twice the cost of a routine or urgent-care center visit.
Pete
Repete
The cost of an emergency room visit and having Boy's head glued shut cost me ZIP with Standard and my suplement. Had I not had the suplement it would have cost me $60.crabcake said:Again, I am NOT complaining about the costs associated with Tricare. Those couldn't be better. I'm talking about the fact that yesterday, when I was trying to avoid the unnecessary costs of an ER visit (which Tricare would be paying -- and ultimately the taxpayers -- not me), they were of no help in clearing up a minor mistake on their part that would have made it possible for me to take DQ to an urgent care facility or other physician for a non-emergency situation. Instead, they chose to give me a run-around for several hours with the end result being us hanging out in the ER for the better part of the day. In other words, I was trying to be "frugal" (for lack of a better word) with the benefit rather than wasteful.
I have no idea what the costs for that ER visit are, but I have to think they're going to be at least twice the cost of a routine or urgent-care center visit.