My wife and I are not quite old enough for Tricare for Life (Medicare primary, Tricare secondary) but we have been using Tricare Standard for almost twenty years now. The choice of Tricare Standard and Tricare Prime is yours but I actually find that Tricare Prime may or may not be cheaper but is much more restrictive. We live in Texas and also find that if you choose Humana Military is also a good choice.
Tricare Standard does not require you to use an "in network" physician but does require a twenty five percent copay after your $150.00 per person or $300.00 per family deductible is met. The twenty five percent copay is not what you may think it means. It is twenty five percent of what Tricare allows the physician or medical facility. If the physician bills Tricare $200.00 but Tricare only allows $50.00 for the visit or procedure your copay is only $12.50 after your initial deductible is met. The key is to make sure that you physician/facility accepts Tricare. I have no problem finding excellent physicians/facilities that accept Tricare. Tricare billing has improved immensely over the years so doctors don't have to wait long for their fees, much quicker than Medicare.
We use no supplemental insurance because in my calculations it is not cost effective. Tricare has a catastrophic cap of $3000 annually per family so if your Tricare Prime or supplemental insurance costs you more than $250 per month you are probably spinning your wheels. My work insurance is too expensive now so we don't even take it.
In a nutshell Tricare Standard can cost you no more than $3000 annually, does not require you to select an "in network primary care physician" (you can choose anyone / anytime you select - make sure they accept Tricare), and does not require a referral to see a specialist. If you want to see a cardiologist - find one and go see him/her, if you want to see a neurologist - find one and go. I find it as simple as that. Tricare Prime is much more restrictive - requires you to select an in network primary care physician and also requires referrals for specialists. Do your homework on the internet and select what fits you. This data is correct as far as I know but again, verify for yourself. Your mileage may vary.
Tricare Standard has served us well for almost twenty years now. Also, ExpressScripts which is part of the Tricare systems is wonderful. Ninety day prescription for the price of thirty day by mail. Three dollar for most generic.
Good luck in your choices and thanks for serving!
Hey, Joe, thanks for all the details. That's pretty much the kind of information I was hoping for. The $3000 out of pocket is pretty much what we have now, but that's on top of the $1800 a year premiums we also have to pay...each. I know I should have seen a proctologist last year to get my head out of my arse about TriCare, but better late than never.
I've looked extensively at the Prime option, and in our area, it doesn't work. There are no military facilities other than the VA. And I don't like bull-pen medicine. I've already talked with our current primary care doctor (who we've been seeing for several years), and they are familiar with TriCare and bill to it, even though they are not part of the network. I'm going to work on her a bit to get them to join. There isn't much to it beside formally agreeing to accept what TriCare pays. I need to contact the local hospital and see what their take is on it. My idea of a supplemental insurance, or something like AFLAC, is to cover any differences between what they bill vs. what they accept from TriCare. Having seen some of the Statement of Benefits from our current plan, it's crazy. They bill $500, the BC/BS will allow $300, which I have to pay until I've met the $3000 out of pocket. Without the insurance, the provider could chase me for the $200 that the insurer doesn't allow. I kind of read that in the TriCare info, that that could be a possibility using an out-of-network provider.
I went online, looking for info on supplemental plans. Actually got a call from one agent who was a retired Master Chief. Told him what my "plan" was and he thought it was the way to go, even though he didn't have a supplement to sell me. I've got an inquiry in to AFLAC, and I think I'll check with our financial advisor for his input. Could be we forget the supplement and use our savings to handle any costs beyond the coverage.
I've got another 3 years before I qualify for TFL, and the wife's another six.
Again, thanks for all the inputs. I'll be sure to post what I finally come up with.