Mox Nix

Just retired. Never even considered Prime... partly because I wasn't going to live near a base, and partly because I didn't want to be tied to the PCM system and have to get referrals. The freedom of choice seems liberating to just pick a doctor and go if I need a specialist (of course, call first and see if they're in the Tricare network).

As UALT38 said, cost may not be a big difference, depending on how much you have to go see a doc. I'm guessing people think Prime is the best because "it pays for everything." But you have an annual premium, and are tied to the PCM for a referral process (which I got very tired of during my last couple years of active duty). Standard has no premiums... the cost involves an annual deductible and 25% copays.

As far as supplements, I've been looking at MOAA to cover the copays and overcharges (some providers can charge up to 15% over the Tricare rates). MOAA has a few different options: just in-patient, or both in/out-patient, and a couple different levels of deductible. I chose the in & out-patient plan, with the $400 deductible (or maybe $800, I don't remember offhand). My plan, to cover me & the wife (ages 47/42, she's a smoker) and two teenage kids, was $67/month or $203 per quarter.

I don't know how MOAA's plan compares to others, I was already a member so I just went with their plan. I'm sure there's other military associations, even USAA, that offer Tricare supplements.

Sputnik

Thanks for replies, some good thoughts. How about dental?

Also, for the airline guys, did you stick with tricare or go with airline benefits?

UAL T38 Phlyer

I'm going company dental and vision; WAY cheaper (and better benefits) than Tricare.

ExAF

Been on Standard for 15 years. The civilian care has been top notch. Out of pocket most years has been less than what Prime payments would have been. One year the wife had 2 major surgeries. One planned...one (the more serious one involving days in the hospital and months of antibiotics and home nurse visits) not planned. That year we hit the catastrophic cap of $3K. Peanuts compared to the hospital bills that rolled in for tens of thousands of dollars that said "you pay 0." I don't use company medical, but I do use company dental.

full of luv

Nice thing about moaas supp is they are tied into Tricare eob system so they auto claim you if you use Tricare doc. Only claims to submit are for drug copays.

Duksrule

So after you hit the cap there are no more out of pocket expenses? I am currently prime but the wife is sick of fighting to find a DR that takes it as it seems that list is getting shorter daily. That 20% of the negotiated rate is what scares me, especially not knowing what that rate is. We have a baby on the way and I don't want to switch and get stuck with a couple grand in hospital bills when on prime it would be $12 so any insight would be great.

ExAF

Correct...after the 3K max, I didn't pay another penny for that fiscal year. Fortunately her case didn't spill over into the next fiscal year. Prime isn't offered where I am so I have no comparison. Typically I don't ever approach the out of cost expenses that it would take to cover the premiums of prime or company health care. Fortunately my family has been pretty healthy.

Duksrule

Thanks I think I am going to bail from Prime to Standard and also look at standard supplements. Prime is just to much of a pain in the rectum.

Sputnik

Max you're going to pay on standard is 3k/year for the entire family. Not saying 3k ain't a chunk of change, but it's still a steal for health care in this day and age. And it has to catastrophic cap, which is also pretty amazing. I don't honestly know that it will be easier to find doc's that take standard than prime. We've always found them, but it has sometimes taken a few phone calls.

Congrats on kid, and reminder that on standard your cost share of hospital bed is ~$800ish a day. So you could hit your annual limit real quick.

C17turtle

I'm AD AF retired, and do Tricare only, but use a "split" system--I do prime for myself, since it's only about $22 a month, and my civilian PCM sets me up with a few specialists I see regularly each year. Just $12 a visit.

My family, however, has standard. My wife's doctor and kid's pediatric clinic don't accept Tricare Prime, but do accept standard, just at the out of network rate of 75/25, which I can live with. I've been out a year and it has worked well. I have them on a MOAA supplemental plan to protect against the big $3K hit if it came, it's merely a hedge as it kicks in at $400 per individual, or $800 per family.

I'm with AA, and do their dental and vision. A better deal than Tricare in my opinion...