FDXLAG

I can tell you in Fairfax VA the specialist most recommend on yelp bat about 50% on accepting Tricare as even a secondary insurer.

Flyinhigh

JJ; there is a difference between Tricare For Life and Tricare Standard. If your doctor accepts Medicare he will automatically accept Tricare For Life. The two programs work together. I have been on Medicare and Tricare For Life for just over two years and like you my out of pocket has been virtually zero. I did enroll in a Plan N supplement to cover catastrophic illness but the VEBA through the union reimburses all of that cost. When I was using the active pilot program through FedEx this same doctor did not accept my Tricare Standard as a supplement so I had to file the paperwork myself. With only a $20 copay sometime I didn't even bother to file it.

Raptor

Tricare for life is the Medicare "supplement" Tricare style. Almost all doctors who accept Medicare will accept Tricare for life as a secondary insurance. They do this because the paperwork standards and requirements are nearly the same for both.

For Tricare standard it's a different story. Many doctors don't like taking Tricare Standard or Prime either for primary or secondary insurance because the processing paperwork and requirements are generally more burdensome than "normal" insurance. Also, Tricare payments are very difficult if the practice doesn't accept Medicare patients per Tricare rules.

Short story: if you have a doctor who takes Medicare, you are good to go with any flavor of Tricare. Even if you have to file secondary Tricare paperwork yourself, as long as the practice takes Medicare you're OK.

Flyinhigh

One of the things you will want to put on your retirement checklist prior to turning 65 is to make sure all of your doctor's accept Medicare. My doctor was not accepting any new Medicare patients and only kept me because I was an existing patient. I have not had a problem with the hospitals or urgent care facilities in our area. This can be a huge factor if you plan to relocate after turning 65.

Jetjok

Thanks guys for setting me straight. John, I was looking at that PM you sent me last December again, and have decided to buy into the Medicare Supplement Plan F too. Thanks again.

olly

I have used Tricare standard exclusively for 9 years. My monthly out of pocket is zero. My family deductible is 300, co-pay 20% in network, 25 % out, and my catastrophic cap $3000. (all copays & deductibles go towards the cap). So my out of pocket is limited to $3k + copay on drugs (usually $5-10 unless I go to a military treatment facility then no copay for drugs- it's just a pita)

My analysis was the monthly cost of the company plan is a known annualized is $3060. Well that is more than I'd pay "if" I reached the catastrophic cap.

I have reached the cap in only a few years when my bride had some serious issues, so my out of pocket for those years was limited to 3k, most years it is not that much.

So if: 1) you live in an area where Tricare is accepted, 2) your docs/specialists accept Tricare reimbursement rates, it is a better deal cash flow wise. Company= you will spend 3K+, Tricare= you're limited to spending up to 3k, but only if you have a bad health year.

your mileage may vary

Raptor

When people say YMMV with Tricare, they mean it. You must do a lot of research before you make decisions.

Where I live, most doctor's staff have no idea what Tricare is! Not many ex military in my area. And, many specialists in my area don't take Medicare. When doctors don't take Medicare, the government essentially says they don't play well with others and thus Tricare rules are written that in most cases you get NO reimbursement.

So, while my costs are higher having both FedEx health and Tricare Standard, FedEx gives me access to virtually every doctor and specialist in my area. Those that take Tricare as a secondary--bonus. When they do, I normally have no copay at all.

Tip: if you have Tricare and FedEx health, never use the FedEx 90 day prescription mail order options. The processor for FedEx's mail order pharmacy benefit doesn't accept secondary payers while most drugstores do. Therefore, non-preferred Rx mail order may cost you $120 out of pocket, but if you process them as 30 day Rx at your local drugstore with refills, your out of pocket cost is generally zero!

Flyinhigh

If you are using FedEx as your primary and your doctor does not accept Tricare, you can still file for Tricare reimbursement. You will need the DD form (2965 I think) plus a copy of the EOB from Anthem and (this is very important) the diagnosis code provided by your doctor. Send it all off to Tricare and in about four weeks a check shows up. You can also do the same with the mail order copays from Express Scripts. Just be careful to send them to the proper Tricare center. For our area the doctor goes to Camden, South Carolina and the pharmacy goes to Phoenix. Took me about three tries to get the paperwork correct but once I got it figured out it works well. Have been reimbursed 100 percent for all copays.

Raptor

And that's why we stopped doing mail order prescriptions. Processing the paperwork was a hassle to get my reimbursement check. Plus Express Scripts (the FedEx mail order Rx provider) would take two weeks to start a new Rx, and would often contact the doctor to try to get them to change off the medication he prescribed my wife for a cheaper one that didn't work through the same mechanism. ExpressScripts can be overly aggressive managing costs...so we've now removed them from our health care equation!

Every retail pharmacy I know of will process Tricare as a secondary. Therefore, we got our doctor to reissue our mail order 90-day prescriptions into 30-day prescriptions with refills. Now we get my wife's prescriptions with one day turnaround and it costs us nothing--but this time I have zero paperwork to file and no reimbursement check to wait for and none of the ExpressScripts hassle.

Flyinhigh

Did Walgreens rejoin the Tricare program? I know they did not participate for quite some time.