EP3driver

The first person I talked to at Tricare wasn't sure how they would handle the deductible portion of the Purple plan and another person said that Tricare wouldn't cover the deductible. I call BS on this but I didn't really wan't to argue since I have decide to go with Tricare Prime next year (I was able to get a PCM out in town with the same doctor I would have got with Anthem). I am going to see how things work out for my family and others next year so I can make a better educated decision next year. I agree that the Purple plan could potentially be a good deal if you start banking the HRA money but it also looks like a lot of paperwork and potential headaches dealing with Tricare.

Doogs

My experience dealing with Tricare as a secondary insurance has been pretty easy. There is the occasional hiccup that requires the medical provider to refile, but it has always been because they filed with Tricare simultaneously without waiting for an EOB from Anthem to send with the Tricare claim.

Doogs

My experience has shown that it is not quite that simple. Tricare has their own maximum allowance for various services, which are based on Medicare rates, and can be really low compared to the Anthem negotiated rates. They will figure their rate, and subtract your cost share and deductible ($150) and pay that to your provider. You are on the hook for the Tricare deductible and cost share.

I imagine that you can pay your share with HRA dollars, so your HRA shrinks, but you still have $0 out of pocket.

Finally, Tricare counts some of that OHI money towards your out of pocket cap, so as you reach your Purple deductible and they start paying 90%, your responsibility shrinks and you hit your out of pocket cap mostly with Purple's (not HRA) money.

Based on some recent EOBs, sketchy calculations, and a few WAGs, I think that your max expenditure will be roughly $1000-1200 dollars of HRA money and $0 out of pocket. You're probably still ahead, i.e., more money left in your HRA than you spent in premiums, but it'll be close to a wash at the extreme.

As I get hit by the UPS truck monthly, I will max it out and should be able to report back in March or so how wrong I was. Too late to help anyone this year, but you'll have a data point for next year.