Health and dental insurance military retirees
#31
Second that. My wife had a major surgery ($120K +) last year. No issues and only the max out of pocket spent.
#32
Gets Weekends Off
Joined APC: Apr 2007
Posts: 441
There is no yearly cap on the Regular Plan just a max out of pocket. So once you reach the $2500 max out of pocket (per family not individual) the Regular Plan pays 100% so Tricare ends up paying nothing. Until you reach the $2500 the Regular Plan pays 80% and Tricare will pay 20% of the remaining 20%. So for every $100 (after the $200/300 deductibles are met) the Regular Plan pays $80, Tricare pays $16, and you pay $4. Once you are out $2500 (which includes what Tricare pays so you really only end up out of pocket $500) the Regular plan will pay $100 of the $100.
#34
Gets Weekends Off
Joined APC: Apr 2013
Posts: 3,436
Health and dental insurance military retirees
With two insurance coverages (Regular Plan and Tricare Select) how does it work if you reach the yearly cap on the Regular Plan? Are you then responsible for the Tricare cap? Sounds like one could get screwed under certain circumstances.
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No. That’s now how dual insurance works. I think you are also mistaking a catastrophic cap (or OOP Max) for a coverage limit. The catastrophic cap means YOU are done paying and they cover everything from there on out. A coverage limit means the opposite.
Tricare is secondary by law. Normally the insurance with the earliest effective date is secondary.
In my case, UHC is primary. I pay a $300 family deductible at the beginning of the year (it can be much less if your first few claims are pharmacy due to a technicality). From there on, my secondary policy (tricare) picks up my 20 percent coinsurance until I reach my out of pocket max of 2500 for UHC. Now, I didn’t pay that 2500, Tricare did. From there on, everything is covered 100 percent by UHC. The regular plan does not cover preventive, but Tricare covers it 100 percent. So, if a claim for a checkup or mammogram gets bounced by UHC, Tricare picks it up.
There are a few things I don’t like about the plan, but I pay $300/yr for a family of 6 in health care for the year. The annoyances are minor in comparison. That’s a huge savings over any other plan that I know.
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