Using Tricare Select

[Christine]

I know it's a longshot but I thought I'd put this out here in case we have a good-sized military population here (or retired). I've been posting on some Tricare forums but just not getting much response so fingers crossed.

My husband did 8 years active duty and completed his full 20 years through the reserves. He turned 60 this year, so we are eligible to opt into Tricare Select (not interested in Prime). The cost for us would be $317 per year. I have checked and most of my doctors take Tricare. The copays for visits are higher than what I pay now, but prescriptions look much better, although we don't use many of those at this point.

We currently have health insurance through his employer that goes into retirement. It used to be free to us while he was working, but since he retired, we pay the retiree cost of approximately $420 per month. This includes medical, dental, and vision.

I am also eligible for health care through my own employer through retirement. I've never used it because my husband's plan was always free. The costs for my employer's plan would probably run $500 per month for the same coverage we get now.

So, here's my struggle. I have heard *some* good things about Tricare Select. I have a coworker who has the ability to pay higher premiums through work for various plans, but chooses Tricare Select and he's perfectly happy with it. His wife has been dealing with metastic breast cancer for a few years and there's never been an issue; been to the best doctors, covered well, etc. But everyone's degree of satisfication is different and some people might suffer to save a nickel. I'm not that person, but I also don't even know if Tricare Select is good, bad, or neutral. I've asked several military people (active duty right now) and that's all they've ever known so not much to compare to. There are some very negative reviews online, but my own health insurance has those also.

The catch is that if I go with Tricare and drop my husband's insurance, we can NEVER go back on it again. My insurance is somewhat the same. If I don't use it during the 5 years before retirement, I cannot take it into retirement so would lose that too.

If I do get Tricare, I will have to buy a dental and vision policy through my employer which would probalby run me about $40 per month for both my husband and I. So this brings my monthly cost to probably about $70 per month for Tricare vs. $420 per month for what we have now.

It's now open season and I've got a decision to make. Granted I can always join Tricare at any furture open season so I don't have to do it this year, but I need to figure it out. And it would be nice getting in close to $300 per month discretionary income. Oh, and if I buy Tricare as just another insurance, it won't even give me a feel for how it works because, by law, it has to be my secondary insurance so I'll never know how it functions as a primary (only) insurance.

Anyone have any thoughts on their own Tricare insurance--the good, the bad, and the ugly?

 

[becauseimnew]

DH is medically retired, we receive Tricare Select for free. And I love it. I will say that DH gets all his medical through the VA so we don't pay for any of his medical. We are a young family so the plan is perfect for myself and our 2 teen daughters. We never have to worry about getting referrals, we pay 20% cost share after the tiny $300 deductible, and 20% of the negotiated rate isn't much. My regular dermatologist appointment is about $23 so less than most co-pays. Our daughters' sick visit to their pediatrician are about $30. We have never hit the $3,000 catastrophic. We just took DD1 to urgent care, where she had an x-ray, I can come back to update you with cost once we get the EOB.

If your employer offers FSA I would highly suggest you use it. We usually load about $1,500 and that covers all our dental, vision and doctor, and RX expenditures. The RX prices are incredibly low, I've walked out with 90 cent prescriptions.

 

[Christine]

DH is medically retired, we receive Tricare Select for free. And I love it. I will say that DH gets all his medical through the VA so we don't pay for any of his medical. We are a young family so the plan is perfect for myself and our 2 teen daughters. We never have to worry about getting referrals, we pay 20% cost share after the tiny $300 deductible, and 20% of the negotiated rate isn't much. My regular dermatologist appointment is about $23 so less than most co-pays. Our daughters' sick visit to their pediatrician are about $30. We have never hit the $3,000 catastrophic. We just took DD1 to urgent care, where she had an x-ray, I can come back to update you with cost once we get the EOB.

If your employer offers FSA I would highly suggest you use it. We usually load about $1,500 and that covers all our dental, vision and doctor, and RX expenditures. The RX prices are incredibly low, I've walked out with 90 cent prescriptions.

Wow, thank you for posting your experience. Good to hear. I do have an FSA at work and always use it.
Do you go to the military base ever to fill your prescriptions or do you just use the retail or mail aspects of the plan. We are quite close to two military bases and thought maybe we could try those out.

 

[becauseimnew]

Wow, thank you for posting your experience. Good to hear. I do have an FSA at work and always use it.
Do you go to the military base ever to fill your prescriptions or do you just use the retail or mail aspects of the plan. We are quite close to two military bases and thought maybe we could try those out.

We don't live by a base anymore. Walgreens is our pharmacy.

I Just looked up my last dermatologist visit
Amount Billed $175.00
Other Ins. Paid $0.00
TRICARE Allowed $118.66
TRICARE Paid $88.99
Amount you owe $29.67

And just DD1's urgent care visit. The chargers were 15 minute office visit $174, xray $60, xray review $100.
Amount Billed $334.00
TRICARE Allowed $215.18
TRICARE Paid $161.38
Cost Share/Copay $53.80

 

[Christine]

We don't live by a base anymore. Walgreens is our pharmacy.

I Just looked up my last dermatologist visit
Amount Billed $175.00
Other Ins. Paid $0.00
TRICARE Allowed $118.66
TRICARE Paid $88.99
Amount you owe $29.67

And just DD1's urgent care visit. The chargers were 15 minute office visit $174, xray $60, xray review $100.
Amount Billed $334.00
TRICARE Allowed $215.18
TRICARE Paid $161.38
Cost Share/Copay $53.80

That sounds a lot like what I pay.

So when you go to a doctor's office (not Urgent Care), you don't have a flat co-pay going in? When I read Tricare Select info, It looks like I have a copay for places like a primary care or specialist visit. But it's clear you have a 20% co-insurance deal going on. That's why my current insurance has.

 

[becauseimnew]

That sounds a lot like what I pay.

So when you go to a doctor's office (not Urgent Care), you don't have a flat co-pay going in? When I read Tricare Select info, It looks like I have a copay for places like a primary care or specialist visit. But it's clear you have a 20% co-insurance deal going on. That's why my current insurance has.

I'm pretty sure we are paying the co-insurance, we never pay a "co-pay" during any of our visits.

 

[tvguy]

My FIL and his wife had Tricare in Texas and loved it. Paid nothing out of pocket for care. Not sure it matters but he was active duty for 28 years.
My MIL and her husband had Tricare in California and they loved it too. Also paid nothing out of pocket for care. I think he was active duty 25 years. Only issue they had was one provider was the local fire department and they tried to bill them $1,500 for an ambulance transport. They mentioned it to the local Veterans Advocate who said NOT to pay it because that fire district got federal funds to buy the ambulance, and one of the provisions of that grant was that the fire district take whatever Tricare paid for an ambulance as full payment. The advocate was furious, because he felt it wasn't a mistake, but an attempt by the fire district to get money they weren't entitled to. His reasoning? We have one of the largest concentrations of retired military personnel in the country, plus, at the time two active Air Force bases IN that fire district. They HAD to know that they couldn't bill for the ambulance. They fixed it immediately when called, but it was shady to say the least because I suspect a huge portion of their ambulance transports were of Tricare covered patients.

 

[Ms Bibbidi]

As a retiree, the Tricare benefit gets even better when you turn 65 and go with Original Medicare and Tricare for Life. Tricare also travels to all of the US and a lot of overseas locations. But, check with official Medicare and Tricare for all of your questions. https://www.tricare.mil/Publications/Handbooks

 

[Christine]

As a retiree, the Tricare benefit gets even better when you turn 65 and go with Original Medicare and Tricare for Life. Tricare also travels to all of the US and a lot of overseas locations. But, check with official Medicare and Tricare for all of your questions. https://www.tricare.mil/Publications/Handbooks

Thanks. Yes, I was aware that we'd switch from Select to Tricare for Life at age 65. It would be free then. My current health insurance drops down also at age 65, from the $420 per month to about 150 per month for us when we start with Medicare.

It all just makes me so nervous because I'm freaked out about a loss in "service" possibly. And once the choice is made, it's permanent.

 

[fly girl]

Thanks. Yes, I was aware that we'd switch from Select to Tricare for Life at age 65. It would be free then. My current health insurance drops down also at age 65, from the $420 per month to about 150 per month for us when we start with Medicare.

It all just makes me so nervous because I'm freaked out about a loss in "service" possibly. And once the choice is made, it's permanent.

I don't blame you one iota about worrying about it. Completely understand your concern.

We looked at Tricare when my husband retired from the military versus our current employer insurance. Problem we had was none of our current doctors accepted Tricare. Pretty crummy. Dh does go to the VA for a lot of things since it's free.

But sounds like you have done research and looks favorable in your area!

Sorry I don't have any advice, but good luck!

 

[Christine]

I don't blame you one iota about worrying about it. Completely understand your concern.

We looked at Tricare when my husband retired from the military versus our current employer insurance. Problem we had was none of our current doctors accepted Tricare. Pretty crummy. Dh does go to the VA for a lot of things since it's free.

But sounds like you have done research and looks favorable in your area!

Sorry I don't have any advice, but good luck!

Thanks. My other concern is that I'm not going to live here forever (lots of military here which is probably why many doctors here take Tricare). My goal is to always move somewhere with good medical facilities, but that doesn't necessarily equate to Tricare accessibility.

 

[nw6675]

My DH is retired and we have Select. Yes, for many services there are flat copays. Generally if your physician is affiliated with a hospital/health system then they are likely to take TRICARE. I have never had a problem finding a participating provider, even in areas with little military. The best part is no specialist referral for Select. There is also an annual out of pocket max ($3700ish) in case you have a lot of services at some point.