TRICARE?

Montana Jim

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Sep 18, 2006
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Well... I knew it would happen - eventually I'd need to call Tricare and try to get an appointment for an allergy shot. I've been retired since last December and was about to find out for myself how this whole deal would go down...

I was NOT disappointed - I have Tricare Prime, and I had to wait so long for an appointment at the on-base clinic I decided to go pay for the dang shot myself. LOL

I know there is NO lack of Tricare Medical stories out there... :tard:
 

Bridge End Farm

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Tricare is good :thumbsup:

The only problemI have wirh medial nsurance and still do is my primary always trys to get Tricare to pay first and I have to call and remind them for me they are secondary.

Still I am thankful many I know can not afford any insurance
 

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Montana Jim

Montana Jim

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I have no real issues with Tricare yet... I think the appointment issues are with the clinic here.
 

LadyDigger

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So far, all is well with Tricare Prime. We have our own Tricare approved Physician, who's great! My son needs an ENT Doc and appt was set up...no probs. Even have the Retiree Dental plan...works like a charm! And you can't beat the price for the plan!

And when it comes to my kids getting updates on shots and all, I just go to the clinic and walk in...I may wait a bit...but I don't make appts...I just go!
 

Bridge End Farm

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Ron and Ann said:
So far, all is well with Tricare Prime. We have our own Tricare approved Physician, who's great! My son needs an ENT Doc and appt was set up...no probs. Even have the Retiree Dental plan...works like a charm! And you can't beat the price for the plan!

you like the dental? I am thinking of it too
 

LadyDigger

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Bridge End Farm said:
Ron and Ann said:
So far, all is well with Tricare Prime. We have our own Tricare approved Physician, who's great! My son needs an ENT Doc and appt was set up...no probs. Even have the Retiree Dental plan...works like a charm! And you can't beat the price for the plan!

you like the dental? I am thinking of it too

I sure do. I have had the plan since they first started. When I retired, it was not even thought about. Then I got a letter in the mail about signing up and been satisfied ever since. Just make sure you get a dentist in your area that takes Delta Dental (Retired Military Plan). For awhile, it was hard around here (yeah, strange for a military town huh?)...to get a dentist to accept Delta Dental for Retirees...we did pay a pretty penny out of pocket for awhile (even with the insurance), but now we have one who's great. He is also a retired Navy Captain (Dental). I only have the dental plan cause of my boys....but for me, it is worth it. To me, it's a bit steep in price for a monthly deduction (which comes right out of your pension as does Tricare Prime)... but again, with the boys, it's worth it!
 

Bridge End Farm

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Ron and Ann said:
Bridge End Farm said:
Ron and Ann said:
So far, all is well with Tricare Prime. We have our own Tricare approved Physician, who's great! My son needs an ENT Doc and appt was set up...no probs. Even have the Retiree Dental plan...works like a charm! And you can't beat the price for the plan!

you like the dental? I am thinking of it too

I sure do. I have had the plan since they first started. When I retired, it was not even thought about. Then I got a letter in the mail about signing up and been satisfied ever since. Just make sure you get a dentist in your area that takes Delta Dental (Retired Military Plan). For awhile, it was hard around here (yeah, strange for a military town huh?)...to get a dentist to accept Delta Dental for Retirees...we did pay a pretty penny out of pocket for awhile (even with the insurance), but now we have one who's great. He is also a retired Navy Captain (Dental). I only have the dental plan cause of my boys....but for me, it is worth it. To me, it's a bit steep in price for a monthly deduction (which comes right out of your pension as does Tricare Prime)... but again, with the boys, it's worth it!

thanks I appreciate the info
 

LadyDigger

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Bridge End Farm said:
Ron and Ann said:
Bridge End Farm said:
Ron and Ann said:
So far, all is well with Tricare Prime. We have our own Tricare approved Physician, who's great! My son needs an ENT Doc and appt was set up...no probs. Even have the Retiree Dental plan...works like a charm! And you can't beat the price for the plan!

you like the dental? I am thinking of it too

I sure do. I have had the plan since they first started. When I retired, it was not even thought about. Then I got a letter in the mail about signing up and been satisfied ever since. Just make sure you get a dentist in your area that takes Delta Dental (Retired Military Plan). For awhile, it was hard around here (yeah, strange for a military town huh?)...to get a dentist to accept Delta Dental for Retirees...we did pay a pretty penny out of pocket for awhile (even with the insurance), but now we have one who's great. He is also a retired Navy Captain (Dental). I only have the dental plan cause of my boys....but for me, it is worth it. To me, it's a bit steep in price for a monthly deduction (which comes right out of your pension as does Tricare Prime)... but again, with the boys, it's worth it!

thanks I appreciate the info

You are most welcomed. If you have youngins'...it's worth it..get the family plan. I pay 98 a month, but without it, I would be paying forever on dental bills! The kids get 2 cleanings (checkups a year)...we schedule 2 appts each year...our dentist is very busy, so we schedule far in advance for their coverage cleanings. It was like 35 a month when it first started! I also have dentures and I get 50 percent coverage with dentures...which is better than nothing. That is something they added on a few years after the program started. And start calling around first to dentist near you to see if they accept the plan...we got lucky, ours is 5 mins up the road from the house! And call them all until you find one. You DO NOT need approval for a dentist, just one that accepts the plan and they do ALL the paperwork....you just pay your share directly to the dentist! It really is a very easy plan. Delta Dental will ALWAYS send you papers after your dental work was done...just for your records and it breaks down what is covered and what you paid, etc. You will like it! :) Keep Smiling!
 

Bridge End Farm

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Ron and Ann said:
Bridge End Farm said:
Ron and Ann said:
Bridge End Farm said:
Ron and Ann said:
So far, all is well with Tricare Prime. We have our own Tricare approved Physician, who's great! My son needs an ENT Doc and appt was set up...no probs. Even have the Retiree Dental plan...works like a charm! And you can't beat the price for the plan!

you like the dental? I am thinking of it too

I sure do. I have had the plan since they first started. When I retired, it was not even thought about. Then I got a letter in the mail about signing up and been satisfied ever since. Just make sure you get a dentist in your area that takes Delta Dental (Retired Military Plan). For awhile, it was hard around here (yeah, strange for a military town huh?)...to get a dentist to accept Delta Dental for Retirees...we did pay a pretty penny out of pocket for awhile (even with the insurance), but now we have one who's great. He is also a retired Navy Captain (Dental). I only have the dental plan cause of my boys....but for me, it is worth it. To me, it's a bit steep in price for a monthly deduction (which comes right out of your pension as does Tricare Prime)... but again, with the boys, it's worth it!

thanks I appreciate the info

You are most welcomed. If you have youngins'...it's worth it..get the family plan. I pay 98 a month, but without it, I would be paying forever on dental bills! The kids get 2 cleanings (checkups a year)...we schedule 2 appts each year...our dentist is very busy, so we schedule far in advance for their coverage cleanings. It was like 35 a month when it first started! I also have dentures and I get 50 percent coverage with dentures...which is better than nothing. That is something they added on a few years after the program started. And start calling around first to dentist near you to see if they accept the plan...we got lucky, ours is 5 mins up the road from the house! And call them all until you find one. You DO NOT need approval for a dentist, just one that accepts the plan and they do ALL the paperwork....you just pay your share directly to the dentist! It really is a very easy plan. Delta Dental will ALWAYS send you papers after your dental work was done...just for your records and it breaks down what is covered and what you paid, etc. You will like it! :) Keep Smiling!

No rugrats mmmmmmmm wonder if I can use it at the vet for my doggies cleaning mmmmmmmmm lol seriously I do appreicate the info
 

LadyDigger

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Military . com is a great site... been a member since forever LOL... also a great site to hook up with your shipmates!

Have ya'll ever checked out "Together we served"? It's a place where you can also locate shipmates you served with. It's pretty cool. Of course, my dau hooked me up and I had to get a page LOL
 

Don in SJ

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I have not gone for Tricare Prime, although maybe the yearly premium would pay for itself IF it helped cover what BC/BS does not. However, after talking to many others in my part of the state who retired, I was told Tricare Prime not worth it here. So, I am presently Federal BC/BS covered, Tricare Standard as a Secondary, although nothing has been submitted to them yet. I just enrolled finally for the Retirees Dental Plan effective August 1st for me.

I am a bit miffed by the lack of knowledge in trying to figure out how Tricare Prime works in my area, seem to get different answers from different folks, so I played it safe and kept my Federal BC/BS. I do wish I could use the Tricare for my prescriptions, but my most expensive one is not even on their list! I also read, Tricare would be secondary on Prescriptions, and that does not do me much good I guess, with the mail in Federal program, again, just confused on how it could work better for me. It would be cheaper for prescriptions thru the Tricare but it says BC/BS is primary! Grrrrrrrrrrrr.

Nearest base to me is McGuire AFB at about 50 miles and USCG station in Cape May, about 45 miles.

Don
 

LadyDigger

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UPDATE: Went to the website, found a doctor in my area who is enrolled...called them, verified Tricare Prime and my only initial cost is $12.00 for my son and set up appt. Called Tricare back, gave them the doc's fax number and new referral is being faxed to the Doc's office....whew! Tricare said they couldn't believe that the appt desk at CHKD was saying that and secondly, they are to set appts, not discuss payments etc....

So, it's not always Tricare....it's the place you are trying to set up appt's with...don't let them argue with you about it...you are only required to pay your co-pay (for me and my kids, that's $12.00 a visit per person). They file the paperwork and you will receive a bill for your share.

The main link for Tricare: http://www.tricare.mil/mybenefit/ProfileFilter.do;jsessionid=LKvp8hVpBRmj2GntpRp1p2hxHN0wdKLQGxhDbwkkyM0B2m52VJj4!1173450805?puri=%2Fhome%2Foverview%2FPlans%2FPrime

http://www.tricare.mil/mybenefit/home/Medical/FindingAProvider >>>Use this link for TRICARE to find a provider in your area.....don't just look for the military bases / hospitals.

Annmarie
*****************************
I am SO FUSTRATED.......Just talk to CHKD (Children's Hospital of the Kings Daughters) in Norfolk, and they are now telling me TRICARE PRIME WILL NOT pay for my son's hearing appt which has been approved for 5 visits. I have been on the phone with Tricare twice today and they tell me that IT IS COVERED and the doctor has received the paperwork regarding this. This referral was set up through my Primary Care Physician. This is NOT the fault of Tricare, but the Appt Desk at CHKD!!!! UGH!!!

They are arguing with me that my Tricare Prime will not pay for this and I am trying to tell them they will!! They are saying I have to pay 280 dollars before I can make an appt! WHAT THE $*@#($*($*((#()@)@)? This doctor is enrolled in Tricare Prime and I DO NOT pay anything, other than my $12.00 Copay at the visit until the claim has been filed by the doctor, in which I will get a bill for my share.

Tricare gave me another number for this doctor and it goes to the same appt desk I have been talking too all morning! So, now my son can not be seen until I pay this amount to CHKD first!!!! They are really ticking me off!!!!

So, I am in search for another doctor and Tricare said they would forward the paperwork to them for me to schedule the appt. If the doctor is ENROLLED, they are to accept Tricare Prime.... and the patient/sponsor is NOT required to pay anything but the copay and when the bill is sent in, they the patient/sponsor pays their share....that is how it works.

Thank God my Delta Dental Plan (retiree) works great!!! Never a problem and the dentist office does ALL the paperwork. We do, at the end of our appt, pay our percentage and sometimes we may pay a few dollars extra. Then when Delta Dental files the claims and gets all monies and benefits squared away...there have been some appts we did not have to pay a share...cause we have over paid, as per Delta Dental! :):):)

Ok...let's see if I can get another freakin' appt desk to come to their senses!!! Wish me luck!
 

LadyDigger

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Well, things have worked out well, since trying to get an appt. Tricare was absolutely wonderful and I chose another Specialist, they faxed the paperwork to the doc I picked and we had our first appt. I love this doc...him and his staff are absolute DOLLS!!! My youngest son has hearing loss in his left ear, I did not realized it was so bad :-[ .... They set up an appt for him for two days later to get a CAT SCAN. That went well, strange looking at these xrays and seeing my sons brains and all!!! And the next appt for the results is the 22nd...next week! I am very pleased in the services Tricare and this Doctor and his office has provided so far. As for my son, well, the doc is not sure why my son has loss some hearing and calls is "Asymmetric Sensorineural Hearing Loss", based on the exams so far. My son may need a hearing aid as well. :-[

Studies have shown also, that infants who spend time in Infant ICU grow to have hearing loss. My son was in NICU for a week, he was a preemie and only 4 lbs and 4 ozs. BUT, untill he looks at these xrays and do more testing, his hearing loss could be due to NICU, the many ear aches he had, or it could be genetic...so we don't know as of yet.

So, I have yet to have any compliants about TRICARE! I can't blame them nor the doctor I was trying to get an appt with the first time, it was the lady I was talking to at the previous doctors office to get an appt made!!!

Now tomorrow, my boys are gonna' be upset...it's shot day!!! Have to make sure their shot records are up to date and my youngest has to have this new one before entering 6th grade...TDAP or PDAP...whatever it's called. So, we have an appt at noon tomorrow for that! Got to keep their shots up!!!

Hope everyone has a wonderful weekend!!!
Annmarie
 

markmopar

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My son was in NICU for a week, he was a preemie and only 4 lbs and 4 ozs. BUT, untill he looks at these xrays and do more testing, his hearing loss could be due to NICU, the many ear aches he had, or it could be genetic...so we don't know as of yet.

funny you mention that. I was 4lb 8oz when I was born and have had lots of earaches and many ear infections.
 

LadyDigger

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markmopar said:
My son was in NICU for a week, he was a preemie and only 4 lbs and 4 ozs. BUT, untill he looks at these xrays and do more testing, his hearing loss could be due to NICU, the many ear aches he had, or it could be genetic...so we don't know as of yet.

funny you mention that. I was 4lb 8oz when I was born and have had lots of earaches and many ear infections.

Hmmm, that is interesting.... Dr. Debo said that studies have shown that the infant being in NICU has shown hearing loss as their ears are not fully developed. So, for adults being in the room, the noise level is very minimal to us...but to the infant, it's ... I guess very loud!

Now, my oldest (dau)...she was 6 lbs 7 ozs at birth and never spent a day in NICU...but also has hearing loss in her left ear, but not anywhere (as far as we know at this time) to my youngest (son). She also had alot of ear infections. Now, my middle child (son), had ONE ear infection and never spent time in NICU and his hearing is good! So, between my oldest and my youngest, the only thing they have in common are the ear infections...so it could be genetic, but also, with my son, spending time in NICU could have caused his hearing loss to be greater than my daus. And both are in the LEFT ear!

Have you been diagnosed with hearing loss?
 

markmopar

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My last hearing test was over 15 years ago and they said then that I had some damage that was consistent with my being around lots of loud cars and gunfire for years.
I do notice that whenever I leave the room or turn over the TV remote to my girlfriend the forst thing she does is turn it down.
I also think I have a mild case of tinnitus as I often notice ringing. My Mom has a pretty bad case.
 

Soverign#48

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Hello
I am retired USAF Medic 902/4NO 21 Yrs and have some good and bad experiences with Tricare Prime. But let's examine my last experience. My wife had a Cardiolite stress test at the base (NO CHARGE) It was a Positive Cardiolite (stress test). Next she need Cardiac cath (+) results were positive so while they were in her heart screwing around they put a stent in. She spent one night in the hospital. This cost me ZERO DOLLARS FROM MY POCKET!!!!! I only pay my annual Tricare fee and I think it's $460 a year. Do you have any earthly Idea what that would have cost me with Blue CROSS/SHIELD OR SOME OTHER INSURANCE? I am blessed I have what I have for my family and it was well worth 21 yrs of my service. They are attempting to change Tricare, and they pay less than Medicare to outside providers. This is something we must fight as a group and keep them from changing our earned benefit's!
I now work for the Veterans Administration and this is a benefit any Veterans should explore if they have no health insurance. If you are rated or not rated you can get some health care free for the service rendered to your country.
 

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