Soooo confused....

Chippmunk · August 2011

OKay, so when my DH was put on his Active orders, he wasn't put on Title 10, he was put on NG-32... (Pretty sure I got those right...) Well, when this happened, I called Tricare to make sure we were still covered since we got a letter in the mail saying we no longer qualified for Reserve Select.

They said yes, my DH had been transfered to Prime and I had been put on Standard. This was fine with me, personally. However, she told me that once he deploys and is on true Title-10 orders, I would be transfered over to Prime as well.

So I asked her if I would be able to continue seeing my Doctor when on Prime, because as far as I know, on Prime if you live within 50 miles of a Military Base, you have to go to the Military hospital and see the Military doctors. She told me I would most likely have to change my doctor over to one at the Base hospital because we're not over 50 miles away from the Base. We're 49.

Does anyone else have more experience with this? Do I HAVE to switch to Prime? If so, do I really HAVE to switch my Doctor?

I really want to continue seeing the doctor I've been seeing. I mean, I'm halfway through my Pregnancy. It seems like it would suck big time to switch to new Doctor at this point. Thanks in advance for any help and advice.

LuluP82 · August 2011

I don't think they can just switch you from Standard to Prime without you actually doing the switching. I haven't dealt with reserves at all, but as far as I know, I can walk into the tricare office anytime and switch from Prime to Standard. I know I can't switch from Standard to Prime for like a year after switching to Standard (if that makes sense) due to H's rank, but I can switch to Standard anytime I want.

I don't blame you for not wanting to switch halfway through, that's insane.

punkin1180 · August 2011

I just recently got married and my husband is on title 10 orders (he is part of the National Guard), and when I was enrolled in DEERS and Tricare I was automatically put on Standard. I can switch to Prime if I choose, but it's my choice. I don't see why they would automatically switch you when I wasn't automatically rolled onto Prime when he is on Title 10. I hope that makes sense.

Chippmunk · August 2011

Thanks for the input, y'all. I was just confused, I guess. The way the woman on the phone explained it made me think I'd automatically be switched. I'm going to call back in the morning and see if they'll explain it to me more carefully.

Hopefully the woman I talked to won't answer the line I'm on again. XD

LuluP82 · August 2011

Also ask if it's an option to be switched or an automatic thing you have no control over

BLT20051 · August 2011

I'm active national guard on title 32 orders and I live 45 miles from the closest base, an hour and a half drive(stupid expressways) and they still make me go to the MTF. I tried to apply for Prime Remote and was denied. My husband is my dependent and he also has to go to the MTF. You should be put on standard automatically, you have to enroll to be in tricare prime. At least that was my experience. Even though I was told I had to be on prime as the SM, I still had to enroll in it because I was automatically put onto Standard. Honestly, I'd wait until he gets put on title 10 and then contact the TriCare office. They can't do anything until he has those orders anyway because you have to have 30 days worth of orders to be eligible for coverage. If they make you go to prime and the nearest base, see the doctor you're assigned to and request a referral. My PCM referred me out to an OBGYN I was already seeing. Sometimes the doctors are an easier solution than going through Tricare directly.

Joie80 · August 2011

Interesting. I live about 20 miles from base and I am able to go to the OB here in town...

DueinAug11 · August 2011

Let me tell ya' that most Tricare reps have no idea what they are talking about. Very rarely will you find a person who knows what they are talking about. I have had friends who have problems even with Active Duty Tricare. I would say wait till you get your Tricare Prime Remote packet, and that has better information. From my personal experience, we live about ~50 miles from a military hospital so we qualify as Remote. My DH got deployed last year we got put on Prime Remote and I stayed with my doctor because he was within the network. Right after we got active duty orders I called like you did and since my DH was pre-deployment training in GA, we live in CA, I was told I didn't even qualify for Tricare because we weren't living together at the time. I told the lady that unless spouses are now allowed to deploy with the soldier then that would be a problem. If your doctor is in the network and they take Tricare you can stay with them.

LuluP82 · August 2011

Bacon+lettuce+tomato:
I'm active national guard on title 32 orders and I live 45 miles from the closest base, an hour and a half drive(stupid expressways) and they still make me go to the MTF. I tried to apply for Prime Remote and was denied. My husband is my dependent and he also has to go to the MTF. You should be put on standard automatically, you have to enroll to be in tricare prime. At least that was my experience. Even though I was told I had to be on prime as the SM, I still had to enroll in it because I was automatically put onto Standard. Honestly, I'd wait until he gets put on title 10 and then contact the TriCare office. They can't do anything until he has those orders anyway because you have to have 30 days worth of orders to be eligible for coverage. If they make you go to prime and the nearest base, see the doctor you're assigned to and request a referral. My PCM referred me out to an OBGYN I was already seeing. Sometimes the doctors are an easier solution than going through Tricare directly.

This doesn't always work. My PCM is a civilian since I live far enough from base to not have to go to the MFT for PCM. She referred me to a civilian OB. Tricare denied the request and sent me to base. I ended up liking the hospital and OB clinic on base so it's not huge issue, but different hospitals have different rules. At ours, the first X number of pregancies per month belong to the base hospital. After they reach capacity, they start referring out.

It has nothing to do with distance (I live too far to see a PCM on base, yet having a child on base is not an issue...call me crazy, but I'd rather drive extra time to go get a routine Pap than to give birth!) and the doctors can't do that much either, unless they find that you need specialty care that base can't provide for you.

The easiest way if you want to see a specific doctor is to switch to Standard, and not play the Russian roulette of getting your referral approved.

Epeter1 · August 2011

I had the same problem when DH and I got married. The closest mil. hospital is 30 mins away, but the closest mil. hospital with an OBG is more then 2 hours....but because my standard doc is only 30 mins if i were on prime I woulda had to go to the mil hospital 2 hrs away.

You can stay on standard and stay with your doc. I dont think they can switch you to prime unless you authorize it

Soooo confused....

Re: Soooo confused....

Choose Another Board

Search Boards