Tell me about switching to Tricare Standard — The Bump
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Tell me about switching to Tricare Standard

I am FED UP with our MTF's pathetic excuse for a pediatric clinic and have decided that I'm switching DS to Standard. Any input on your likes/dislikes of going Standard vs. Prime?

At this point, I would so much rather pay a few co-pays here and there than have to deal with our peds clinic and their horrible practitioners (and lack of available appointments). At least he'd be seeing the SAME doc each time rather than sometimes the NP, sometimes the Pedi, but usually we end up with a referral off base because our clinic is always booked solid. And in that case, no information is transferred to his chart, so I always have to recount everything that went on, what the diagnosis was, what was prescribed, etc. And I'm so over it.

TIA.

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Re: Tell me about switching to Tricare Standard

  • Have you tried requesting a PCM change to a civilian pedi? We are at Hunter and DH went to the Tricare office and filled out some paperwork and was approved 5 days later to see a civilian doctor. The kids were able to stay on Prime that way, I still go to the MTF and its enough to make me want to switch to Standard.
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  • We dealt with the same thing at our MTF's pedi clinic.  We actually saw one doctor who wanted to refer DD for early intervention because she wasn't talking in 2-3 word sentences at 14 months.  Moron.  Based on that and several of the issues you mentioned, we requested to stay on Prime and be seen by a civilian off base.  We had no problem having the request approved so you may want to try that first.  We just made sure to have all of our grievances typed up (access to care, continuity of care)  and brought it into the Tricare office and stood our ground. 

     

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  • I've tried to get a referral off base, but our entire base has been "frozen" for the past two years and is denying all requests to be seen by a civillian on Prime. Believe me, I tried. I had the Frigate office convinced, and all I needed was DS's PCM's approval. She refused. Add that experience to my overall disgust for our peds clinic.
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  • Wtf is Frigate? That should be TRICARE. Stupid autocorrect (posting from my phone). ;)
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  • I love standard.  I like seeing the same doc every time and being able to pick that doctor. 

    I'm expecting my first bill since DD was born.  I got an EOB from Tricare that some part of her immunizations we would have to cover, but I haven't gotten the bill from the pedi yet, so I'm not sure how much we will have to cover.  

    Although I've never been on Prime, so I'm not sure how it all relates, but I'm very happy with standard. 

  • We are both on Standard. I love it. So far I have paid $30 total for DD to have 2 & 4 month shots. I think it will be less than that once we meet the deductible. That is more than worth it. The doctor remembers us and we always get an appointment.


  • Here's my experience: best decision I ever made and I will never ever ever go back to Prime! We hit our cap last year and will again this year because DD requires some super expensive vaccines due to being a preemie, but even paying $1K a year is SO worth the fact that we see who we want, when we want, no referrals, no waiting three days for a sick visit. Piece of mind is priceless : )

    P.S. I'd also suggest seeing about a civ Dr on Prime first, which is what we initially did for DD, but that still left me at a HORRIBLE MTF clinic, so switching us all over means 2 (and soon to be 3!) people covered at our own Drs for the same deductible and cap per year.

    P.P.S. If you are really concerned about the standard of care you're receiving, also do not forget to use the ICE process.

  • Here's my experience: best decision I ever made and I will never ever ever go back to Prime! We hit our cap last year and will again this year because DD requires some super expensive vaccines due to being a preemie, but even paying $1K a year is SO worth the fact that we see who we want, when we want, no referrals, no waiting three days for a sick visit. Piece of mind is priceless : )

    P.S. I'd also suggest seeing about a civ Dr on Prime first, which is what we initially did for DD, but that still left me at a HORRIBLE MTF clinic, so switching us all over means 2 (and soon to be 3!) family members covered at our own Drs for the same deductible and cap per year.

    P.P.S. If you are really concerned about the standard of care you're receiving, also do not forget to use the ICE process.

  • The ONLY qualifier I have about switching to Standard is making sure that the Pedi you want to go to not only ACCEPTS TRICARE Standard payments (standard is about the same as medicare...which is low), but accepts New Patients AND will Submit all claims for you.

    I know of many providers who will take TRICARE Standard Patients at the TRICARE reimbursement rates, but will make the patient pay all upfront. 

    HOWEVER, I never once regretted going Standard when I was pregnant and will more than likely stay Standard when we go back to the Fort Walton Beach Area if they cannot give us a civilian PCM.

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  • imageseastar77:

    Here's my experience: best decision I ever made and I will never ever ever go back to Prime! We hit our cap last year and will again this year because DD requires some super expensive vaccines due to being a preemie, but even paying $1K a year is SO worth the fact that we see who we want, when we want, no referrals, no waiting three days for a sick visit. Piece of mind is priceless : )

    P.S. I'd also suggest seeing about a civ Dr on Prime first, which is what we initially did for DD, but that still left me at a HORRIBLE MTF clinic, so switching us all over means 2 (and soon to be 3!) people covered at our own Drs for the same deductible and cap per year.

    P.P.S. If you are really concerned about the standard of care you're receiving, also do not forget to use the ICE process.

     

    Just wondering what docs you started out with if you're at Campbell.  We're at Campbell, on Prime, and my son is seen at a pediatrician off post and I've never had to wait 3 days for a sick appointment.  I got to pick which pedi I wanted him to see (there were none in the area that didn't accept Prime). 

     

    I totally understand wanting to go on Standard though - we were at Lee before Campbell and had we been there longer than 6 months, I would have switched my son to Standard in a heartbeat.  I was on Standard while pregnant and for the first 6 months of DS's life and it was a great experience!

  • imageJENandJEH:
    imageseastar77:

    Here's my experience: best decision I ever made and I will never ever ever go back to Prime! We hit our cap last year and will again this year because DD requires some super expensive vaccines due to being a preemie, but even paying $1K a year is SO worth the fact that we see who we want, when we want, no referrals, no waiting three days for a sick visit. Piece of mind is priceless : )

    P.S. I'd also suggest seeing about a civ Dr on Prime first, which is what we initially did for DD, but that still left me at a HORRIBLE MTF clinic, so switching us all over means 2 (and soon to be 3!) people covered at our own Drs for the same deductible and cap per year.

    P.P.S. If you are really concerned about the standard of care you're receiving, also do not forget to use the ICE process.

     

    Just wondering what docs you started out with if you're at Campbell.  We're at Campbell, on Prime, and my son is seen at a pediatrician off post and I've never had to wait 3 days for a sick appointment.  I got to pick which pedi I wanted him to see (there were none in the area that didn't accept Prime). 

     

    I totally understand wanting to go on Standard though - we were at Lee before Campbell and had we been there longer than 6 months, I would have switched my son to Standard in a heartbeat.  I was on Standard while pregnant and for the first 6 months of DS's life and it was a great experience!

    My bad experiences were at Ft Benning. DD was on Prime seeing civ, but I had a terrible time a) being seen and b) having a Dr who knew how to treat me at the MTF. That's when I made the switch to Standard. Would've switched back at Campbell, but they wouldn't see me for high risk pregnancy until 12 weeks and I needed earlier intervention, so I've stuck with Standard. (As for sick visit waits, I was just referring to how long my friends have had to wait before for the MTF ped clinics with their kids. I've never had to wait at all with civ Drs : )

  • Thank you for all of your input!

    I just spoke with a friend this morning who told me that our base is now allowing civilian referrals on Prime. So I'm heading to the Tricare office this afternoon to see if I can make this happen. If we weren't PCSing in two months, I'd go ahead and switch to Standard anyway. But for some reason, I'm thinking that it'll be easier to PCS with all of us on Prime, rather than 2 on Prime and 1 on Standard. Who knows if that's true, that's just my personal logic. :)

     

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