Tricare question

croberts22

DH got word that because he is getting deployed (see post below) we were both placed on Tricare as of March 4th.  He is National Guard and currently works for the state of Ohio, so we have Aetna insurance. 

I know that regardless, we will be cancelling me from his plan, because Tricare is secondary otherwise and it pays much better than Aetna. 

Question is, I was automatically enrolled in Standard, but with the option to upgrade to Prime Remote. Which one is better? Does anyone else use Prime Remote?  And how hard is it to meet the requirements of getting the referrals and everything if you are going to Civilian doctors?  (We aren't near a post with medical facilities).  Or if you are on Standard, how much do you pay?  I was able to find my midwife in the list of doctors, but not my primary care physician.  I don't want to give up my PCP as it's literally the only doctor I've seen since I was born. 

I feel so overwhelmed with the whole Tricare thing.  We are uber busy this week and half to have the paperwork to switch to Prime in by Friday if we want it to take effect before May 1. 

GreenFlamingo7

The amounts that you would pay on Standard are available on the Tricare website.

shall923

I have no idea how Prime Remote works but I have Standard and will never go back to Prime. I was on Prime for maybe 3 months and couldn't get an appt or a referral. At the time we were living in VA Beach. The bases there are very busy.

I had my daughter on Standard and the hospital stay cost $63 for the nightly room charge. There is a yearly deductible that is based on your husband's rank. However, maternity care is covered completely for free. I will happily pay the deductible for me and DD in order to go to my own doctor and not have to go to the base.

krissywave

Just about everyone I know once they get prego they switched to standard.  Most of them feel that standard makes it a lot easier for care for prenatal and birth of their child.

ufsandra85

I have prime (not remote) and I love it. I go to a Yale specialist every single week, get an ultasound every week and dont pay a cent. I think for prenatal care you dont pay anything no matter if yoa have prime or standard. You are automatically in Standard but that doesnt mean you can see anyone. You still have to see doctors in network so if you doctor doesnt accept standard you might have to switch.

renaeml

I was in your situation months ago.  They send you paperwork for standard and you fill it out.  If you become eligible for Prime Remote - then you HAVE to fill out new paperwork and they don't tell you that.

The difference for me between Prime Remote and Standard is co-pays and deductibles.  With PR - I can see any provider that accepts Tricare and don't have to worry about referrals since it is a "remote" area.  While accidentally on standard - we were responsible for co-pays and deductibles and it was a huge mess.  Now it's all sorted out but we did have to pay for fees we wouldn't have if it would have been set up properly in the first place.

HRO had to help us - TriWest was a giant pain to work with.  Good luck.

v_tonona

I would talk anyone out of prime if it ment you had to go on base. This is my own horrible experience. If you in an area that isnt so bad then thats your choice. I have to go to Eglin AFB and they are so incompetent its scary. 

standard- you dont pay anything for prenatal. you pay 20% of all copays so usually 12 dollars for other visits like the normal doctors office or dentist stuff like that. 

applejackrach

We have tricare prime (but not remote) and live near Cincinnati. Health Net Federal Services is the Tricare North Region provider. From what I understand, Tricare Prime Remote (TPR) has better access to providers and specialists. I would definitely call Health Net Federal Services to ask about your area, or use their website to search for doctors in your area. TPR has much lower co-pays than Standard. Good Luck.

squirrly

Prime Remote wasn't an option for me - either Standard or Prime.  I stuck with Standard because I wanted control of what doctors I see - that's worth the co-pay for me.  I think it cost me $8 for a regular "I'm sick" visit, $160 for all of the ultrasounds/bloodwork/etc., and that's it so far. 

If Remote means you can choose your doc and just have to have a token referral or something, I'd probably go with that, but I wouldn't deal with regular Prime and have to use the MTF near here, personally.  (I'm in the North region, btw.)  I have friends in Texas who have had horrid experiences with Prime as well.