Has anyone used/know anything about US Family Health Plan? It is a Tricare option only available in a few parts of the country. From what I can tell, it seems really similar to Prime except everything is done through civilian doctors instead of MTF, and the network of specialists available is much larger. We live 2.5 hours away from the nearest MTF so we are currently using Prime Remote for civilian doctors.
The reason I'm thinking it might be a good option for us is that my REcis specifically listed as in network for USFHP. I am confused about whether or not my RE is in network for Prime. Up until now Tricare has covered everything for my appointments. I recently got a statement saying "provider may bill you $83", which is not much, but still made me wonder if something was up with the coverage. Well, a few days later I got a call from the REs office saying they never got a referral from Tricare (which confused me, I thought the PCM wrote referrals, and Tricare wrote authorizations...). I come to find out that my PCM never wrote the referral! They say they didn't submit it because they were not sure if tricare covered fertility treatments. (What? Um, how about calling them, looking it up online, or asking me, and honestly why should it matter to them? I have the right to choose to pay OOP, or not, if my insurance won't authorize!). This is also the first time I have ever gone through the referrals process so I did not know until now, that I should have received a copy of the authorization (or denial) in order to know it had been processed. I just didn't think to question the authorization status because all the tricare statements said everything had been covered "provider may bill you $0". Anyway, I'm stuck in this whole mess of trying to get a back dated referral, blah blah blah. Upon further investigation I found that while my RE's office is listed as an in network facility, none of the doctors in the office are listed as being on network. I'm not sure if that means tricare will authorize the referral or not....BUT my RE is listed as in network for USFHP, hence my reason for considering it.
If any of you guys have used USFHP I would appreciate hearing your thoughts! I think it's looking like a good option at the moment, but I don't know if there is something I'm not seeing. We are going to a Q&A on it this afternoon, but some real life experiences would be good too.