Standard question

hunterjumper102 · June 2011

Hey ladies,

I don't post here much but DH and I just PCS'd from GA to VA and were currently undergoing IF treatment in GA. To be able to go see the doctor I need to see for IF I have to get a referral and once again Tricare is giving me the run around with this whole process. So here is my question...for those on standard is a non-network provider considered any doctor that Tricare wouldn't cover say if I stayed on Prime? The IF clinic I want to go to does not accept Tricare and so I am wondering if I can use Standard to go to them since Prime won't cover this clinic.

sweetpea2003 · June 2011

Hi,

Unfortunately, if the doctor doesn't take Tricare Standard then you will be OOP.

Some doctors accept Tricare Prime patients (obviously this hinges on the patient getting the referral), some doctors only accept Tricare Standard (my dermatologist in Maryland was like this), and some doctors do not accept Tricare. If they don't accept Tricare then you have to find an RE that does.

Of course, you could always submit the paperwork to Tricare yourself and hope they reimburse YOU, but I wouldn't hold my breath with that.

Tricare Standard doesn't mean you can see any doctor you want whereever you want without checking to make sure Tricare is even accepted. It is just a program that gives you freedom to choose your doctors (from the list of doctors that take Tricare) and you are free from referrals and MTFs.

hunterjumper102 · June 2011

Thanks, the whole non-network provider thing confused me on what that really meant. Thank you.

mysticl · June 2011

There are network and non-network providers. My OBGyn is in network, my pcp is non-network but still takes Tricare. The provider can tell you if they accept Standard but Tricare is the one to tell you if they are in network or not. At least that was the case for me.

hunt2005 · July 2011

The above isn't true. All of my meds were covered, as well as testing, and for the IUI process since I went to the military RE, all I had to pay for was the actual procedure ($250). The total I would have paid out of pocket is in the thousands. IVF through the military clinic would have been $5000-8000 depending on protocol.

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