Tri care prime or Standard when ttc? — The Bump
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Tri care prime or Standard when ttc?

Which is better when ttc? Prime or Standard? 
SSgt wife

Re: Tri care prime or Standard when ttc?

  • If you want to choose your own doctor when you become pregnant, you might as well switch to Standard now. If you want to be seen on base, do Prime. While you are TTC, it doesn't really matter. Unless you are dealing with infertility, you won't be seeing a doctor until you are pregnant or are ill. You need to decide what kind of flexibility you want AFTER you are pregnant. For me, I switched to Standard midway through my pregnancy, and I wish I would have done it sooner.
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  • TRICARE Standard is ONLY ALL INCLUSIVE ONCE YOU GET PREGNANT, not during conception.

    You WILL have to pay 15%-20% of each provider visit until you are officially (ie the OB states that you are pregnant - so that visit is not paid for as well) pregnant. 

    And you will have to meet your fiscal year annual deductible before the % kicks in.

    And while you DO get a Catastrophic Cap of $1000 per fiscal year, you need to be 100% sure that you are capable of pulling that $1,000 out of your pocket incase you have an emergency.

    Mind you, if you get pregnant at the end of the fiscal year, say in June and you fork over your Deductible and your out-of-pocket %s, you will start ALL over again October 1st.

    I am NOT trying to talk you out of swithing from Prime to Standard, I just want people to realize that for ease of service (ie not using an HMO), there are costs.

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  • We had to do IF treatments (IVF) and opted for standard (although the majority of IVF expenses was not covered, some were).

     

    GL! 

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  • Thank you all for your advise. Just so i'm clear... if i do decide to stay on prime can i find an ob that will be able to stay consistently with me until I deliver and also Will I have to pick a different Dr to deliver?
    SSgt wife
  • imagemlssharrison:
    Thank you all for your advise. Just so i'm clear... if i do decide to stay on prime can i find an ob that will be able to stay consistently with me until I deliver and also Will I have to pick a different Dr to deliver?

    If you stay with Prime you can only pick a civilian doctor if they let you. I was assigned to a MTF and not allowed to change to go in town. I switched to Standard before I got pregnant because I did not want to go to the Navy drs/hospital. I love Standard and will never go back to Prime.   

  • If you have problems ttc I would stick to prime. I have gone to the doctor at least one time every week, if not more, since march. I have had a couple of surgeries, tons of ultrasounds, blood work etc in addition to my doctor visits and those co pays would have really added up.  I havent had to pay a cent. I had no problem getting a referral to an awesome RE and have had no problems getting the referral renewed many times (they were only for 16 visits each). I love being on Prime

    Married 11/27/09 and TTC right away
    Dx: Complete septate uterus with cervical duplication, endometrial polyps, PCOS, endometriosis, hypo thyroid, luteal phase defect
    4 uterus surgeries to correct my complete septum and to remove polyps and 2 years of seeing the RE, medicated cycles and IUIs
    Baby 1 and 2: BFP 3/3/11 with 2 babies EDD 11/1/11, M/C 4/6/11
    Baby #3: 8/11 pregnant EDD 4/27/11 and m/c:(
    Baby #4: 10/12/11 BFP! EDD 6/16/12m/c 10/26/11
    Baby #5: 3/13/12 BFP! EDD 11/25/12 ANOTHER m/c :(

    Baby #6: 2/14/13- BFP! EDD 10/24/13, CP 2/19/13
    Baby #7: 3/15/13- BFP! EDD 11/27/13, another CP
    Baby #8.  BFP 5/19/13 EDD 1/22/14. 8 was not our lucky number

    4th septum resection on 5/31/13.
    Baby #9: 6/29/13 BFP. C section scheduled for March 5th!

    My miracle baby was born March 5 at 9:33am. He was 8 lbs 12.5 oz and 21.25 inches long!

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  • I have prime and I love it. I haven't had any trouble with picking doctors or anything. I've been able to pick my OB and be seen off base without any trouble on a couple of occassions.
  • I'll be high risk and potentially seeing a RE as well. I'm on standard so that I can be sure I can find a Dr I enjoy rather than one I'm told to go to.
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  • usually when they are sending you off base you get to pick who you want to go to, they dont tell you. do your research before your referral appointment and let them know who you want. If you end up not like them you can switch to any in network provider and it is pretty easy

    Married 11/27/09 and TTC right away
    Dx: Complete septate uterus with cervical duplication, endometrial polyps, PCOS, endometriosis, hypo thyroid, luteal phase defect
    4 uterus surgeries to correct my complete septum and to remove polyps and 2 years of seeing the RE, medicated cycles and IUIs
    Baby 1 and 2: BFP 3/3/11 with 2 babies EDD 11/1/11, M/C 4/6/11
    Baby #3: 8/11 pregnant EDD 4/27/11 and m/c:(
    Baby #4: 10/12/11 BFP! EDD 6/16/12m/c 10/26/11
    Baby #5: 3/13/12 BFP! EDD 11/25/12 ANOTHER m/c :(

    Baby #6: 2/14/13- BFP! EDD 10/24/13, CP 2/19/13
    Baby #7: 3/15/13- BFP! EDD 11/27/13, another CP
    Baby #8.  BFP 5/19/13 EDD 1/22/14. 8 was not our lucky number

    4th septum resection on 5/31/13.
    Baby #9: 6/29/13 BFP. C section scheduled for March 5th!

    My miracle baby was born March 5 at 9:33am. He was 8 lbs 12.5 oz and 21.25 inches long!

    image"">

  • I was on Prime until I got my BFP and then switched to standard.  Although a couple days after I switched to standard I got a letter stating I could switch {while on prime} to an off post OB because of a lack of doctors on post.  If I had known I wouldn't have switched.  Bummer.  But whatever.  
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