I have Standard.
It is still very cheap, but I need the flexibility and time saving that comes with Standard. As a busy mom (who works a little bit), I dont have the time to make an appt. with my PCM, wait for that appt, etc. all with the desire to get a referral to the specialist I need (eg: a scary mole that needs to be seen by the dermatologist - I want to just make an appointment with the dermatologist). I just simply don't have time for all of that.
So I pay a little bit extra to be able to choose my doctors, not need referrals, etc. The cat cap is $1000 (and that is a FAMILY cap - not an individual cap). Yes, that is a decent chunk of change, but in the health insurance world it is NOTHING. And the deductibles are low.
I personally really don't have anything against military medicine. I was on Tricare Prime for awhile and, for the most part, was happy. I still advocated for myself and made sure I was getting good care. I really went to Standard when I needed more choices and was working a lot and couldn't take time off to have two doctors appointments for every specialist ailment.
My advice is to do your research on Tricare's website. Honestly, Tricare really pushes Prime. If you go to a patient rep they tend to be like, "eeeeeek, it is pricey to switch! and you can't switch back for a loooooong time" kind of thing. In reality, it is up to you to decide whether you can afford it and care about the benefits.
Kate ~ 7/3/09 *** Connor ~ 11/11/10
4 miscarriages: 2007, 2009, 2013, 2014
No more TTC for us. We are done, and at peace, as a family of 4.
"Suffering has been stronger than all other teaching, and has taught me to understand what your heart used to be. I have been bent and broken, but – I hope – into a better shape.” — Charles Dickens
Personally, I think it has to do with the care available at your current location. Where we are currently the military system is flat out overwhelmed. So much so that often the standards of care just can't be met in regards to offering appointments within acceptable timeframes, etc.
At our last duty station I was on Prime and perfectly happy with it but when we moved I chose to switch to Standard in order to birth where I chose. I've remained on Standard because it is next to impossible to get an appointment within a reasonable amount of time and, like the pp said, my time is limited so I can't exactly be at the mercy of whatever the clinic or hospital has available. I'm willing to pay out of pocket for a bit more flexibility.
However, when we move soon I will probably re-enroll into Prime and make my assessment of the situation then.
I have standard. I am happy I have standard because where I live, if you have prime, you HAVE to go to a military medical facility and been seen by a military doctor AND deliver your baby at the military hospital. There isn't a choice because we live so close to 2 military hospitals.
I personally don't like being told what doctor I can see or which hospital to deliver at. I also don't like having to make 2 appointments every time you need to see a specialist about something. I think its redundant and stupid.
As for the costs...its super cheap to be on standard. I use to have Blue Cross and the copays were ridiculously high and far more expensive than what we are paying now. I would definitely do your research and discuss it with your spouse. Once you drop Prime, you have to wait until open enrollment to join again.
saywhut82:Once you drop Prime, you have to wait until open enrollment to join again.
ArmyQM:saywhut82:Once you drop Prime, you have to wait until open enrollment to join again. Unless it's changed recently, dependents of E-4 and below can change back immediately while those E-5 & above must wait a year.
Gotcha...my hubby is E-5...so that's what I was told. Didn't know it was different for E-4 and below so thanks for the info.