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andieb0316 · December 2012

Today I guess is my first official day as a military wife, my husband left yesterday for Basic Training for the Air Force, and my head is completely spinning! I'm still waiting for that first official phone call, so I didn't sleep hardly at all last night, I'm terrified that my phone will ring and I won't hear it. Right now I'll take any advice I can get! I have to try to go to MacDill AFB this week so I can get my military ID and get my insurance switched to TriCare, any recommendations for what plan to get? My husband doesn't go to the doctor for anything, but I've had really severe endometriosis, so I visit my OB/GYN quite often, I've had to have multiple surgeries and expensive medications, I just don't want to get the wrong coverage and end up paying a ton out of pocket, plus our son (he's due February 10th) has a good chance of having a rare blood disorder that will require not only a hematologist but he'll also need surgery in couple of years. I've always had excellent coverage through blue cross blue shield and I'm just not sure what to expect from TriCare. Any tips or advice would be amazing and greatly appreciated! I wish everyone the best of luck and Happy Holidays!

HisChamaoleGirl · December 2012

andieb0316:

Today I guess is my first official day as a military wife, my husband left yesterday for Basic Training for the Air Force, and my head is completely spinning! I'm still waiting for that first official phone call, so I didn't sleep hardly at all last night, I'm terrified that my phone will ring and I won't hear it. Right now I'll take any advice I can get! I have to try to go to MacDill AFB this week so I can get my military ID and get my insurance switched to TriCare, any recommendations for what plan to get? My husband doesn't go to the doctor for anything, but I've had really severe endometriosis, so I visit my OB/GYN quite often, I've had to have multiple surgeries and expensive medications, I just don't want to get the wrong coverage and end up paying a ton out of pocket, plus our son (he's due February 10th) has a good chance of having a rare blood disorder that will require not only a hematologist but he'll also need surgery in couple of years. I've always had excellent coverage through blue cross blue shield and I'm just not sure what to expect from TriCare. Any tips or advice would be amazing and greatly appreciated! I wish everyone the best of luck and Happy Holidays!

Are you still covered through blue cross blue shield? The reason I ask is it is my understanding that Tricare will be secondary insurance while blue cross blue shield would be your primary.

BLT20051 · December 2012

*HiS ChAmAoLe GiRL*:
andieb0316:

Today I guess is my first official day as a military wife, my husband left yesterday for Basic Training for the Air Force, and my head is completely spinning! I'm still waiting for that first official phone call, so I didn't sleep hardly at all last night, I'm terrified that my phone will ring and I won't hear it. Right now I'll take any advice I can get! I have to try to go to MacDill AFB this week so I can get my military ID and get my insurance switched to TriCare, any recommendations for what plan to get? My husband doesn't go to the doctor for anything, but I've had really severe endometriosis, so I visit my OB/GYN quite often, I've had to have multiple surgeries and expensive medications, I just don't want to get the wrong coverage and end up paying a ton out of pocket, plus our son (he's due February 10th) has a good chance of having a rare blood disorder that will require not only a hematologist but he'll also need surgery in couple of years. I've always had excellent coverage through blue cross blue shield and I'm just not sure what to expect from TriCare. Any tips or advice would be amazing and greatly appreciated! I wish everyone the best of luck and Happy Holidays!

Are you still covered through blue cross blue shield? The reason I ask is it is my understanding that Tricare will be secondary insurance while blue cross blue shield would be your primary.

This is correct. Also since you already have doctors and such I'd stick with BCBS if you can until you get to your first duty station.

HisChamaoleGirl · December 2012

Oops! I forgot to say "welcome!'

maganh91 · December 2012

When you sign up for tricare you can choose one of two plans. Tricare prime and tricare standard. They are both good but a little different. With standard, you can go to what ever doctor accepts tricare no questions asked and you don't need a referral for a specialist. But, you have a copay. Now, there is a cap on the copays and if you hit it you won't have to pay anymore for the rest of the year, but i think it's somewhere around 2,000.
With tricare prime, you don't have a copay, at all, anywhere. But, tricare assigns your doctor and you DO need a federal for specialists. Usually you go to the doctor on base and if they are full, which they frequently are, they will refer you to a local doctor. As far as OB/GYNs, I was going to a specific one before I got tricare prime and they let me continue seeing him. And they will work with you if you would really prefer a doctor other than the one on base.
Prescriptions are always free on base, I believe they are 3 at Walgreens.
Hope it helps!

reindeer12 · December 2012

Welcome! My husband is in the navy. We got married in Feb '12 and are expecting in August of '13. After much deliberation (I have a pre-existing condition), I decided to stay on Tricare Standard. If you decide to go for Prime, you have to pay extra (I think per month); you have no copay at your doctor, but you will HAVE to visit one on base in order to get a referral to a specialist. To me, keeping the doctors that I have was more important than switching or going back and forth. On Tricare Standard you have a catastrophic cap at 1,000 per year (starts in October). You can't pay more than that per year. Your deductible ($150- usually split over several visits) and all copays, and prescription copays go towards that amount. My copays were very small, you can reduce them even further by filling all prescriptions on base. My local Tricare office was very helpful in figuring all of these things out, and if your doctors accept Tricare, they will be able to help you too. Either way, since you aren't the one who is enlisted, you have to pay something. You will also need to decide for your son- standard or prime. Tricare can be a pain, but it can also be amazing, especially with tricky conditions or preexisting things. You can always decide to switch later, if you don't like whatever you choose. For the remainder of your pregnancy, since you are due so soon, stick with BCBS if you can, then switch things around when you have the time. And if you get confused about anything, go to your Tricare office and have them explain it to you in person. Good luck! And hopefully your sweet boy is completely healthy! -Lauren

Audaciousarica · December 2012

maganh91:
When you sign up for tricare you can choose one of two plans. Tricare prime and tricare standard. They are both good but a little different. With standard, you can go to what ever doctor accepts tricare no questions asked and you don't need a referral for a specialist. But, you have a copay. Now, there is a cap on the copays and if you hit it you won't have to pay anymore for the rest of the year, but i think it's somewhere around 2,000. With tricare prime, you don't have a copay, at all, anywhere. But, tricare assigns your doctor and you DO need a federal for specialists. Usually you go to the doctor on base and if they are full, which they frequently are, they will refer you to a local doctor. As far as OB/GYNs, I was going to a specific one before I got tricare prime and they let me continue seeing him. And they will work with you if you would really prefer a doctor other than the one on base. Prescriptions are always free on base, I believe they are 3 at Walgreens. Hope it helps!

The max catastrophic cap is $1000 which is nothing spread out over a year. And, it's pretty difficult to get even close to the $1000.

Audaciousarica · December 2012

reindeer12:
Welcome! My husband is in the navy. We got married in Feb '12 and are expecting in August of '13. After much deliberation (I have a pre-existing condition), I decided to stay on Tricare Standard. If you decide to go for Prime, you have to pay extra (I think per month); you have no copay at your doctor, but you will HAVE to visit one on base in order to get a referral to a specialist. To me, keeping the doctors that I have was more important than switching or going back and forth. On Tricare Standard you have a catastrophic cap at 1,000 per year (starts in October). You can't pay more than that per year. Your deductible ($150- usually split over several visits) and all copays, and prescription copays go towards that amount. My copays were very small, you can reduce them even further by filling all prescriptions on base. My local Tricare office was very helpful in figuring all of these things out, and if your doctors accept Tricare, they will be able to help you too. Either way, since you aren't the one who is enlisted, you have to pay something. You will also need to decide for your son- standard or prime. Tricare can be a pain, but it can also be amazing, especially with tricky conditions or preexisting things. You can always decide to switch later, if you don't like whatever you choose. For the remainder of your pregnancy, since you are due so soon, stick with BCBS if you can, then switch things around when you have the time. And if you get confused about anything, go to your Tricare office and have them explain it to you in person. Good luck! And hopefully your sweet boy is completely healthy! -Lauren

You do not pay extra for TriCare Prime. Also, if you have TriCare Standard your prescription coverage is through Express Scripts.

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