Fort bliss / tricare prime — The Bump
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Fort bliss / tricare prime

I found a clinic off post that has been recommended by several women. I called and she said they only take tricare standard, not tricare prime. I called tricare, and asked if it was weird they take the lower insurance and not the upgraded. The woman thought it was weird too. I guess we could downgrade insurance but then we'd have a copay? I'd prefer not to see a dr on post for this pregnancy. Any one experienced down grading insurance to see a recommended dr? Can anyone suggest a great doctor to see in El Paso?

Re: Fort bliss / tricare prime

  • That is strange. I'm running into a similar issue when trying to find a new PCM where I'm being told the drs are at their limit for tricare patients. The dr office tells me it's a tricare issue and tricare tells me it's a dr office issue. This happened with 3 drs so I gave up and kept mine.

    You can switch to standard and maternity care is still covered 100% except for a small amount each day for the hospital stay. But depending on rank, you may be stuck with it for a full year. (E-5 and above) Make sure you do your research before making that choice.

    Also from what I'm hearing from others, the MTF's are not giving many referrals off-post if it's something they can handle.
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    Pregnancy #1 EDD 1/20/13, D&C for unexplained miscarriage at 12w
    Pregnancy #2 EDD 8/28/2013, Carson was born on 6/28/2013 at 31w - spent 37 days in the NICU
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  • Tricare Prime and Tricare Standard are different types of coverage one is not necessarily an "upgraded" version.  When you have Prime you are seem primarily on post for care (dental and vision are different) unless you are referred off post by your PCM.  When you have standard you can be seen on post but there are restrictions and you will only be seen if there is availability due to Tricare Prime members having priority, you usually choose your in network doctor and will have a small copay.  I was referred off while I was on Tricare Prime due to the influx of pregnant soldiers who are given priority.  I went with Dr. Gustavo Martell on the East Side.  Hope this helps! 
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  • Yes thank you, I was originally told by tricare, with Prime we could see out of network. Figuring out that is not the case though. Where did you deliver with dr martell? I am planning on delivering at Sierra Providence Eastside. If they're as nice and helpful in person as they were on the phone ill be happy. First baby at military hospital was a nightmare, "due to the sequester" was the excuse they told me thru my whole stay.
  • I'm at ft bliss and just had a baby off post. I delivered at umc. I had to switch to standard because it wad my choice to go off post.
    The only way you can keep prime and go off post is if its a medical problem or the clinics are full and they refer you out.

    I didn't read all the words, so not sure if someone else mentioned this.

  • LaBellaVidaLaBellaVida member
    edited December 2013
    Ps. I saw Dr. heidi Lynn. She's up at Texas tech, right next to umc. (university medical center)

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