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Thread: Military Tricare

  1. #1

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    This is more about financial planning then investing. I know we have military that come here. Thought you would find this of interest:

    http://www.military.com/MilitaryRepo...SRC=miltrep.nl

    The TRICARE system stands a chance of becoming virtually unusable for many servicemembers and retirees because the payment rate to physicians continues to go down and is expected to drop another 4.3% in January, 2006.

    Be careful. I understand it is hard to get refunds or reimbursements if your doctor goes over the limit that TRICARE will cover. May be wise to think about supplement insurance. I know Jan 06 is six months away - but something to explore while you got the chance.

    Thank you for your service. I appreciate it greatly.


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  3. #2

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    I know that this is an old thread. I am trying to reach out to military retirees using Tricare Prime. I am retiring in March, 2019 from USPS and at the same time I will turn 60 years old. I am a retired reservist and was told that I will qualify for Tricare Prime for my health insurance aside from Military pension aside from USPS pension.
    Currently, I am under spouse's FEHB. I don't want my spouse to discontinue covering me under FEHB's Blue Cross BlueShield if Tricare Prime doesn't live up to expectations . I guess my questions are:
    1. Anybody has experience with Tricare Prime? Reading from previous threads, I gather that it is hard to get an appointment and that you have to be "in network" to save on copayments and that you need referrals before seeing a specialist unlike BC/BS.
    2. Will spouse, 60 years old, be covered, too by Tricare Prime?
    3. Can we have FEHB and Tricare Prime at the same time?
    4. Currently, I have a VA PCM and a BC/BS Primary doctor. I can see either or depending on what I need.
    I am not sure how it happened, but when I came back from mobilization Kuwait, VA has covered me since. I am not a disability retiree.

    Thanks to anybody who can give me information.
    Wife is always Right!

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  5. #3

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    Quote Originally Posted by bmcar View Post
    I know that this is an old thread. I am trying to reach out to military retirees using Tricare Prime. I am retiring in March, 2019 from USPS and at the same time I will turn 60 years old. I am a retired reservist and was told that I will qualify for Tricare Prime for my health insurance aside from Military pension aside from USPS pension.
    Currently, I am under spouse's FEHB. I don't want my spouse to discontinue covering me under FEHB's Blue Cross BlueShield if Tricare Prime doesn't live up to expectations . I guess my questions are:
    1. Anybody has experience with Tricare Prime? Reading from previous threads, I gather that it is hard to get an appointment and that you have to be "in network" to save on copayments and that you need referrals before seeing a specialist unlike BC/BS.
    2. Will spouse, 60 years old, be covered, too by Tricare Prime?
    3. Can we have FEHB and Tricare Prime at the same time?
    4. Currently, I have a VA PCM and a BC/BS Primary doctor. I can see either or depending on what I need.
    I am not sure how it happened, but when I came back from mobilization Kuwait, VA has covered me since. I am not a disability retiree.


    Thanks to anybody who can give me information.
    Not sure how this ended up under Day to Day Market Talk. The mods here are exceptionally good and will move it if they think it needs it.


    In 2019 TriCare is still alive and well. Still paying claims.


    I was active duty but think the TriCare Prime for reservists over 60 yo is the same program and the same rules.


    First thing is Tricare Prime is not free. I don't care how many people told you over the years you would get free medical care for life or how many brochures you may have saved about it but it is not free. It is cheap. Last year I was eligible and currently my spouse paid/pays $24.75 per month.


    When I was under 65yo the rules for Tricare Prime were I had to see a Primary Care Manager (PCM) at the nearest military installation. Keep in mind this was 21 years ago and grandfathered. I did have to see my PCM for any referrals. Where you have to go for medical care varies based on the policies of the military installation you choose. When I turned 65 Luke AFB basically threw me out and told me to go find a doctor. This will vary, some installations will still care for retirees. Base policy made by the Wing commander on this training base for fighter pilots. For the last two years before I turned 65 Luke would still see me but the PCM assigned to me had been "no longer associated with the 56th Medical Group" and a new PCM was never assigned.


    When I turned 65 I had to apply for Medicare and buy part B to continue Tricare, which turned in to Tricare for Life. So $24.75 per month turned in to $134 per month. Tricare for life is "free" as long as you get Medicare part B. My wife who is 62 is still enrolled in Tricare Prime and I stll pay $24.75 per month for her insurance. Go to https://www.tricare.mil/Plans/Eligib...GRRandFamilies for more info.


    To answer your questions based on my experience:


    1. The whole appointment thing will depend upon where you are located. Go to the URL above. Things may have changed. My wife seldom used Tricare due to having to see PCM for any referrals. I had no problems getting an appointment once I figured out how to do it on line. Calling, even on the first day of the month, just got me the standard Airman answer "your PCM is booked for the month, call back next month". The Airman were just following policy I am sure.The only way to get an appointment on the phone was to declare it "urgent". You may or may not have to use the nearest miltary installation. Go to the Tricare site.
    2. Spouse will be covered if you pay the premium for spouse. Go to the web site.
    3. Yes. FEHB will be the primary insurance, Tricare will be secondary. There may be some problems at first getting the care provider to send the claim to the right place.
    4. Can't help you there.
    So far, BCBS, Tricare and Medicare for me have covered almost everything including major surgical procedures for the spouse. The same applied before I turned 65. Just make sure whoever is providing care accepts your FEHP, VA and Tricare.


    Some one with more expertise on the reservist status will probably answer.

    Somewhere on the nearest military installation or Tricare referenced place there will be a tricare advisor who does not work for the installation you are trying to deal with. Here it is called Benificary Counseling Assistance Coordinator. No telling what it is called in your area.


    Thanks for going to Kuwait.

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  7. #4

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    Thanks for info PO. Big help. Since you are >65 years old, do you carry both FEHB and Tricare for Life? Since your spouse is less than 65, is covered by Tricare for life or Prime? Does she have FEHB. too?

    I hope a reservist using Tricare Prime will see this post, too.
    Wife is always Right!

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  9. #5

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    Quote Originally Posted by bmcar View Post
    Thanks for info PO. Big help. Since you are >65 years old, do you carry both FEHB and Tricare for Life? Since your spouse is less than 65, is covered by Tricare for life or Prime? Does she have FEHB. too?

    I hope a reservist using Tricare Prime will see this post, too.
    I am >65 yo. I am enrolled in Medicare, pay for part B. I carry FEHP Fepblue which I pay for. I am covered by Tricare for Life (TFL) which is free IF you pay for Medicare part B. Since I retired from government civilian service, Medicare becomes my primary insurance, FEHP the secondary insurance and TFL is the third insurance. Before I retired from government civilian service FEHP was the primary insurance, Medicare the secondary and TFL third.

    My wife is <65 yo so not enrolled in Medicare yet. She has FEHP under my BCBS Basic+Family. She also has Tricare Prime. FEHP is the primary insurance and Tricare Prime is the secondary. I pay premiums for both. When she turns 65, If she enrolls in Medicare and buys Part B her Tricare Prime automatically converts to TFL. If she does not buy Medicare Part B Tricare drops her.

    This can be a little confusing, especially when you turn 65.

    What I believe would apply to you is you would enroll in Tricare Prime and start paying the monthly premiums. Tricare Prime will always be the last payer if you have other health insurance. Maybe your current BC/BS primary doctor uses Tricare. Your VA PCM cannot bill Tricare.

    Look here: https://tricare.mil/Plans/Eligibility/NGRRandFamilies.

    Make sure your Defense Enrollment Eligibility Reporting System (DEERS) info is up to date.

    Good luck.

    PO

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    Quote Originally Posted by bmcar View Post
    Thanks for info PO. Big help. Since you are >65 years old, do you carry both FEHB and Tricare for Life? Since your spouse is less than 65, is covered by Tricare for life or Prime? Does she have FEHB. too?

    I hope a reservist using Tricare Prime will see this post, too.
    bmcar,

    I think I may be the person you are looking for to answer some of your questions as I was a reservist with the Air National Guard as well as an Air Technician. Before I turned 60 and while I was an Air Technician, I was enrolled in the FEHB program for both myself and my wife. Most of the time I was with BCBS and I was also enrolled in a dental plan with FEDVIP.

    When I turned 60, I enrolled in Tricare Prime which costs me $47. per month for both my wife and I. I suspended my FEHB benefits (make sure you suspend and not cancel) and kept the FEDVIP dental plan, which cost about the same as the military dental benefits, but covered more. It is very important to SUSPEND your FEHB plan and not CANCEL it. That way if you are unhappy with Tricare, you can always go back to the FEHB plan.

    As far as getting appointments, I deal with Aberdeen Proving Ground (Army) which is about 15 miles from my home, so I fall into the service area. Most times, getting an appointment with my Primary Care Manager works well, but there have been occasions where I could not get an appointment, but was able to by requesting to see the on call Dr. And of course if it is really serious, I can always go to the emergency room at my local civilian hospital and pay a copay of $30.

    Getting referrals for specialists through your PCM works pretty well. You make an appointment with your PCM, they see you, decide to send you to a specialist, input it into a computer, and within 24 hours, I log into Humana Military and print out the referral.

    Another thing I like is by using the Pharmacy at Aberdeen, my prescriptions do not cost me anything.

    I am currently 63 years old. When I turn 65, I must enroll in Medicare part B, which I think currently runs about $134. a month. Part A, does not cost anything, and I will also be transferred to Tricare for Life at no cost. If I do not enroll in Medicare part B, I will lose my Tricare benefits. So I guess enrolling in Medicare part B is mandatory. When that happens, Medicare will become my primary insurance and Tricare for life will be my secondary.

    As for my wife, she is 3 years younger than I am and will continue with Tricare Prime until she turns 65 and I will be paying her Tricare premiums until then.

    All in all, I have been very pleased with Tricare Prime. There is an adjustment period for the additional things the military requires to get service, but once you catch on, it is pretty good and a definite cost savings.

    Hope this helps to answer some of your questions. If you have any other questions, feel free to post them here and I will answer what I can, or you can PM me if you like.

    Good luck,

    ravensfan

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    Medicare Part B is now $135.50 per month. Also if you have Federal BC/BS (basic) and have Medicare Part B you can get up to a $600 rebate for Part B.

    ravensfan, very good information on SUSPENDING not canceling your FEHB insurance.
    May the force be with us.

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  15. #8

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    Thank you, Ravensfan, PO and NASA - my spouse (Maricar19) is correct. This website has a lot of information and people willing to help and give information.
    Ravensfan, It is good to know that I must choose suspend and not cancel my FEHB. How long can I suspend it?
    PO, correct me if I am wrong, you carry both FEHB, TTFL and Medicare Part B for yourself and and your wife, FEHB, and Tricare Prime?

    Thanks especially to the founder of this website - Tom.
    Wife is always Right!

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  17. #9

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    PO,
    What do you mean by "Your VA PCM cannot bill Tricare." Isn't the VA PCM under Tricare?
    Wife is always Right!


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    Quote Originally Posted by bmcar View Post
    Thank you, Ravensfan, PO and NASA - my spouse (Maricar19) is correct. This website has a lot of information and people willing to help and give information.
    Ravensfan, It is good to know that I must choose suspend and not cancel my FEHB. How long can I suspend it?
    PO, correct me if I am wrong, you carry both FEHB, TTFL and Medicare Part B for yourself and and your wife, FEHB, and Tricare Prime?

    Thanks especially to the founder of this website - Tom.
    bmcar,

    Here is a link that explains suspension of your FEHB as opposed to canceling it. If I read it correctly, you can reinstate your FEHB benefits if you suspended them and later on lose your Tricare benefits for any reason. If you cancel your FEHB benefits, you are not allowed to reinstate your FEHB benefits in retirement.

    Here is the link: Suspension of FEHB coverage
    "the biggest mistake that traders make is to let these short-term trades turn into longer-term investments when they don’t work." RevShark

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    Quote Originally Posted by bmcar View Post
    PO,
    What do you mean by "Your VA PCM cannot bill Tricare." Isn't the VA PCM under Tricare?
    I read that in some PDF file about Tricare which I cannot find right now. VA care which may be called CHAMPVA is seperate from Tricare.

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  23. #12

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    Quote Originally Posted by bmcar View Post
    Thank you, Ravensfan, PO and NASA - my spouse (Maricar19) is correct. This website has a lot of information and people willing to help and give information.
    Ravensfan, It is good to know that I must choose suspend and not cancel my FEHB. How long can I suspend it?
    PO, correct me if I am wrong, you carry both FEHB, TTFL and Medicare Part B for yourself and and your wife, FEHB, and Tricare Prime?

    Thanks especially to the founder of this website - Tom.
    I carry FEHB (Fepblue basic+family), TFL and Medicare Part B for myself. Medicare Parts A and B because I must, so I can keep Tricare from dropping me. FEHB because the wife wants to. The wife is covered under FEHB and Tricare Prime.
    I may be overinsured. Wife is always right.

    PO

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