chiefcramer
USA Somewhere
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Trying to sift through the different terminology on the Contractors website (north, south and west). What if anything is the difference to the beneficiary between a "Tricare Provider - in Network" and a "Non-network Tricare Provider - Participating"? Same question regarding the difference between a "Tricare Authorized Provider" and a "Non-network Tricare Provider - not participating"?
I'm hoping to hear from someone who has actually used Tricare Prime for routine care outside their region. I want to know if that type of situation worked well for them.
We are going to be traveling for a couple years between all three areas and want to be sure what we are looking at if we drop our Prime enrollment.
I checked all of the regions websites plus mytricare.com. All are very good at describing how things work in their region but none of them address dealing between regions.
Thank you for your assistance.
* This post was
edited 06/04/08 07:32am by chiefcramer *
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larrygranny1
el paso, tx
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Can't answer your q directly but consider this, It does not matter what region your in with the prime or for life if you go to the emergency room. Had surgery in el paso, tx got to the navy base in Jacksonville, had a problem, went to emergency room, they took all info and I saw a surgeon. Didn't mess up the region stuff where I am enrolled. make sure if you drop the prime, you can enroll again at a later date if you desire to.
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chiefcramer
USA Somewhere
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I'm not concerned about emergency care - as you said that is not a problem either way. What I am talking about is for example - it is time for an annual physical and we won't be back to Florida for another 9 months, or husband has to have bloodwork done to check that prescription medication is doing what it is supposed to be doing. How do you handle that with Tricare Prime when you are out of your 'region'. Does anyone have their Primary Care Manager (PCM) give a referral to a Tricare provider in another 'region'? I have to believe that would be a paperwork fiasco billing between network regions.
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dutch1918
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chiefcramer wrote:I'm not concerned about emergency care - as you said that is not a problem either way. What I am talking about is for example - it is time for an annual physical and we won't be back to Florida for another 9 months, or husband has to have bloodwork done to check that prescription medication is doing what it is supposed to be doing. How do you handle that with Tricare Prime when you are out of your 'region'. Does anyone have their Primary Care Manager (PCM) give a referral to a Tricare provider in another 'region'? I have to believe that would be a paperwork fiasco billing between network regions.
I would ask your primary care provider for those answers.
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chiefcramer
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dutch1918 wrote:chiefcramer wrote:I'm not concerned about emergency care - as you said that is not a problem either way. What I am talking about is for example - it is time for an annual physical and we won't be back to Florida for another 9 months, or husband has to have bloodwork done to check that prescription medication is doing what it is supposed to be doing. How do you handle that with Tricare Prime when you are out of your 'region'. Does anyone have their Primary Care Manager (PCM) give a referral to a Tricare provider in another 'region'? I have to believe that would be a paperwork fiasco billing between network regions.
I would ask your primary care provider for those answers.
I did and he said "Seems like you should be able to but I guess we'll see". Great physician but not too good on the paperwork.
I also checked all of the regions websites plus mytricare.com. All are very good at describing how things work in their region but none of them address dealing between regions.
I'm hoping to hear from someone who has actually used Tricare Prime for Routine Care outside their region. I want to know if that type of situation worked well for them.
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Tenn Stud
Northeast, TN
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Try calling TriCare 800-538-9552
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jnharley
Virginia Beach, Virginia
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Have you considered using TRICARE Standard and a supplement? We have researched this extensively and it looks like the best way for us to go. The supplement will cost approximately $100 per month. TRICARE Prime is just like an HMO and really only works well for routine medical matters when you are within your Prime area. An emergency is a different matter.
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dgo1369
Georgetown, TX, US
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Hard to get a straight answer, isn't it?
When we had to go to "routine" (cold, flu, etc) appointments when out of region, it was a royal pain in the butt. There are two things you can do. One, you can temporarily change your region and this opens it up to use any TRICARE authorized physician in your new region, or you can call TRICARE and have them authorize an "urgent" requirement to see a physician. I did the former after going through what I felt was a hassle with the latter.
As a full-timer, however, you may be in different regions throughout the year and this will complicate things. I agree with those who recommend that you check with TRICARE regarding this type of situation. I'm afraid you will find this may be a great deal of trouble. Or, even better, you can wait until - like me - you qualify for Medicare and Tricare for Life and it won't make any difference where you are!
Let us know what happens
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johnhboyd
Southern California
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Dave,
I too am retired military (US Army), and will be retiring from my civilian job in two months at age 63. I am planning on going Tricare Standard with a suplement. With a $300 deductible, the rates are very good. Check with any of the military associations or insurance companies for quotes.
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j2catfish
Newport, NC, U.S.of.A.
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We have been retired (from the USMC) since 1978. We are not full timers, more like half timers. We have used Tricare STANDARD for all our travels (with a supplement from MOAA before we qualified for TFL). Absolutely no hassles; we have also had various tests away from our doctor (primary care physician)with the results faxed back. Same for prescriptions - doc will call in a script at our temporary location, no problem to obtain medicine on the road. Of course the scripts cost a copay but we try to get scripts from nearest military treatment facility (MTF). Prior to a trip, we use the mail order pharmacy for all meds not carried by the MTF. PRIME seems to me to be the best deal for folks that do not travel very much. As stated above, you can move your Prime coverage to another area, but then you have to change it back if you return to a "home" area. As far as the confusing terms for care providers, we have found that if they say TRICARE providers, you will have no problems. Simplest way to determine, is just ask them prior to treatment!
Hope this helps.
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