My husband is due to retire soon and I was wondering if anyone can give me any information (or suggestions) on medical benefits for retirees? Right now we have tricare prime remote. I called them to see if we can keep the same insurance. She said that tricare prime remote isn't available for retirees. She suggested tricare prime standard. She said it will be $460.00 a year for a family of 2 or more plus co-pays. Does anyone know anything about this insurance? What is covered? What isn't covered? Any information will be appreciated.
TRICARE Prime Remote is available to Active Duty Members/Dependents only. As a Retiree, you would be eligible for TRICARE Standard (by default), or if there is a TRICARE Prime network where you live, you may enroll in that option. The coverage under either program is the same. The difference is the Deductibles and Co-payments. Under TRICARE Standard, there is an annual (1 OCT-30 Sep) Deductible of $150/member or $300/family and then you would be responsible for a co-payment of 25% of TRICARE Allowable Charges. Under TRICARE Prime, you would pay an Enrollment fee of $230 for 1 person or $460 for the family and then you would have co-payments for other services. TRICARE Standard gives you more freedom of choices (no Primary Care Care referrals) with higher out-of-pocket costs. TRICARE Prime may have lower out-of-pocket costs, but you have to deal with referrals from the Primary Care Provider and more Pre-authorizations, etc. Please remember that Dental coverage is not part of the TRICARE entitlement and you would have to purchase coverage under the TRICARE Retiree Dental Program (www.trdp.org). You will find detailed information at TRICARE's site: http://tricare.mil/mybenefit/. Just complete the profile as a Retiree and it will show the various options.
Children -- I live in the Daytona Beach area... I have been on Tricare Prime for a few years now.. It is GREAT! We pay the $460 per year.. and $12 co pays when we go to the doctor.. It doesn't have the large deductable that Tricare standard has... and the cost (co-pay) is cheaper as well....
In short, I am very satisfied.. My son has had his appendix taken out and my wife has had a few operations.... I think my son's operation and the 4 or so days he stayed in the hospital was only around $125 or so.... The operation and all was over 20K.
Where will you be retiring? You can do your homework ahead of time.. like finding doctors etc...
>>TRICARE Prime Remote is available to Active Duty Members/Dependents only. As a Retiree, you would be eligible for TRICARE Standard (by default), or if there is a TRICARE Prime network where you live, you may enroll in that option<<
When I called tricare they checked and we do live in a tricare prime network. She was actually confusing me when talking to her so I thought I would come here and have it put into normal words for me. LOL
>>Under TRICARE Prime, you would pay an Enrollment fee of $230 for 1 person or $460 for the family and then you would have co-payments for other services. TRICARE Standard gives you more freedom of choices (no Primary Care Care referrals) with higher out-of-pocket costs. TRICARE Prime may have lower out-of-pocket costs, but you have to deal with referrals from the Primary Care Provider and more Pre-authorizations, etc.<<
Is that $460.00 a year? I actually don't mind getting referrals and authorizations. So far I haven't had any problems with neither and my PCM is pretty good about giving me a referral if I want one.
>>Children -- I live in the Daytona Beach area... I have been on Tricare Prime for a few years now.. It is GREAT! We pay the $460 per year.. and $12 co pays when we go to the doctor.. It doesn't have the large deductable that Tricare standard has... and the cost (co-pay) is cheaper as well<<
I think this is the one we'll go with.
>>Where will you be retiring? You can do your homework ahead of time.. like finding doctors etc<<
He's retiring in the fall. I already have a PCM that I go to. I just hope that she's taking new patients with tricare so my husband can go to her too. I used to go to her without insurance. When we got married, I called to see if she took tricare, she said they used to but not anymore but since I'm a patient of theirs, they will (which I thought was very nice) but I see she's still on the tricare website as a PCM.
Children, whether it is good or not, make sure you do your homework for the area where you will be retiring. I have Tricare Prime but I only use it for the medications & emergency room. I use my wife's health insurance. I found out that in the DC area (NVA to be specific) I have never ever in 6 years been able to see the same doctor twice. With that said, I find that the medical services overall are just adequate. In my opinion, health care should not be anything less than the best...adequate doesn't cut it for me. But as Wray indicated above, in his area he seems to get great medical services. Good luck.
Keko, I don't understand... when using Tricare Prime you must get a primary care doctor... He is the one you will normally see for everything.. Then, if you need to go to a specialist, he will be the one to write the referral.
I haven't seen my tricare doctor in years... mainly because I use the VA doctor.... My wife does see her tricare prime doctor, and then seeis others if needed... The only disadvantage is you need to get a referral. I have had no problem ever getting one.
I have been retired for 7 years now living on the Cape in MA. Tricare Prime via US Family Health Plan has been fantastic. I have had the same primary care doc for about 5 years now and could not be happier. The referalls are no big deal and are good for numerous visits. This is by far the best deal in town. I have a great union job with a large international company and the plans they offer dont come close to this. It seems like you may have mixed up the message. Check out the U.S. Family health plan web site and see if you are in an area that is covered. My guess is that it will cost you much less than any employer sponsored plan out there.
I have Tri-care prime and am happy with it. The only complaint I have is that I've had five different doctors since I retired in 2000. Navy Doctors get transferred/retired/out like anyone else. The most important thing is that I have never had a problem getting a referal for a specialist which is what I want if it's anything more than a routine check-up anyway. I had shoulder problems, I was refered to an in town Orthopedist, ended up needing shoulder surgery...total cost $25.00. I have to look at the scar to remember which shoulder it was, surgeon did a great job. Like I said I've been happy with Tri-care prime...good luck.
Wray, that's what I thought. But I am told that I have to wait 3 1/2 months to see him or take the next available doctor (3 weeks wait anyhow). I have no choice but to take the next available doctor. I am told that in the DC area the military population is what causes such a waiting period. So we opted to pay health insurance thru my wife's job, which covers both daughters while away in college...tricare prime is not available in their area. Another good reason for having fired them. Based on my experience I rate the medical care as a C-, at least for this area, and it should be nothing less than an A. When it comes to our health, B+ is just adequate. Just my take on it.
Keko, that definately sucks... You know if you have a real problem you can simply go to the emergency room.
As for the military population in DC, well.. they can have it. You could offer me a GS 15 job and I wouldn't go there. A happy lifestyle is more important (to me) than the money... Just remember, ya can't take it with ya...
You have worked hard. I'm sure you are set with you $$$$. Find a nice place you & the wife want to spend some quality time and go for it.... Several of those I worked with or knew while in the CG have already crossed the bar. Life is too short not to enjoy it.
You are absolutely right 101% in your assessment. Yes, the ER services are great at Ft. Belvoir and we use them as needed...and unfortunately, there has been a few instances. As far as working in the DC area, you are correct too. I just do it while I get my daughters graduated. One down and one 3 years to go. But after 3 more years, all I will have is 5 years left before being able to retire again from Civil Service w/ the minimum age, so might as well hang in there, and like you indicated, take it w/ me elsewhere. That's the plan. But for now, got do what I got to do. But you are correct in your assessment.
keko, imagine you and me in agreement.. in fact I think we have been a lot lately.. who would have thunk it? Maybe one day you will let me know who you are.
When I was talking about emergency rooms I was talking about real hospitals like Mary Immaculate or Riverside. (I had kids born in both of them).
I have 2 in college myself.. Fortunately I have the Florida Prepaid college program and they both have gotten scholarships... not a lot of out of pocket expenses on my part... of course I've bought each of them a car, and pay their insurance... I suspect if I EVER get an "Empty Nest" the financial drain will slow down considerably. I'm waitin'....
I will, I promise. But while here at puzzle palace so close to the big wigs, I can't. Retaliation and retribution are VERY real in this organization. I don’t care what anyone says. I'm sorry, but I can’t reveal flat out who I am. As it is, I get people guessing who Keko really is…some are right.
You mentioned a very good thing that if I could go back in time I will take advantage of. That's the pre-paid tuition. Whoa, if had to give an advice to a young father, this would be one...pay now or pay more later.
Cars, oh God, I hear you. Same here. My only hope is that soon the recently graduated one will find a job so she can take over the car payment and insurance. In the meantime, I'm holding the Fort for her.
