Just need some clarification. As of right now my family has Tricare Standard due to my spouse being active. From what I understand I have the option to enroll with Tricare Prime?! If so is it a better idea to go with the the Prime instead of the Standard? Thank you, just a little confusing to me!
It depends on what you want as a person. Some people stay with Standard and never have a problem at all. You go to a civilian provider that is approved by Tricare, you have a yearly deductible and a co-pay for each visit. With Prime you normally are assigned a PCM at the MTF (base clinic/hospital) and go to them. For anything else you can need a referral. There is no charges at all.
We have had Prime since we got married and never had any issues including overseas. Gone to both military and civilian providers. Sometimes though it can be difficult with Prime if they are packed, which happened to us in San Diego. We were able to go to a civilian provider and stay with Prime. It can be an option if they are too full.
Something else to think of also is that if you go to an MTF, if your on Prime you have a higher priority than you would if your on Standard. I prefer Prime because I have not paid for any of mine or my kids medical care out of pocket. The only thing I have paid for is some of my meds. Yes we have had to fight to get referrals at times, but honestly it was worth it. Not having to pay co-pays on over 35K in medical bills is worth it for us.
its pretty common for Prime beneficiaries to be assigned civilian providers if the MTF that qualifies them for Prime is small and crowded. We are Prime (EACH at ft carson) but my son attends the University of Colorado at Boulder and lives in Broomfield-he is eligible for Prime because he is within 50 miles of Buckley AFB-but they have only a clinic which can not accommodate their airman population let alone other dependants and retirees-so he was automatically assigned a civilian doc.
I would more than likely have to use a civilian provider. We do not live close to a base. So that was why I wondered if Tricare Prime is a better option or not. Thaks for all the replies everyone.
if you do not live with in 50 miles of and installation with an MTF then you become Tri Care Prime Remote-and thats somewhat different-you might be better off with standard since providers for prime remote can be rather hard to find.
The Prime Remote thing isn't as black and white as they make it sound. When we lived in Raleigh, we were on Prime, and a few miles over the 50 miles/MTF deal. The only reason I could think of is that Raleigh has a lot of huge recruiting centers. It was definitely harder to find doctors who took Prime vs. Standard, but they were there! If you WANT Prime, your best bet is to call Tricare and ask if it's offered where you're at. When I first called Tricare, I was like hey, I need to find a Standard PCM ... they asked me for my zip code to check coverage, and I argued and was like oh no we're nowhere near an MTF, don't even bother. But like I said, there was coverage! I'm so glad I called, I would never have known otherwise.
