When we got orders to PCS overseas, one of the things I was dreading was using Tricare Prime for our healthcare. I was a staunch Tricare Standard user for over 11 years. While Prime hasn’t been quite as horrible as I imagined (mainly because we are stationed right next to Europe’s ONLY major military hospital), we have still had some frustrations, including a doctor who missed my daughter’s strep throat and gave her a flu vaccine, resulting in a 104+ fever and a visit to the ER. That got me thinking about my beloved Tricare Standard, and I came up with some reasons why you should consider switching to it, especially if you are stateside:
1. You get to choose your doctors.
That condescending pediatrician who looks like she just graduated from high school? That family practice doctor who just keeps giving you Motrin instead of ordering an MRI? Guess what: if you’re on Tricare Standard, you don’t have to see them again. You can switch doctors whenever you want. Yep, you don’t need anyone’s permission. As long as they will see Standard patients (and trust me, many if not most doctors do), they will see you. If you’ve experienced Tricare Prime Remote and had difficulty finding care, it’s because hardly any civilian doctors know about Prime or want to participate in it. Standard is a totally different story, and you can pick and choose your providers with ease.
2. You can easily fill prescriptions – even at drive thrus!!!
This benefit saved me many times. When you have a sick baby, you don’t want to have to go pull a number at the MTF pharmacy and wait and wait and wait until you have a shrunken head like in Beetlejuice (if you are too young to understand that reference, do yourself a favor and watch that movie)! It’s nice to be able to go to the drive-through at CVS. Or drop off a prescription while you shop at Target. While Tricare does encourage you to get maintenance prescriptions through the mail order pharmacy, you can actually get your prescriptions filled almost anywhere. Yes, there’s a co-pay, and the amount depends on where you get your prescription filled. If you don’t want to pay anything, go ahead and take a number at the MTF, because prescriptions there are still free. But if you’re willing to follow my tip below for keeping costs down, then you have a lot of freedom to get prescriptions filled wherever you want.
3. You don’t need referrals for most care
Think your kid broke her foot at soccer practice? Want to have that mole checked out by the dermatologist? Well, get this, you don’t need to go see your primary care doctor and wait and wait to be referred to a specialist. Yep, you can phone and make appointments with the dermatologist, the cardiologist, or any other “ist” you can think of. In fact, only a handful of services (biggies, like organ transplants) need any kind of authorization.
4. Travel without any worries
Before we left the states, we went on a round of family visits all across the country, spanning several Tricare regions. Inevitably, one or the other kid got sick. Visiting an urgent care center was no big deal (and we had to do it in Pennsylvania, Texas and Orlando!). We just walked right in; the only phone call I made was to get directions to the clinic and double check that they accepted Standard, and they all did.
5. It’s affordable
High out of pocket costs. This is usually the top reason why people are afraid of Tricare Standard. While there is definitely some cost involved, it is actually ridiculously low when you compare it to comparable health care in the civilian sector. The deductible is only $300 per year per family, and if you are below E-5 in rank, the deductible drops to just $100 per family. Once you have satisfied the deductible, then depending on whether the doctor is in or out of network, Tricare pays 80-85% of the cost of a visit. This might make you uneasy, but there’s a way to keep these costs down – by getting a Tricare Standard Supplement offered by many military associations and insurance companies. We had ours through MOAA for many years. Here’s how it works: pay the relatively low quarterly cost for the supplemental insurance policy (I paid about $100/quarter for our entire family), satisfy your family’s deductible, and then the supplement will take care of what Tricare doesn’t cover – the 15-20% copay and ALL the prescription copays. Even if you choose not to get a supplement, Tricare has something called a “catastrophic cap” which limits your out of pocket costs for your entire family to $1000 per year.
Tricare Standard is fabulous healthcare. For under $1000 per year we were able to see top local doctors and have all our prescription needs filled. Most of all, for our family, Tricare Standard provided peace of mind – knowing that we had the level of healthcare we had chosen, on our own terms. That’s something Tricare Prime can’t give me. While I am certainly enjoying being stationed abroad, the second we get to the states, I’m switching back to Standard!
*Please note: The above information applies to Tricare Standard for active duty families. Retirees and their families have different costs.