Anyone with experience using Tricare for military families?

[babyonbrain]

My husband is considering joining the military and we are looking into the health insurance offered as part of the benefits package. We have great insurance right now through my husband's work and would be trading it for Tricare if he were to join the military. I believe that the options are Tricare Prime and Tricare Standard. If you have experience using either Tricare plans, why did you chose one plan over the other and were you satisfied with the service you received? We are mostly concerned with the length of time it would take to get an appointment and the level of difficulty involved in getting a referral to a specialist. If you have experience with both civilian doctors and military doctors, would you say the quality of care provided was similar or was one superior to the other?
Any other comments regarding your experience with Tricare?

Thanks in advance for any input you can give.

[crl]

No real experience using Tricare. I believe when dh was in the Marine Corps I wasn't eligible to go to civilian doctors because he was stationed at bases with military care? My dad is retired and my parents have Tricare as secondary insurance to Medicare. They don't seem to have any difficulty with it, but they are near a major university medical center that provides most of their health care and bills Medicare and then Tricare for them.

My experiences with military medicine were dismal. Appointments were difficult to obtain, two different doctors actually handed me bottles of antibiotics that I am allergic to despite the note in my chart on the front of my chart and on the check in sheet, Zero continuity of care, etc, etc. I was a civilian federal employee at the time and we ended up paying for me to have insurance through the federal employees benefits so I could avoid military doctors.

Catherine

[sariana]

We have Tricare Reserve Select, which is a bit different from either of the plans you mention. We don't live close enough to a base to use military doctors (and I think we're bottom of the list anyway). The only issue I have had with Tricare RS is the somwhat limited options for doctors in some specialties (eye care, specifically, but we have other vision coverage now).

We chose to go with Tricare Reserve Select because it was a much better deal than what DH's company offers. Overall we have felt it was okay, but we really miss our old Kaiser HMO. I don't like having a PPO because I don't have the expertise to know what specialist I need. So being able to "self refer" doesn't help me much. I think with Prime and Standard, though, you need referrals for specialists. So it would be different for you.

One recent complaint I do have is spefically for the West region. I am not overly impressed with UnitedHealthCare, the new plan administrator. I always had good experiences with TriWest, the former administrator, but the transition to UHC has been rough. DS had a referral that expired in the transition, and UHC was too disorganized to get referrals transferred on time. It all worked out, but it was a nuisance. I don't know what region you are in, but there are several, and your experiences will depend somewhat on your plan administrator. It isn't just "TriCare" that matters--who runs the program matters, too.

So far we have used TriCare for DS's orthopedist and to see a Neurologist, which has led to more (yet to be sent) referrals. We have been happy with all the doctors we have seen. I also like the kids' pediatricians. But to reiterate, these all have been civilian "network" doctors, not military doctors.

[nfowife]

We have been military for 14 years now and have been Tricare Prine the entire time. It's worked very well for us and with prime you have almost no costs. Even prescriptions can be free if you get them on the base. Prime is basically an HMO so you are assigned a Primary Care Dr. known as your PCM. You have to go through them for referrals to specialists but then there is no cost or copay for you. If you live near a base and the clinics are not at capacity then you will be assigned a PCM at the base health clinic (usually family practice or peds for kids). We have not had problems with Prime and have mostly been authorized to use civilian PCMs because we lived further from base and they were at capacity.
Tricare Standard is basically a PPO where you don't need a referral to see anyone but there are costs and copays involved. So if you want to see a dermatologist you just make an appt and go but then you have a copay and deductible.
We just transitioned to the reserves and tricare reserve select is very similar to tricare standard. I haven't gone to the dr. yet but I am sure I'm going to miss those days of no copays!

[AngB]

We had Tricare Prime because our first base was in a remote location and there weren't really any local civilian options. When we came back stateside we only had 1.5 years left so we just kept it.

Ditto the abysmal military healthcare. I saw one doctor- an NP- who I liked, the rest of the doctors sucked. DH had knee problems for 3 years, they kept brushing him off saying it tendonitis and gave him motrin--multiple different doctors at 2 different bases--before he finally got fed up with it and requested an MRI, turned out he had had a torn meniscus the whole time. It caused permanent damage to his knee. I am 100% certain that if I had been seeing the military doctors we saw at our bases, during my pregnancy with DD (he was out by then and we had civilian healthcare) when everything went really really bad, I would be dead right now, no way they would have ever figured out what was wrong and they would have brushed me off with tylenol like they did for everything. (Well, motrin was their favorite rx.)

Anyway, I don't know much about the different insurance plans but I highly recommend you get civilian healthcare. I would much rather pay for a decent doctor then do the free plan but get stuck with really really crappy doctors.

[tropicalmom]

No personal experience but my sister refused to have her children at military hospital for safety reasons. She had heard too many horror stories.

Her husband has since passed away but my niece and nephews have Tricare Standard. She can take them to see anyone who accepts Tricare (which has lousy reimbursement rates from a provider standpoint TBH) and there are many providers that don't accept Tricare for that reason so that's something to consider.

[jam224]

I'm a military brat and I'm married to the military. I've been on Tricare Prime my entire life. It's nice to not have to worry about co-pay. I've always been happy with it, but then I'm generally healthy, so I really haven't had to deal with anything complicated. Getting an appointment is pretty easy if you're sick, otherwise it probably takes about a month to be seen. (DD is on Tricare Prime and if she's sick, I can get an appointment usually the next day, sometimes even the same day. For her well-baby check-ups, I have to schedule those about 3 weeks in advance. Once, we had to take her to the ER and because they don't have a pediatrician on-call here, we just took her up to the local Childrens Hospital; Tricare covered everything.) I don't have any experience with getting referrals. You could always start out with Tricare Prime and if you're not happy with that, then you could switch to Tricare Standard.

I would say give military doctors a chance. They're not all terrible. Every base is different. I can tell you that I had an exceptionally wonderful birthing experience at the military hospital here. They had several midwives on staff, so I happily chose one to handle all of my prenatal care. She was wonderful, but unfortunately suffered an injury that prevented her from actually delivering DD. Instead, a doctor I had never met before delivered DD and he was amazing. In fact, everyone who took care of me during my 27-hour labor was completely respectful of my birth plan and desire to go epidural-free. I'm incredibly thankful for that.

[crl]

I'm a military brat and I'm married to the military. I've been on Tricare Prime my entire life. It's nice to not have to worry about co-pay. I've always been happy with it, but then I'm generally healthy, so I really haven't had to deal with anything complicated. Getting an appointment is pretty easy if you're sick, otherwise it probably takes about a month to be seen. (DD is on Tricare Prime and if she's sick, I can get an appointment usually the next day, sometimes even the same day. For her well-baby check-ups, I have to schedule those about 3 weeks in advance. Once, we had to take her to the ER and because they don't have a pediatrician on-call here, we just took her up to the local Childrens Hospital; Tricare covered everything.) I don't have any experience with getting referrals. You could always start out with Tricare Prime and if you're not happy with that, then you could switch to Tricare Standard.

I would say give military doctors a chance. They're not all terrible. Every base is different. I can tell you that I had an exceptionally wonderful birthing experience at the military hospital here. They had several midwives on staff, so I happily chose one to handle all of my prenatal care. She was wonderful, but unfortunately suffered an injury that prevented her from actually delivering DD. Instead, a doctor I had never met before delivered DD and he was amazing. In fact, everyone who took care of me during my 27-hour labor was completely respectful of my birth plan and desire to go epidural-free. I'm incredibly thankful for that.

Wow, you actually got to see the same person for your care throughout your pregnancy? I inquired when we were trying to get pregnant and was told flat out that they would not even TRY to schedule me to see the same doctor and that given the number of doctors on staff and changing assignments I would very likely see a different doctor at every appointment.

I am sure there are great military doctors. In fact dh had an excellent orthopedic surgeon when they did his shoulder surgery. I will say that my mom (Dad was career Army) refused to have us go to military doctors when we were kids because, as a nurse, she felt the care over all was subpar. (She had a bad delivery with me and ended up seriously ill back in the hospital for several days with a post C Section infection.) That was a very, very long time ago and I would dismiss it entirely except that it mirrored my experiences.

I was completely unable to get a sick appointment over the course of three or four years and ended up as a walk in at the closest military urgent care every time I was sick--which was about a forty five minutes drive away even though the closest military clinic was a five minute walk away. That urgent care was where I was handed a drug (literally the bottle because it was after hours for the pharmacy) I am allergic to twice. All of this was in the late 1990s in the Washington DC area, which has tons of military medical facilities. I did have a good experience at Bethesda with trying to sort out my migraines.

The free prescriptions are awesome. I had really long waits at the pharmacy though and a hard time getting drugs that weren't in the formulary. The pharmacy staff were great though. Thorough and nice.

Catherine

[jam224]

Wow, you actually got to see the same person for your care throughout your pregnancy? I inquired when we were trying to get pregnant and was told flat out that they would not even TRY to schedule me to see the same doctor and that given the number of doctors on staff and changing assignments I would very likely see a different doctor at every appointment.

Geez, that's frustrating! Yes, I got to choose my midwife (of the 3 there) and they always tried to schedule me with her. It wasn't until the end of my pregnancy that she got injured and I had to see a couple of other doctors before I delivered (at that point, it was clear that my midwife wouldn't be doing the delivery anyway, so I decided to see different doctors, on the off chance that I would *maybe* recognize the doctor that ended up doing the delivery... wasn't the case, but I ended up loving the doctor who did!). Having my birth plan printed out and in their records was SO helpful!

Continuity of care is definitely a factor with military doctors, that's true. You're dealing with people who get deployed and PCS'd all the time. It can be frustrating to deal with, but it's something I'm used to, I guess. In fact, DD's pediatrician had to take maternity leave for a while, so there were several appointments where we had to see other doctors. In general though, they really try their best to schedule us with her whenever possible, which we appreciate.

[wendmatt]

I have been in the USA for 16 years and DH was active duty for 12 and now retired for 4. we have always been Tricare Prime and seen on a military installation. I cannot say enough good things about the health care we have received. Of course there are blips (that is the case for civilian also, I read plenty of stories of people unhappy with care) but you have the right to a second opinion at any time. I have rarely had a problem getting in to see someone for same day appointment, and if it's urgent and you can't get in, you can get a referral to go offpost. DD has had some serious health issues this year and had a TON of tests done, and it's cost us nothing, totally amazing care at the military hospital in San Antonio and we've seen the same specialist for 2 years. Yes, drs move/deploy, but it's never been an issue. If you want to go off post you can still get Tricare Prime (I wouldn't recommend standard) and choose to see a civilian dr and just pay a copay and prescription copay (if you get the meds on post it's free). Good luck with your decision to join the military.