I used to work in a hospital. I dealt with insurance companies day in and day out for five-and-a-half years. And, yet, I still don’t understand them. I am far from an expert on the subject, but I want to share our personal experiences with healthcare with you.
Tricare Standard or Prime?
When MyHero first joined the Army, we were covered by TRICARE Standard. Under this plan we still paid a copay/deductible, but the majority of our medical bills were covered. Now that we are at a permanent duty station (PDS), we are on TRICARE Prime.
So far our medical bills have been covered 100%. Let’s go through a typical doctors appointment:
Making an Appointment
I call our Army Medical Center appointment line. They give me a time and date for a doctor’s appointment. We show up and check in using my military-issued ID as our “insurance card”.
Whoever has the appointment is examined by the doctor. Issues are discussed, and options weighed.
Tests and Medications
A treatment plan is decided upon. If tests (blood, X-ray, etc.) are needed, we can typically go somewhere inside the same Army Medical Center and have these tests completed.
We then walk through two hallways to the pharmacy, where we pick up any medications that were ordered. Notice that I have yet to pull out my wallet.
Outside Referrals
In some instances, the Army Medical Center cannot provide the type of care needed. For example, Stinky has epilepsy and is on medication for it. He needs regular neurology appointments and blood tests.
A pediatric neurologist is not available in the Army Medical Center so his pediatrician referred him to a private practice ped. neuro. TRICARE receives the referral and, in our case, approves it.
In fact, today was our first appointment with the new doctor. Another EEG needs to be completed, so this doctor (or rather his staff) will contact TRICARE to request approval for an EEG.
Once that comes through, the test will be completed in his office. I still haven’t pulled out my wallet. This doctor also made sure that Stinky has a sufficient supply of medication.
If he hadn’t, we would have received a written prescription and taken it back to the Army Medical Center to have it filled.
Minimum Fuss, Minimum Expense
All of this came at a minimum fuss to us, and so far with no out-of-pocket costs. Like any other insurance company, TRICARE can sometimes be a pain, although so far we’ve had no problems with it.
I take exception with those who say that the military receives “free” healthcare for my husband works VERY hard for this benefit. However, it is usually an amazing program, that we are very appreciative of.