I had a brand new Army Reservist wife email me earlier this week with some questions about TRICARE. TRICARE can definitely be overwhelming when you’re first getting started, particularly for Guard and Reserve spouses who often aren’t anywhere near a base to go talk to someone.
Laurin and her husband are both in their 40s and have not had insurance for almost a year. Her husband will deploy next year. She’s wondering what her best options with TRICARE are and is feeling pretty overwhelmed and wondering where to start. As I explained to her in my email back, I am not an expert when it comes to TRICARE but I am more than happy to share what we did, and point out some resources/links to check out and follow up on. I thought the same info might help someone else so I’ve pasted my response to Laurin below while leaving out specifics like location. If you have additional thoughts or advice to add, please comment below! We can all help each other!
Hi Laurin!
First, I wanted to say I’m glad you wrote and that we have all been there trying to negotiate the endless forms and information that is TRICARE! I’m not an expert on TRICARE but I can tell you my experience and what we did and hopefully point you in the right direction to get the answers you need.
Make sure you know which TRICARE region you fall under (click here for a map), which is based on where you live. This is important to know because each region is operated a little differently. There are three TRICARE regions – North, South and West – and each has their own website in addition to the main TRICARE website (www.tricare.mil).
Oh, which reminds me – one GREAT resource you should definitely keep on your speed dial and in your online favorites list is Military OneSource. They offer free information and free resources to anyone connected to the military. You can call them for questions about TRICARE as well, and there’s a ton of info on their website that will help you as you get ready for deployment. Their phone is 1.800.342.9647. They just recently updated the site – it’s very, very helpful. Take time to look and you’ll find a lot of great useful info.
The type of insurance you decide on when it comes to Tricare will depend on how partial or picky you are when it comes to doctors. Prime and Prime Remote require that you have a designated primary care physician (they’re more like HMOs) and if the doctor you currently see isn’t in the Tricare network, you may have to switch. If that doesn’t bother you, than go with one of those. You’re eligible for prime remote only if you live and work more than 50 miles away from a MTF – military treatment facility.
We went with Prime Remote and while we did have to ultimately change doctors, we loved not having to pay ANYTHING for doctor visits while my husband was active and prescription co-pays are only $3 usually.
If you go to tricare.mil you can do a search for MTF’s to determine if you’re eligible for Prime Remote. The website is down for maintenance today; otherwise I would give you a couple of links to take you there directly. Try back later tonight or tomorrow. You can also google “military treatment facility locator” and that will take you to the right place.
We also have Tricare when Cliff isn’t active. They only started Tricare Reserve Select right before Cliff deployed. We switched for a couple of reasons: it was much cheaper than my husband’s employer’s insurance and it made things easier, especially since we know Cliff will be deploying again in 2011 – we don’t have to deal with any of the switching back and forth from private to military insurance, when Cliff is active and when he’s just drilling. Depending on your husband’s rank and whether or not you need insurance just for the two of you or for you and the kids, TRICARE is very affordable, and many Reserve and Guard families are finding this a great option, especially for those who are self-employed or who do not have insurance through their employers for whatever reason.
Now, how to apply. You can apply online (when the site’s back up) or you can see about going into a TRICARE Service Center (TSC). These are Tricare offices located throughout the country. Look at your respective regional site and there should be a TSC locator that will allow you to enter your zip code and find the closest one. We have one in Nashville and it helped us a lot. Just be sure to call ahead though, because you don’t want to get there and find out they’re not open.
Since your husband isn’t deployed yet, you would probably go ahead and get Reserve Select first (choosing Prime or Prime Remote) and then you will switch over to Active status, choosing Prime or Prime Remote after your husband has been active for 30 days. This information should all be provided to you at a briefing before the unit deploys.
If you have questions and need answers, call your region’s Tricare hotline (you can find numbers for your region here).You’ll need your husband’s SSN (he’s the service member), and you’ll need to make sure you’re listed in DEERS in order to be eligible for TRICARE.
Ask your husband about DEERS if you don’t already know about this – he’ll need to add you as his wife/dependent and you will need a military i.d. Here’s a link to help you locate where you can get your id if you don’t already have one – http://www.dmdc.osd.mil/rsl/owa/home. Be sure to call the DEERS office before you go and verify the documents they need you to bring in order to get your i.d., as well as confirm their office hours.
ALSO – if you need dental insurance – that’s also available through the military. Your general TRICARE insurance covers bi-annual eye doctor appts each year, though glasses/contacts aren’t covered.
Okay, hope this helps and I hope I didn’t overwhelm you with info! When dealing with TRICARE, it always helps me to write my questions out ahead of time and keep a record of who you talk to and when you talk to them and what they say. Good luck and let me know if you have any additional questions and I’ll do my best to help point you in the right direction.
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For anyone whose hubby is separating from service, I recommend looking into the Tricare Continued Health Care Benefit Program (CHCBP). I am certainly no expert as I am just trying to learn about this as we go! Basically, you can still use Humana Military insurance (it is like using Tricare Standard or Extra from what I can tell, but we always used Prime, so there may be differences I am unaware of) for a certain amount of time after leaving the service, but you have to pay a premium every 3 months (we pay $1996.00 for our family), and then some out of pocket depending on services and which doctors you choose. Not everyone separating is eligible, and different eligibility groups have different rules for using CHCBP. The only people I know can apply (since this is how we are eligible) are active duty members and their families who separate after being held under a stop loss. I am sorry this is vague and leaves you much leg work if you are interested, but I wanted to post this, because no one told us about this service when my hubby separated from the Army. We "just happened" to find it on our own (thank you, God, since we do not have other insurance from an employer!). We've been happy with CHCBP, and even went through prenatal and delivery with little out of pocket expense. My one caution is to be prepared for people not really knowing about the program, and having to talk to multiple people to get the answers you are looking for (maybe not many people using this program??). You can call 1-800-444-5445…I don't think CHCBP is ever an option…just speak to a representative.
Jennifer Howe
Jennifer,We are eligible for the Tricare CHCBP. We are debating it. Can you please give me a rough estimate of how much out of pocket it cost you for your prenatal care and delivery?
Trisha Lynn
It just hit me as I went to call Tricare today that the number I posted here is for the southern region. Hope that didn't cause issues for anyone!
Jennifer Howe
Thanks Sara. There are so many guard and reserve families that struggle with trying to use this benefit. I'm going to share your article with families in my FRG. You explained it in "real people" terms.
Vanessa Burhorn
Military Retirees have paid their premiums
Military retirees have paid their premiums by time and service rendered. Although budget items are of great concern, how do you take or cut from those who already paid. In many circumstances, the price they have paid is far more then the benefits they have earned and are entitled to.
There are areas in TRICARE that the DoD can work to reduce the overall budget and at the same time, not hurt the beneficiary. TRICARE Standard is by far the best plan for retires vs. Prime, this is a good starting place for the DoD to consider. Even though TRICARE Standard is a good place for the beneficiary, they still need a TRICARE Supplemental Insurance Plan http://www.tricaresupplement.us/
We are concerned DoD will hurt the benefits of the Military Retirees & we agree the budget needs better control on spending in other areas. Keep in mind, after a tour of duty, many fine Americans return home with injuries and disabilities that last the rest of their lives
Tom Franks