Tricare Select vs. Prime for traveling fulltimers

[remoandiris]

A search of the forum didn't provide any info on this.

For you full timers who travel and have Tricare Select, how well has it served your medical needs?  If you were previously on Prime, has Select been more or less useful?  Has Select been more or less cost effective?

Over the past 4 years we have part timed and had good results with Prime, but I am wondering if Select is better when we fulltime next year.

[RV_]

Sorry, Tricare For Life (TFL) here from 2017 when they made all the changes from Tricare standard to select. It's sometimes best to call Tricare for those answers. My wife turns 65 in six months too.

Back when wwe were fulltiming we did standard because there was a problem with changing Tricare regions too often.

[LifeUnderway]

We had the same question this morning and searched the site for answers... We plan to go full-time in 2019 and were wondering about the "ups-and-downs" involving Tricare while underway. Any guidance/insight in this matter is welcomed.

[oldbutspry]

I'm interested as well.  Retirement isn't far away.

[RV_]

I can't believe none of the currently active full time RVrs who retired from the military aren't jumping in. First off you have the VA too so get a VA card listing your disabilities if any. Prime will want in more in-system providers and long ago when we fulltimed for seven years, on retiring from a 27 year USAF Career at age 45, we moved into our RV in 1997. Back then Tricare was strict about getting care outside your zone. Now with fewer Tricare regions, it may be better. We chose Tricare standard because we were and are healthy. Back then you did not prepay the $150 each initial fee, but only if you went to the doctor's. There were many years we only paid $150 and a co-pay or two for Lynn's female preventive maintenance on equipment I don't have.

We are now TFL (Tricare For Life) which is a hybrid between Tricare and medicare that kicks in at 65.

I can tell you what you need to research.

First make an appointment and get your VA rating if any or sign up and get your VA card.

Next check with Tricare and ask them what the issues will be if you travel across the country in your retirement. If with Prime you have to use a Primary care physician in the Tricare approved list, that can be a PITA when you are across the country from them. Here is a page with the traveling restrictions today. As I said, you will need to read and plug in your facts etc. to see which will serve you best.

I do not know which applies any more but if you are healthy and in your lower 40s or upper 30s remember that once you have paid $3k in any year (the catastrophic cap) you have no more co-pays in that fiscal year, which are now calendar years if I am remembering correctly.. That may or may not have changed. But that means that if you have at least $3k set aside for any catastrophic illness you are set.

So if you are fulltiming you need to find which does not penalize you, or shockingly not cover you when you are out of your home Tricare region. There may be no differences in being covered, just annual fees and co-pays. If you are very healthy like we were remember you can change plans every year and only stand to lose the Catastrophic cap amount.

Go here: https://tricare.mil/CoveredServices/BenefitUpdates/Archives/08_17_18_TRICARE_Catastrophic_Cap

One group has my group's $3k cap, the other group $3500.00

They have new rules for you younger guys. Once you do due diligence, post back here for the folks following you.

Hope that helps.

[RV_]

Since you guys are about to retire from the military take heed of this too:

Chief Wright to Airmen: Know your retirement options

Since we are getting questions from military folks interested in full time RVing right away like I did at age 45, I thought I'd pass this along too.

I'll just excerpt this and let the about to retire guys read the source article:

Excerpt:

" Beginning Jan. 1, 2018, the Department of Defense will transition to the Blended Retirement System. If you haven’t heard about BRS, you need to get up to speed now and learn all you can. I need each of you to take an active interest in your financial planning by using every resource we’ve made available to learn about the BRS.

The BRS gives Airmen an opportunity to save their money in a portable Thrift Savings Plan while receiving matching government funds at the same time. This is the most basic layman’s description of the program, which is why I need you to arm yourselves with all of the research and information available. To help you, our Air Force leaders have put together a team of experts ready to provide extensive training. Certified personal financial counselors are available at your Airman and Family Readiness Center. These experts cannot decide for you, but they can help you evaluate which retirement plan is best for you. Every Airman’s situation is different, financial goals are unique to each Airman and there is no “one size fits all” decision.

Airmen who enter the Air Force on or after Jan. 1, 2018, are automatically covered by the BRS. Active component Airmen serving now and those who enter the Air Force on or before Dec. 31, 2017, will be grandfathered under the current retirement system. Airmen with fewer than 12 years of active service on Dec. 31, 2017, or Reserve Component Airmen with fewer than 4,320 retirement points as of Dec. 31, 2017, have the choice to opt into the BRS. Reserve Component members’ “retirement points” and retirement eligibility for the defined benefit are the same under the BRS as under the current retirement systems. The opt-in window for BRS will run from January 1, 2018 through December 31, 2018.

Make your decision knowing only you can determine which system is best for you, and understand that if you opt into BRS, it is irrevocable. You only have one chance to make this choice, so it’s imperative you and those involved in making financial decisions for your family fully understand the pros and cons of both retirement systems.

I encourage each of you to take all of the training available on ADLS and utilize the BRS comparison calculator on the Military Compensation website (http://militarypay.defense.gov/Calculators/) before making an appointment with your base financial counselor. The calculator provides a comparison between the current retirement system and the BRS. Doing your homework and preparing your questions ahead of time will help you get the most from your financial counseling appointment. I would like to see all eligible Airmen trained as soon as possible to give everyone time to really think about their options and be fully prepared before making this life-impacting decision. "

Source:

https://www.af.mil/News/Article-Display/Article/1387709/chief-wright-to-airmen-know-your-retirement-options/

 

[Ronbo]

Tricare prime you have a list of PCP’s. Tricare Select you can go to the provider of your choice. If traveling, prime may not have a provider in your area. You will then have a higher copay. With select you just go to any provider that accepts tricare. 

[RV_]

Ronbo,

Gotcha covered!

 

[Ronbo]

Yes, I am sorry. Fixed now.

[RV_]

No need to feel sorry, I fixed my post too!

[remoandiris]

On 12/8/2018 at 12:34 PM, Ronbo said:

 If traveling, prime may not have a provider in your area. You will then have a higher copay. 

Nice thing about Prime is 6 urgent care visits are allowed a year.  Have used 1 visit a year the past 3 or 4 years when traveling.  Tricare East (or was it Tricare South) has been VERY easy to work with when we were in the west region the past 3 years, too.     

Once we go FT, we'll transfer to Tricare West.  We'll be in that region a LOT more than East.  We'll probably stay in Prime.  IDK if the costs for Prime vs. Select will be much different.  We'll probably have a PCM in Az and take care of tests and such during the winter.  Summertime will be travel and maybe workamp. 

Kinda done with letting health concerns control the schedule.  Gonna die someday.  Want to enjoy what I can while I can.

[Friz]

On 11/29/2018 at 2:49 PM, oldbutspry said:

I'm interested as well.  Retirement isn't far away.

Wife has Medicare and Tricare for Life. Have never paid a penny in out of pocket expenses excluding the Medicare monthly premium.  Given the number of times she goes to a doctor each month, the Medicare premium is pretty well covered by the co-pays for which Tricare for Life pays. Tricare for  Life has covered 100% of anything Medicare does not.  I use the VA.  Care is no cost. We get our prescriptions filled at the Naval Hospital pharmacy - no cost. Not sure of how the VA works if I am forced to use a non VA facility like when we are on the road. 

[NDBirdman]

If your wife has Tricare for life then you both have to pay for plan b?  We are slowly getting there.  As such, it means you are also covered by mecare/tricare for life.  If you need medical away from the VA, can you not use the medicare/tricare for life?  Your paying for it, use it.  IMHO

My thoughts is for myself since I am forced to pay for part b or lose tricare for life on wife/myself, I plan on not using VA if I can avoid it and see private Drs that accept medicare/tricare for life.  Same with the Delta we lost, my wife needs the coverage for her gums/teeth.  I just transferred to the government employee plan replacing it and one for vision also.  Was not much more expensive to cover both of us so I plan on using that from now on instead of just the VA.

I will use my local VA for things medicare won't cover, like my hearing aids.  Wife got a set, they (medicare/tricare for life) said too bad, you pay for it out of pocket.  That cost me ~4k.  VA is ok on my CPAP, medicare/tricare for life, my wife still has to pay a portion of her CPAP supplies, I think.  Just have to pick/chose what program you use for what illness/medical needs.  I find the VA very slow at getting appointments even in this rural area.  Wife gets Dr appts usually the same day, 2 at most.

[Rover]

2 hours ago, Friz said:

Wife has Medicare and Tricare for Life. Have never paid a penny in out of pocket expenses excluding the Medicare monthly premium.  Given the number of times she goes to a doctor each month, the Medicare premium is pretty well covered by the co-pays for which Tricare for Life pays. Tricare for  Life has covered 100% of anything Medicare does not.  I use the VA.  Care is no cost. We get our prescriptions filled at the Naval Hospital pharmacy - no cost. Not sure of how the VA works if I am forced to use a non VA facility like when we are on the road. 

Husband and I are in the same situation, he uses the VA and I have Medicare and TFL. He gets his medication at the pharmacy at the VA hospital (or the VA mails it to him) which I guess would not be the same as a base hospital? I just thought it was interesting that your wife could get her prescriptions filled for free. I take a lot of medication and with the copay increase from Express Scripts it adds up, especially since I have non-formulary and non-generic medications. I especially like when I have to pay more for the medication than what it cost Express Scripts! Would love to figure out how to fill some of them for free while still traveling.

Vicki

 

[NDBirdman]

3 hours ago, Friz said:

 Tricare for  Life has covered 100% of anything Medicare does not.

Both of them literally told my wife to take a hike when she needed hearing aids.  There are things they will not cover.

[NDBirdman]

13 minutes ago, Rover said:

 non-formulary and non-generic medications.

My wife fought this for a while.  Her Dr said those were worthless for some of her meds, she needed specific heart meds/formulas.  Tri-care fought it hard, took several phone calls from her Dr to get them to stop threatening to refuse to pay for her meds.  Sometimes, flour based generics just don't get the job done.

Can your hubby get his meds sent to him whilst your on the road?  I asked my VA Dr here, she said just give them the temporary forwarding address and they would send them too me.  All my meds are sent to my addy as we live quite a ways from the pharmacy.

[Rover]

The VA sends his meds no problem. I don’t have a problem with Express Scripts paying for the non- formulary generic medications, it’s just the higher copays on them that I don’t like. 😬

Vicki

[NDBirdman]

1 minute ago, Rover said:

The VA sends his meds no problem. I don’t have a problem with Express Scripts paying for the non- formulary generic medications, it’s just the higher copays on them that I don’t like. 😬

Vicki

We have not checked, wife now uses Express Scripts too.  Will they send all her meds to a temp. address when we are snowbirding?  Starting the coming fall/winter, I hope.

[Rover]

Yes, you can put in a temporary address. The only problem I have had is there is a minimum amount of time the address has to be in effect for. I think it is 4 weeks. Since we usually don’t stay in one place very long, I leave my Express Scripts address as my “home “ address and just have the package forwarded with any other mail to wherever we are. I just make sure I stay enough ahead on refills.

Vicki

[NDBirdman]

Thanks for the info, we'll likely do the same since we won't be settled for more than a couple weeks our-self.  New gets old quick.

[remoandiris]

5 hours ago, Rover said:

Yes, you can put in a temporary address. The only problem I have had is there is a minimum amount of time the address has to be in effect for. I think it is 4 weeks.

Huh??  I never had that problem.  Express Scripts emails me when refill time is approaching.  I login to the site, check the address and change it if necessary.  A few days later the script arrives, sometimes to a General Delivery address.

[Ronbo]

If you are on Medicare but not yet 65, tricare prime is treated like TRICARE For Life. No need for preapproval. I go to the va for my pain meds because they will refill them once a month without a visit for a year. I also use express scripts. My chemo drugs cost $18,000 per month. My copay was about $500. On express scripts my copay is less than $30. Quite a change. You have to do your own research because no one will give you accurate information. 

[bryansues]

I get the VA to print me a prescription and then take it to a military pharmacy to fill.  When traveling I make sure I have refills on it and then get it transferred to the nearest military pharmacy to me (can take a few days) or if no military pharmacy available I use Walmart.  It does depend sometimes on your VA doctor as some are reluctant to print the scrip.

 

 

[Second Chance]

On 12/7/2018 at 3:59 PM, RV_ said:

I can't believe none of the currently active full time RVrs who retired from the military aren't jumping in.

Sorry - just now seeing this...

In addition to being retired military and a full-timer, I'm also retired from the health care field. So, here's my take:

The biggest difference between Tricare Prime (requires paying premiums) and Tricare Select (no premiums) is that with Prime, you must select your PCP from a list (ours were not on the list for our area - we would have been assigned a PCP at the local VA) and your PCP acts as a gate-keeper. Pre-approval of referrals to specialists and ancillary providers is required with Prime. Because of the PCP/gatekeeper situation, it is more difficult to get non-emergent/routine care while on the road and not in your home-base area.

With Tricare Select (formerly Tricare Standard), you can choose your PCP and pre-approval of referrals is not required. (My wife just saw a vein specialist in Baltimore - we are "based" in Augusta, GA -  in December. She "referred" herself and everything was covered.) 

When you turn 65 and go on Medicare, Tricare requires that you opt into Part B (and pay the monthly premiums for that) and you are enrolled in Tricare For Life. Medicare is the primary payer and TFL becomes the secondary, picking up anything Medicare doesn't pay. I went on Medicare/TFL early last year (my colonoscopy didn't cost me anything out of pocket two weeks ago); my wife is still "young" and on Tricare Select. We were both very ill last spring out in New Mexico (she was hospitalized for five days) and there were no issues whatsoever with Tricare Select.

Rob