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I'm interested in hearing from reservists who use TRICARE Reserve Select - especially those who use it now and have previously used private insurance. Looking at its premiums, its considerably cheaper than my private insurance. How has your experience been using it? Plusses and minuses?
Health
Insurance
Healthcare
Posted 10 y ago
Responses: 9
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My family and I currently have TRS, since 2007 except when on orders and getting Prime (TRS since late 2011 continuously). I like the coverage and plan on keeping it for the foreseeable future.
The rates are far better than the civilian equivalents, even though they've risen slightly over the last few years. It is essentially the same coverage as Tricare Standard. I have a generally pretty wide array of doctors to choose from, and it has a few perks such as annual wellness checks for children, annual vision exams, and (if you pay the extra dental premium) 6-month dental checkup/cleanings being 100% covered.
What you can get caught on is the same things that can annoy you of civilian insurance, though. For example, go to many doctors and they will have a separate company for lab work and sometimes also for prescriptions, and it's not uncommon to pay a single copay only for them to come back at you for a separate copay for each entity involved (like the independent lab). Similarly, if you go to a more expensive care facility, don't be surprised to have them say that the costs exceeded the maximum allowable charge for particular procedures. Again, this headache is the same thing you face on the civilian side unless you're at the level where you're getting premium PPO with "Concierge Service," so what I'm really saying here is don't expect that part to change.
The rates are far better than the civilian equivalents, even though they've risen slightly over the last few years. It is essentially the same coverage as Tricare Standard. I have a generally pretty wide array of doctors to choose from, and it has a few perks such as annual wellness checks for children, annual vision exams, and (if you pay the extra dental premium) 6-month dental checkup/cleanings being 100% covered.
What you can get caught on is the same things that can annoy you of civilian insurance, though. For example, go to many doctors and they will have a separate company for lab work and sometimes also for prescriptions, and it's not uncommon to pay a single copay only for them to come back at you for a separate copay for each entity involved (like the independent lab). Similarly, if you go to a more expensive care facility, don't be surprised to have them say that the costs exceeded the maximum allowable charge for particular procedures. Again, this headache is the same thing you face on the civilian side unless you're at the level where you're getting premium PPO with "Concierge Service," so what I'm really saying here is don't expect that part to change.
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I am a retired gray area "tweeny" (14yrs to go) and I use Tricare and have had minimal issues. The generic Rxs I have are almost all no co-pay, All my medical Drs except it. The cost for an individual or family medical and dental plans is very comparably priced, I'd even say about 10-15% less when compared to (in my neck of the woods) Blue Cross, Tufts, Harvard Pilgrim and United Health Care. Only issue I have is almost all psychiatric and counseling services in my area don't accept Tricare. I'm looking into away around that to see if Tricare has a max out of network cost for those services so I can get partial reimbursement for those costs. Only other issue I had, and I believe this is with all double coverage issues no matter the providers, is the "who gets billed first" game. My last employer offered free individual Blue Cross coverage which was great as it eliminated all co-pays for me. It took a few months to get BC & Tricare to "agree" who the primary and secondary provider was. Finally after some over charges and over billings , which were all resolved, they got it straight.
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CAPT (Join to see)
Definitely helpful, thanks. I have Blue Cross and family rate went up by 30% this year.
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COL Randall C.
Regarding your question, out of network docs can charge up to 15% of the TRICARE reimbursed amount. You would be responsible for that 15% above and beyond any cost share (also, I don't think the 15% is considered as part of the plan cap on annual out-of-pocket expense).
I just did a quick doc search for Behavioral Specialists (Psychiatry) within 20 miles of Coventry, RI who accept TRICARE and there are more than 20 listed. Closest that take new male patients seems to be Warwick (about 13.5 miles away).
I just did a quick doc search for Behavioral Specialists (Psychiatry) within 20 miles of Coventry, RI who accept TRICARE and there are more than 20 listed. Closest that take new male patients seems to be Warwick (about 13.5 miles away).
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MAJ Robert (Bob) Petrarca
Thank you COL Randall C. I appreciate the info! Problem is I've been with my "Psychotic" team for several years now and have gotten tremendous help and am not eager to change solely because of insurance. I did try a new counselor a year back for that reason but it wasn't what I wanted. Again, thanks I am going to call on the reimbursement issue.
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MAJ Robert (Bob) Petrarca
Same here CAPT (Join to see), we were going to have to pay the 30% increase while the company paid the rest. For an individual plan it wasn't too bad, but had I had the family plan it was almost a $250.00/month increase - outrageous.
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CAPT (Join to see), take a look at the 3 pieces of advice I gave to new RC soldiers at https://www.rallypoint.com/answers/advice-to-new-reserve-component-soldiers?urlhash=172063#172063 ... detailed writeup on TRS.
Advice to (new) Reserve Component Soldiers | RallyPoint
Knowing what you know now, what advice would you give to a new reserve component soldier that is different from the advice you would give to an active duty soldier?
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COL Vincent Stoneking
COL Randall C.
What are the distinguishing features that separate Prime from Standard? I have admittedly done very little research (mainly flipping through the "your benefits" insert from the Army Times a few weeks back), but am currently feeling very confused.
My main concern is that I want to continue to use the civilian medical system and docs that I have been for the last 16+ years. My tour will literally be within 2 blocks of major military hospital on a major post. However, I will also be still living in the house I've been in for the last 12.
What are the distinguishing features that separate Prime from Standard? I have admittedly done very little research (mainly flipping through the "your benefits" insert from the Army Times a few weeks back), but am currently feeling very confused.
My main concern is that I want to continue to use the civilian medical system and docs that I have been for the last 16+ years. My tour will literally be within 2 blocks of major military hospital on a major post. However, I will also be still living in the house I've been in for the last 12.
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MAJ (Join to see)
COL Vincent Stoneking,
Sir, Tricare offers a comparison tool tha may be useful for answering that: http://www.tricare.mil/Plans/ComparePlans.aspx
Sir, Tricare offers a comparison tool tha may be useful for answering that: http://www.tricare.mil/Plans/ComparePlans.aspx
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COL Randall C.
COL Vincent Stoneking
Vince - Prime is required for the Active Duty member and you can elect to carry your family on it (usually - a few strange rules every now and then). You do everything through your primary care and you must use your MTF (unless there is an emergency) that you've been assigned and if there is a need outside the MTF, then they will refer you to it. If you aren't on active duty, then you don't get it. Biggest advantage of Prime is the lack of costs (usually everything is covered).
TRICARE Standard is like a PPO in that there are 'in network' docs and you don't have to get referrals to see a specialist. You see civilian docs (you can also see military docs technically, but you're at the bottom of the list and there are usually no slots because of the population of Prime folks they are serving) and sometimes you have to deal with paperwork.
TRS is TRICARE Standard with a monthly premium.
[edit] .... and MAJ (Join to see) has posted the TRICARE comparison link (saw it after my post)
Vince - Prime is required for the Active Duty member and you can elect to carry your family on it (usually - a few strange rules every now and then). You do everything through your primary care and you must use your MTF (unless there is an emergency) that you've been assigned and if there is a need outside the MTF, then they will refer you to it. If you aren't on active duty, then you don't get it. Biggest advantage of Prime is the lack of costs (usually everything is covered).
TRICARE Standard is like a PPO in that there are 'in network' docs and you don't have to get referrals to see a specialist. You see civilian docs (you can also see military docs technically, but you're at the bottom of the list and there are usually no slots because of the population of Prime folks they are serving) and sometimes you have to deal with paperwork.
TRS is TRICARE Standard with a monthly premium.
[edit] .... and MAJ (Join to see) has posted the TRICARE comparison link (saw it after my post)
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COL Vincent Stoneking
MAJ (Join to see) and COL Randall C.
Gentlemen, thank you both. The website is refreshingly clear.
Honestly, not the answer I was looking for on Prime, but it WAS the answer I was expecting. Looks like Prime for me and Standard for the spouse.
Now I just need to crunch on the son's status (lives with ex spouse, 19 and in College) - I've got all the info I need, just need to determine if I want to give him tertiary coverage (His mother covers him as primary, my civ insurance covers him as secondary). It's been way too long since I paid attention to tertiary coverage to even know if it's still a viable thing. though I suppose I could look at dropping my employer's coverage... back to the drawing board.
Gentlemen, thank you both. The website is refreshingly clear.
Honestly, not the answer I was looking for on Prime, but it WAS the answer I was expecting. Looks like Prime for me and Standard for the spouse.
Now I just need to crunch on the son's status (lives with ex spouse, 19 and in College) - I've got all the info I need, just need to determine if I want to give him tertiary coverage (His mother covers him as primary, my civ insurance covers him as secondary). It's been way too long since I paid attention to tertiary coverage to even know if it's still a viable thing. though I suppose I could look at dropping my employer's coverage... back to the drawing board.
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