(Closed) Tricare Prime

posted 6 years ago in Military
Post # 3
Member
124 posts
Blushing bee
  • Wedding: June 2012

TriCare Prime is supposed to let you seek treatment from non-military medical facilities for a small co-pay. Regular TriCare is just the PCM and gyno with no referral. When they explained it to me, I took it to mean that any medical treatment needed beyond these would warrant a referral from them. With TriCare Prime, you should be able to go to a regular emergency room or urgent care clinic. TriCare, you should go to the emergency room on base or post.

Definitely call your PCM or your base / post TriCare office. This is what I took the explaination of TriCare to be. Hope everything works out for you!

Post # 4
Member
124 posts
Blushing bee
  • Wedding: June 2012

Oh, and I don’t know if you’re employed. I’m keeping my medical coverage through my employer (at least for now) because I can still be paid if I take off time for medical reasons (surgery, maternity leave, etc). Also, I retain the option of not being forced to use Fort Bragg’s medical facilities (we don’t live very close to post in case of emergency).

Post # 5
Member
7779 posts
Bumble Beekeeper

You need referrals for any specialists through your PCM. Maternity care is covered 100% through Tricare, you get 2 ultrasounds.

You just need to inform your PCM of an e-room visit. It’s not as hard as it sounds.

Post # 6
Member
574 posts
Busy bee
  • Wedding: January 2011

You can call your Tricare region by finding the number on this page.  Your regional manager is the best person to ask regarding all the rules and regulations.  From what I understand, things vary slightly between regions in how they manage referrals and such.

It’s honestly not as hard or scary as it may seem!  Really. 🙂

Post # 9
Member
2907 posts
Sugar bee
  • Wedding: July 2011

@nyscpa2be:  I have Tricare prime, and “basic maternity” includes everything. I think I only get the two ultrasounds I’ve already had (dating ultrasound at 8-10 weeks, and anatomy scan detailed ultrasound around 20 weeks). And you have to deliver at a military hospital, and will probably be seen by an NP, not an OB throughout your pregnancy.

Still, they are very efficient and I hardly have to wait at all for my appointments.

 

Getting seen in an emergency room has to be approved by your PCM, but that’s true for any HMO. Basically you have an HMO and everything needs a referral. Best part? NO copays, no deductible, and NO COST AT ALL if you do everything through your PCM.

Post # 11
Member
2907 posts
Sugar bee
  • Wedding: July 2011

@nyscpa2be:  Oh. Good luck! I’m not familiar with Tricare prime remote.

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