Tricare help?

Question

I just got enrolled in Tricare standard and I am SO confused. I need an ob/gyn for my annual pap smear and because we're trying to get pregnant and can't. I also need to see a doctor about getting an inhaler (i've had them all my life) before winter sets in. How on earth do I do this? I chose a civilian doctor but it just says shes a family practitioner. Surely she doesn't do pap smears? What do I do? Do I call her office and make an appointment? Will it be free? What do I pay? I'm just so lost on all of this and I tried to talk with the people at the tricare office but they basically read me my paperwork (which I didnt understand to begin with!) and when I asked questions REread the paperwork to me!! Ugh. I'm confused. Someone please break it down for me!

I'm in standard because thats what you automatically are enrolled in and no one informed me there are other choices! Lol .... man.... how do I switch to prime? I did pick a doctor off their approved list.

Answer 1

Can I ask why you are using Tricare standard? You really should be using Tricare Prime, unless you just really don't want any of the docs in the Tricare system. There is NO expense associated with Tricare prime, even if you are seeing a civilian doc, as long as they are an approved provider.
Her unwillingness to do a pap may be related to your troubles trying to concieve and she may feel you are better served with an OB in this case. Either way, you will need to get a referral from her to go to a specialist. Anymore than that, you will have to deal with the tricare office or with the website. I'm not familiar with Standard, only Prime.

Good luck!!

ADDITION:
Go to your Tricare office and tell them you want Prime! Not sure why they set you up in standard and told you that was the norm. I know in the AF the automatically set you up with prime. Since your doc is on the approved list you will get 100% coverage... no out of pocket! RUN, don't walk, to the Tricare office and get it changed quick!!!!! Keep asking questions... it's the only way to learn!!
Hugs!

Answer 2

A family practitioner can give you a pap. You don't need a OB/GYN for that. Yes, call the doctor's office and make an appointment. You can get you pap and your inhaler in the same visit. No it will not be free. If you had Tricare Prime it would be free but with Tricare Standard you have to pay 15% of the total cost up to $150. You need to call your docotor's office and ask if they file the Tricare paperwork for you. som doctor's require that you pay the total cost upfront and then submit the claim yourself for reimbursement. that's what sucks about Tricare Standard. Why in the world did you sign up for Tricare Standard? With Prime you could have gone to the military hospital and it would be totally free.

Answer 3

The very first thing you need to be sure of is that the general practioner is a Tricare certified provider. If they are, they should file all the claims for you and, aside from whatever your copay is, accept what Tricare pays as payment in full. If the provider is not a Tricare approved provider, you would have to pay the full cost of all services and tests up front and then sumit claims on your own for reimbursement .

A GP can do your PAP and give you a script for inhalers. Generally, generic drugs will cost $3, name brand $9, but there are many drugs (antidepressants being one) that have a higher cost to them if purchased from a civilian provider.

I will be honest...if you are eligable for Prime it is worth the extra cost if you can afford it. coverage is better, you have more options. If you have any questions and the Tricare folks aren't being helpful, you can contact the patient advocate at the nearest military medical facility.

Answer 4

1. You will pay the first $100 of outpatient care per fiscal year (October 1st to of this year September 30th of the next year).
2. You will also be obligated for 20% of the remainder of your outpatient charges over that amount.
3. By billing Tri-Care, your provider has agreed to accept their payment as full and fair payment (along with your deductible)
4. Any family practice doctor can obtain a sample for PAP testing. That same doctor can write you a prescription for your inhaler. Make sure she writes it for the generic version of the drug. You can fill it at any civilian pharmacy for a copay of $3.00 that way. It's $9.00 co-pay for a brand name drug.
5. Make the appointment. Make sure you bring your military dependent's ID card with you. The front desk people at the doctor's office will usually make a xerox copy of the card to use in preparing the claim form.
Hope this helps.

Answer 5

Use this website for all of your Tricare questions .https://www.hnfs.net/common/benefits/TRICARE+Costs+for+ADFM.htm

Answer 6

Go to www.tricare.org .