can you get treatment at a network provider or do you have to get treatment at a military treatment facility? Is it your choice? and if you chose a network provider do you have to pay anything. i have prime.
2007-12-04 07:02:18 · 9 answers · asked by oes 2 in Politics & Government ➔ Military
You can either go to the (MTF) Military Treatment Facility or a Network Provider, it is your choice. You can choose from a list of Network Providers from the Tricare website. Or you can ask a provider if they accept Tricare. If you want to see a specialist or Non-Network provider, you will have to pay out of pocket costs unless you have a referral for a specialist (still has to be in network). The only issue with a Network provider is that claims can get messy if the doctor won't do them for you. You can see him as long as you do the claims paperwork and submit it for payment. It can get very screwy, Tricare has great benefits but they are really bad with claims, it can take a long time to get straightened out.
P.S. Tricare Prime, you DO NOT have to pay for a THING, no co-pays, no prescriptions, etc. It is the active duty coverage, so it is all free. The best type of Tricare there is!
2007-12-04 07:09:58 · answer #1 · answered by P.Y.T.23 3 · 0⤊ 0⤋
The answer is, it can depend. If you live near a military facility, it is generally easier to seek medical services on the base. If you choose to, you can see a civilian, in-network provider. The tricare website will help you find one and generally there is no cost associated with this option. However, in some cases, Tricare can deny civilian services if there is a military facilty close enough that will provide them. We had this happen when our daughter was injured and required extensive physical therapy. Even though Tricare gladly covered all the hospital costs from a civilian hospital and the cost of her working with the orthopedic, civilian surgeon (who was a Tricare network provider) when it came time to PT, they declined our referral from the doctor to have PT with a civilian, Tricare network therapist and had us go to the military clinic instead. Always check with Tricare before beginning treatment with a civilian provider if you plan to use them instead of military facilities, just to be on the safe side. If there is no military facility within a certain mileage or the base does not have the services you need, then you can seek a civilian network provider. Mental health services and dental are almost always referred to off base providers for family members as these two clinics are generally dedicated to active duty only,
PS..Prime does not provide for free prescriptions if you use a civilian (CVS, Walgreens, Walmart, etc) pharmacy. Depending on the medication, your co-pay is $3 for generic drugs and $9 for name brand. HOWEVER, many of the medications used for depression and mental/emotional health issues fall into a different category and will run you $22 to get. This is still a substantial savings over what most people would have to pay, but if at all possible the best way to get meds is through your military pharmacy....then it is always free.
2007-12-04 15:12:08 · answer #2 · answered by Annie 6 · 0⤊ 0⤋
If you are near a military care facility you may be better off there. Some areas near bases still do give you a choice.
If you choose to have your primary care provider as a civilian in the tricare network then you pay a $12 co-pay for each office visit.
You really should call tricare to be sure.
2007-12-04 15:07:29 · answer #3 · answered by SFC_Ollie 7 · 0⤊ 0⤋
You can get treatment at a network provider, but if you want to do this, you will have to get your PCM changed--Primary Care Manager. Find a doctor--family physician--that you want to see, then call Tricare and get your PCM changed to that physician.
As far as I know, it's your choice; however, if you're active duty and are on-base or something, it will probably be a little more difficult to get the PCM changed--but it can be done.
If you need to see a specialist, you will have to get a referral through your PCM. Tricare prime requires referrals for virtually everything--consult visits, MRI's, etc. and it all has to go through the PCM.
Good luck!
2007-12-04 15:08:53 · answer #4 · answered by Anonymous · 0⤊ 0⤋
I have Tricare Prime for my daughter. At first she was seen at the naval hospital till I had some problems with them. So I had gone to Tricare to change her to a civilian doctor and she has seen one for the past yr and I have never payed a copay. But on the other hand, a friend of mine went to change out her son and they said she would now have to change to Tricare Standard to be seen at the dr my daughter is seen. I don't know if they changed it in the past year.
2007-12-04 21:32:12 · answer #5 · answered by NIKKI1118 3 · 0⤊ 0⤋
The answer depends somewhant on which Tri-Care you've opted for or if you fall under Tricare for Life. Contact you local Tri-Care office for the straight skinny or go to thier web site.
2007-12-04 16:20:35 · answer #6 · answered by cranknbank9 4 · 0⤊ 0⤋
I think that if you choose a network provider you have a copay. I think you also need a referral, if you live within a certain distance of a MTF.
2007-12-04 15:06:08 · answer #7 · answered by Sister blue eyes 6 · 0⤊ 0⤋
you chose a Primary Care Manager and you go to that doctor and that doctor refers you to specialists....you usually do not have to pay anything for routine services...somthings tricare might not cover completly.
2007-12-04 15:06:52 · answer #8 · answered by ? 2 · 0⤊ 0⤋
Do you live near a military post?
Either way you should get a referral.
2007-12-04 15:06:32 · answer #9 · answered by your_sunshine78 2 · 0⤊ 0⤋