Tricare Standard?

[amaristella]

Sorry in advance for the post and run. I will come check in again tomorrow some time. I know Tricare Standard has been discussed before, but please refresh me.

There have been some changes with the health clinic that my family goes to. The pediatrics department was closed and only three pediatricians were retained. They distributed one each to the family care groups and then redistributed the pediatrics patients to the remaining doctors. I was originally told that my son would be moved over to one of the remaining pediatricians but when I got my letter from Tricare it seems they switched him over to my PCM who I am not super comfortable taking him to. I don't mind seeing her myself, but I just don't imagine it would work well with my baby. I pretty much saw it coming because there was no way that 3 peds were going to have room for all those extra kids.

Rumor has it that my son's previous doctor (civilian) has a private practice out in town and that people are switching their kids over to standard in order to keep the doctor they had before and I'm thinking of trying to do it too.

Would you consider switching just one member of your family to standard in order to keep a doctor you liked? Do you think it would be worth it? Also, can anybody give me a quick rundown of how standard actually works? I have it in my head that it's roughly equivalent to the average civilian HMO.

[meltoine]

I'd try requesting a PCM change first before switching to standard. I've used standard before and I don't mind it for myself, but for the number of visits babies/toddlers have, the copays would add up.

I believe you will pay 20% of what tricare would cover if you had prime. So, if your doctor charges $150 for a regular well-baby' but Tricare Prime would pay $100, you will pay $20 out of pocket.

[amaristella]

Jun 10, 2014 7:42:06 GMT -5 meltoine said:

I'd try requesting a PCM change first before switching to standard. I've used standard before and I don't mind it for myself, but for the number of visits babies/toddlers have, the copays would add up.

I believe you will pay 20% of what tricare would cover if you had prime. So, if your doctor charges $150 for a regular well-baby' but Tricare Prime would pay $100, you will pay $20 out of pocket.

If I can figure out my log in I want to try switching online to the pediatrician that I was originally told he would be assigned to but I still have lingering concerns beyond that about him being seen in the family practice with only the rumor mill for answers. And it's tough because so far in this situation the rumor mill has given me more correct information than the official statements.

[amaristella]

Jun 10, 2014 14:41:27 GMT -5 Stan said:

Standard is part of the reason the military is poor so I will never go on Standard. I'm on Prime Remote because I have to be due to H's orders. I feel guilty going to the doctor so I haven't. I do need to go because of my injury, but that's line of duty so I get to see a military doctor.

I'm definitely in the minority though. I think the military should get rid of Standard.

While I can certainly appreciate the cost savings/philosophical discussion in this instance my emotions really rule because I don't feel right taking a 6 month old with communication skills somewhere between a dog and a cat to a doctor I don't have faith in. In the discussion I saw last night there were people saying they'd rather get rid of all the commissaries than have their baby seen by their own family care PCM. Despite the official insistence that they can keep up the same standard of care for their patients with 3 doctors where previously there were 11 (borrowing time from the family care doctors to fill in the blanks) just doesn't seem possible to me.

[amaristella]

Okay. Update. I managed to find my Tricare login and requested him be switched to a doctor at a different health clinic that's actually closer to my house than the one we were going to before. Hopefully it gets approved. There are actually two different doctors so if we see the first one and I don't like them then I'll switch to the other one. Whoever advised my husband back in November sure didn't know what they were talking about because apparently there's a policy around here that non active duty beneficiaries can be seen at any clinic regardless of branch affiliation.