Rebecca - posted on 01/26/2010 ( 9 moms have responded )
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My daughter is 11 weeks old and my husband was told by someone he works with that Tricare does not pick up the cost of all her immunizations, is this true? I have tried to call Tricare and ask but it seems like they have high school drop outs as employees and it would be to much effort to ask a supervisor or look it up..
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Danielle - posted on 01/27/2010
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Rebecca, I would change from Tricare Standard to Tricare Prime because they do pay for everything and if you have the Standard, they will pay for only certain things.This is what I pulled off on Tricare about the Con's to having Standard
No Primary Care Manager
Patient pays Deductible and Co-payment
Patient pays balance if bill exceeds allowable charge and provider is non-participating (up to 15% additional)
Nonavailability statement may be required for civilian inpatient care for areas surrounding MTFs
Beneficiaries may have to do their own paperwork and file their own claims
With Prime you can ask them what providers are in your area that you can go to being the base is an hour away and they can give you that list. It is based on what providers are close to your address and who will take Tricare Prime. But I would not stay with Tricare Standard. Plus with Prime you can ask for a referal to go someone else.
Courtney - posted on 01/27/2010
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Tricare Prime covers everything.. I've never had to pay for any of my son's immunizations. I don't know much about Tricare Standard. None of my military friends that I know has Tricare Standard for their family. Sorry I couldn't help.
Ashley - posted on 01/27/2010
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My husband has been in the Marine Corps for 10 years and I have a four year old. We have been both near a base and far away (when he was on Recruiting Duty). I have never had to pay for any medical cost. The only thing I have had to pay is for prescriptions when we were on a recruting duty and used a civilian pharmacy. We are enrolled in Tricare Prime and have been since we got married. I have heard of Tricare not covering the costs of extra things related to special medical and mental health needs.
Heather - posted on 01/27/2010
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Why are you Tricare standard and not Prime, if you dont mind me asking? If you can be switched to Prime then I think you sould really look into it because as a Prime member you wont have to pay for any medical expensises. And like Kari said, if there is an emergancy you can go to the nearest hospital for help you just have to call Ticare. Best of luck.
Kari - posted on 01/27/2010
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You probably have to pay since your not in prime. But I don't know if you know this if your in Prime and your baby gets sick you don't have to go to the base if you go to the ER you just go to the nearest hospital and then call Tricare within 24 hrs and tell them that you went. But I'd call and ask to immediately speak to the supervisor and say that you've called multiple times and you need an answer. If that doesn't work I'd go to the Tricare office I know it's far away but that may be the only way to get an answer.
Rebecca - posted on 01/27/2010
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I am enrolled in Tricare standard ( we are okay with the $1000 deductable) for the meir fact that I can choose my own doctors otherwise ,something new they just started is we would have to go to the base to be seen. That base is almost an hour away and if my baby gets sick I dont want to drive that far to have her seen. Especially if she needs to be admitted to a hospital the nearest one to the base is 35 minutes away! As it stands her doctor is literally right next door all I do is walk out my door and across the parking lot and the nearest hospital is less than 10 minutes away. I was told that my maternity stuff would be covered, well everything but most of the blood work you are required to do and ultrasounds. According to Tricare these things are not medically nessasary for you to have a baby. So far the only bill I have gotten was for her hearing test because the hospital used a doctor that did not accept tricare. Mix up on their part but I had to pay. Out of 19 babies born that day we were the only insurance paying family. We recieved that the day we got home from the hospital which was 3 days after she was born. I keep looking up the stuff on the tricare web site but it is all still pending.
Shannon - posted on 01/26/2010
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If you are enrolled in Tricare Prime, which you should be (have the hubs double tap on that), then everything should be covered. Even if you are out of state visiting family, and your child gets sick.
Jessica - posted on 01/26/2010
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ok Rebecca they will cover the all the immunizations till your husband gets out of the service he is in. and if you need anything message me, i have dealt with this for 4 months for my daughter and I deal with tricare for myself too.
Heather - posted on 01/26/2010
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Tricare Prime will cover ALL of your childs medical needs.. You just have to make sure you have done everything you needed to to get her into DEERS and TricarePrime. If you havent here is what you do.. This is right out of the Tricare Prime Handbook.. lol
You should register your newborn in DEERS as soon as possibel. To register your child in DEERS, you need only a certificate of live birth or adoption. The document does not need to be a certified copy of the official birth certificate. It can be a certificate of live birth authenticated by either the attending physician or other responisble party from the hospital. Registration in DEERS is a separete step from enrolling in Prime.
Children are covered as TRICARE Prime beneficiaries for 60 days after birth as long as one other family member is enrolled in Tricare Prime. If you wish to keep your child enrolled in Tricare Prime, you must submit an enrollment application to your regional contractor within 60 days of birth or adoption for continuous Prime coverage.
On day 61, if you have not enrolled the child in Tricare Prime, she will be covered automatically under Tricare Standard and Tricare Extra until 365 days after the child's birth or adoption. On day 366, if the child is not registered in DEERS, DEERS will show "loss of eligibility," and she will no longer be able to recieve Tricare benefits until they are registered in DEERS.
Here are all the Tricare numbers I have, so maybe if you still have questions you can call them all and try to get someone with half a brain.. lol, good luck.. hope i was some help..
Tricare website: www. tricare.mil
Tricare North Region:
1-877-874-2273
www.healthnetfederalservices.com
Tricare South Region:
1-800-444-5445
www.humana-military.com
Tricare West Region:
1-888-874-9378
www.triwest.com
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