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Which Tricare Plan is for YOU

Which Tricare Plan is for YOU?

Which TRICARE Plan is for YOU ? TRICARE has a number of different health care plans and it can sometimes be daunting when you sit down to choose a plan. This article can help you make your decision in a more methodical way.

Which TRICARE Plan is for YOU?

While the TRICARE Prime health care plan is known to be a very affordable and cost-effective package, which provides all the minimum necessary coverage that has been stipulated by the Affordable Care Act, it provides very little flexibility in the way of choosing your medical care provider. On the other hand, both the TRICARE Standard health care plan and the TRICARE Extra option provide people with much more flexibility. The main difference that then lies between these two plans is that under TRICARE Extra, a person has to choose a health care provider from a list of network providers (that is, those providers who are a part of the TRICARE network).

On the other hand, under the TRICARE Standard health care plan, a person can choose a health care provider who is not a part of the TRICARE network. Therefore, if you are looking for more flexibility, then you can choose from either the TRICARE Standard or TRICARE Extra packages. However, if you are looking for coverage and a cost-effective solution, then Tricare Prime may be a more viable option.

Under the TRICARE Prime plan, you will be required to consult your primary care manager before you receive any health care, who will also be responsible for making all doctor appointments, maintaining and updating health records and providing referrals in case you need to see a specialist doctor. However, there is no primary care manager in the other two programs and you do not need to obtain a referral before consulting another specialist.

If you are covered by the TRICARE Prime health care plan, then you do not need to trouble yourself with filing any claims for reimbursements, as the primary care manager will do that for you. Although this is also mostly done as a part of the TRICARE Standard and TRICARE Extra health care plans, it is possible that you may have to file a claim for a reimbursement yourself if you went to a non-network health care provider for your health care services.

Therefore, if you are looking for a comprehensive but affordable package, then TRICARE Prime may suit you more, but if you want greater choice and flexibility, then you should opt for the TRICARE Standard and Extra packages.

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9 comments

  1. I am trying to find out if a Medicare/ tricare for life member have a civilian primary care and still use other services at Madigan such as the ENT Clinic or Orthopedics clinic.

  2. Joseph E Tibor Sr

    I am retired USMC . The question I have is . Does Tricare medical cover vision and hearing? If not, Does Tricare offer a plan for it? If Tricare does cover vision and hearing, What does it cover? Ive never had to us Tricare for vision and hearing and never gave it much thought. Now that My wife and I are getting older ; we thought we should check into it. I am enrolled in DEERS and I do have Tricare coverage. Your answers would be greatly appreciated. Thank you for your time .

  3. I am wanting to sign up for TriCare. What do I have to do to do this?

  4. My husband is an Air Force Retired veteran, for the month of January he was hospitalized twice. The Doctors have said that he has an infection in his lungs and needs to have this medication named GENTANICIN. The Doctors office has been trying to get authorization for this medicine with no results. He does have TriCare for Life, and I cannot understand why this medicine cannot be approved, we know there might be a deductible and
    that’s fine, if he’s unable to get it, it will mean he will be in and out of the hospital. Please your assistance in this matter is greatly appreciated. Thanking you in advance.

    Mrs Olga Zabala

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