another tricare question

[Meredith]

I'm on tricare prime and I need a surgeon to uh yeah :bartmoon: lol

my parents don't want me seeing anyone that came up on the list cause their all in the ghetto which means they're probably not the greatest surgeons. So they have me going to see a surgeon from a hospital that just took care of my bros arm and it looks great....

question is...can i go to them and then submit a claim to tricare even tho I'm on prime and I'm supposed to go who they tell me to?? will they cover any of it??

my other option is paying the copay...getting the consult. and then calling my friends ex whose uscg and see what he thinks of the MTF on the Coast Guard base on Staten Island...my guess is he doesn't think much of it cause he's a bigger jersey snot than me lol...

[Katie]

OK... I'm going to give you my experience... We have prime. I don't know how it's SUPPOSE to go. But I will tell you the way we have had it work...

With my surgury, We were sent to a surgions office (not on tricares little list) but it was the one my doc wanted me to see. So they submitted the request for it and it was paid, I had no copay at all not for the surgury, not for the visit or anything. I have never had any copays being on prime.

The way the woman on the phone explained to me is you can basically see whomever you want to see in the area you just need the referal. So pick a doc, tell them THIS is who I want to see.. and make the referal for that doc.

Hope it works out for you.

[KristiMarie]

I hope it works out better than Tricare dental! lol I need my wisdom teeth taken out.. and there is NO one within a hour of here accepting united concordia as far as oral surgeons... dentists im fine, about 20 in 10miles... but its not as great as Katie explained... I cant go see them, even with a referral, I still end up paying all $2,000 for the surgery out of pocket :( GAY GAY GAY Now I gota wait till christmas and hope i can get in at campbell to have it done then.. but my wisdom teeth are starting to hurt... like on a daily baisis sooo I dont know if i can make it till then


GOOD LUCK! Hope medical is more friendly than dental!

[Kira]

There is also Tricare Prime Remote, they may have more doctors on that list??? I think that you can see an out of network surgeon and you just have to pay the co-share as if you had Tricare standard, but Katie's suggestion woked so I hope it does for you!!

[Meredith]

thanks ladies. ill call my pcm on monday and have her write me a referral I probably won't get it in time for the office visit but if I don't have to pay for the surgery that would be awesome! I told Mike he should let me go on standard (which is what I've wanted from the start) but he doesn't want to pay the deductible or w/e it is. He's so cheap sometimes lol. I guess he's right, if they're offering free med services I should take them but sometimes it's nice just to do it your own way...esp when it comes to things like surgery.

[KristiMarie]

Mere trust me, I HATED STANDARD. For real, It was so expensive. Just for a Pap Smear I got over a $500 bill :( NOT fun. Then I realized why ppl with no insurance go to planned parenthood for that sort of thing lol

[Mary Cat]

I used who I wanted to use for my doctor visits when I was still in NJ and they paid for it. You should be fine as long as you submit the information asap

[Tissa]

I read that when they are deployed the deductible for Standard is waived. Check it out first of course. Also if you can't get a referral and just want to use another surgeon. You will fall under the Point of Service Option. There's a deductible of $300 and some costs but they will pay a portion of your care. Here's a link to the info.

http://tricare.mil/mybenefit/home/Medical/Costs/PointOfServiceCosts

If you decide to go with Point of Service you can probably call tricare and find out how much they will pay ahead of time. Then maybe work out a payment plan with your surgeon or hospital for the rest.

Also if this is the pilonidal surgery I had that done about 5 years ago so feel free to ask me questions.