TriCare Prime not free for life retiree medical care

[PessOptimist]

I am not really sure where to post this on TSPTalk but this will do for now. If any of you mods/members know a better place say so.
I have been a little pissed off about TriCare Prime military medical care for about 18 years. I have been retired from the military for about 18 years.
First let’s get the bullsh1t about free medical care for life for lifers out of the way. It was not free. I has been cheap. It also has been very difficult to get appointments with your provider. At least for me.
You call the appointment line and they tell you your assigned provider (PCM) has no appointments this month and you must call the first duty day of the next month. You do so early in the morning and the line is busy so you redial constantly and when you get through you are told your PCM has no appointments this month and you must call the first duty day of the next month. Repeat as necessary.
I then discovered TriCare on line and found you could actually get an appointment with your PCM that way. OK, why didn’t the nice person on the appointment line tell me that?
So last Tuesday I am seeing my newly assigned PCM and she tells me I need a follow up appointment in two weeks and she will make it. She then comes back and tells me there is a problem and I must call the appointment line. I cannot talk to anyone there, I must call the appointment line. So I made an appointment on line. Today I get a voice mail saying my appointment is cancelled and I must call the appointment line. No mention of who called, airman noname just said the appointment is cancelled. So I go back to TriCare on line and get a message saying that “appointing” is currently unavailable at my military treatment facility (MTF). That MTF being the 56[SUP]th[/SUP] Medical Group at Luke AFB AZ. So I will call the appointment line tomorrow and get the runaround and proceed from there.
Yes I am venting a little but I would like to know if any others are having the same problems getting medical care through TriCare. It seems to have gotten worse recently.
PO

 

[alevin]

My sister has TriCare for Life. Haven't heard of problems other than difficulty getting an appointment with a neurological specialist who would take TriCare. That and TriCare not making timely payments to outside providers. which created other problems for her. According to a VA doctor I talked to several years ago, she's entitled to go to the VA, but she's never made the effort to get signed up. Wish she would.

 

[PessOptimist]

My sister has TriCare for Life. Haven't heard of problems other than difficulty getting an appointment with a neurological specialist who would take TriCare. That and TriCare not making timely payments to outside providers. which created other problems for her. According to a VA doctor I talked to several years ago, she's entitled to go to the VA, but she's never made the effort to get signed up. Wish she would.

IMHO if you are eligible for any type of Tricare, leave VA out of it. They have so many problems caring for those who are only VA eligible they don’t need any more. Whole other subject.

If your sister has Tricare for life she must be enrolled in medicare and be paying for part B.

I go through this every time I or my spouse deal with a medical provider. This applies to a retiree.

Tricare has three plans.
Tricare Standard and extra
Tricare Prime
Tricare for Life

Tricare Standard and Extra you have to find a service provider, have a $150 deductible and pay about 15% of the cost per visit.

Tricare Prime you pay an annual cost of about $560 for the privilege of seeing a PA or doctor at a military facility if you can get an appointment. After that it is pretty much no fee.

Tricare for Life for life is a wrap around coverage you get for free IF you are enrolled in medicare and pay for part b. Part b premiums the last time I checked were 113% of the Tricare prime premiums. At 65 you are thrown out on the street if you have Tricare prime and must enroll in medicare plus pay for part b AND usually have to find a new doctor.

Does your sister REALLY have Tricare for Life? Does she know which Tricare plan she is part of? If she is not a in medicare she does not have Tricare for life but some other Tricare plan.

Free medical care for life is bull for military retirees, most providers do not understand the tricare system, many people in the tricare system don’t know which plan they are in.

If you want to complain about VA care start another thread. It has absolutely nothing to do with Tricare.

PO

 

[alevin]

My thanks PO. She's a military widow, did service time herself. She's younger than me, a ways from medicare age, so I guess it's not T for Life version. thought that was what she told me it was. She may be confused as well. I'm not complaining about VA care in the least. My commentary was that she's had some problems with tricare not being accepted by some providers and not always making timely payments to providers. My perception has been that she might get better care for the disabling condition she has, if she went to the VA. I have no basis for that perception other than my own frustration with her that I know there is help out there that she has not pursued hard enough. Instead she simply suffers enormously every day. Without complaining. I've seen what severe scoliosis and heart failure do to her, heart failure from a Celebrex-related painkiller. 2 different conditions working in tandem.

 

[PessOptimist]

OK, military widow may be tricare for life. There are so many categories. Social Security death benefit will put you in tricare for life I think. Get her to the VA. I was only saying people like myself who have benefits under tricare and are also eligible for benefits under VA as I am should not try to use both as long as one pays the bills.

 

[jpcavin]

My sister has TriCare for Life. Haven't heard of problems other than difficulty getting an appointment with a neurological specialist who would take TriCare. That and TriCare not making timely payments to outside providers. which created other problems for her. According to a VA doctor I talked to several years ago, she's entitled to go to the VA, but she's never made the effort to get signed up. Wish she would.

VA is worse from what I hear. PCM should send NEURO consult request to Tricare and Tricare in turn, would send your sister a letter with approved Neurologist. It will include number of visits authorized and expiration date of approved visits.

Edit: This may have already been covered by follow on posts that I didn't read. Sorry.

 

[jpcavin]

TRICARE Prime is the way to go unless it is not available in your area or you are not entitled. If you go to VA, Tricare reimburses the VA. When you sign up for VA, you have to sign paperwork agreeing to allow them to bill Tricare. I've signed up but have never been to VA. I still use my Tricare.
Also, as far as care, I have never been happy with any of the doctors in Family Practice ..seems all they have are Nurse Practitioners. The best care I've received has been from Internal Medicine. That's where the real doctors are. At least out here where I am at.

 

[alevin]

thanks jp. I think that matches sis's experience. Unfortunately her attempts at getting decent MRI diagnosis have not gone well either at this point. why they can't figure out that the severe scoliosis is what makes her legs go out from under her without warning, and the reason she can't get up right away when she goes down in the middle of a shopping center parking lot when she's surrounded by strangers who won't offer to help, is beyond me why the specialist can't or won't see that in the MRI. And why they can't or won't diagnose the cause of the extreme pain when she tries to do normal everyday walking. She's pretty well given up on the medical profession, other than for the rheumatoid arthritis that's now developed in her hands on top of everything else. I urged her to get second opinion on the MRI reading after the first incompetant reading, but she's not very assertive when discouraged. She's pretty much given up on getting better diagnosis. just lives with it. family too far away to serve as advocates.

 

[James48843]

I am enrolled in the VA and get occasional care from them. I am very, very happy with quality of service and appointment process through VA.

I also have regular FEHB HMO - and have much of my care through them. Never had an issue.

I am retired Army National Guard, and will be eligible for Tricare for Life AFTER I turn 60 and start collecting Guard pension. Not until then, however. Since there are no military medical facilities of any kind near me, I plan on using VA (about 30 miles away) for perscriptions and that care that is VA approtiate, and then FEHB HMO/and Tricare for Life when I retire.


My experience with VA has been overall very positive. No experience with Tricare.

 

[nasa1974]

I am not really sure where to post this on TSPTalk but this will do for now. If any of you mods/members know a better place say so.
PO

PO, This is the right spot for this thread. Good luck with TriCare.

 

[PessOptimist]

I am enrolled in the VA and get occasional care from them. I am very, very happy with quality of service and appointment process through VA.

I also have regular FEHB HMO - and have much of my care through them. Never had an issue.

I am retired Army National Guard, and will be eligible for Tricare for Life AFTER I turn 60 and start collecting Guard pension. Not until then, however. Since there are no military medical facilities of any kind near me, I plan on using VA (about 30 miles away) for perscriptions and that care that is VA approtiate, and then FEHB HMO/and Tricare for Life when I retire.


My experience with VA has been overall very positive. No experience with Tricare.

James, I also have a FEHB plan mainly because after spouse used Tricare Prime for a while after I retired from the AF she got real fed up with the difficulty getting appointments and having to be screened by family practice for any referral, even a follow up to a referral. The FEHB plan becomes “other health insurance” and is the primary payer. Not the cheapest solution premium wise but we have very few out of pocket expenses otherwise. I have noticed since United Healthcare Military & Veterans became the contractor that things paid in the past are now denied. I am getting sort of off topic here maybe.

Main reason for replying is I think you need to double check which Tricare program you will be eligible for at 60. The lines between ArNG and reserve are gray on the site linked below and somewhere it does say for NG members to contact your readiness NCO.
At Eligibility - Retired Reserve Members and Families it is pretty explicit that Tricare for Life is only for Medicare A and B enrollees. No doubt you qualify for some kind of Tricare at 60 as it says but I would advise you to check it out. Being confused about which Tricare category you fall in to is not unusual. Health care providers are even more confused.

Of course that time is years away for you kid, right?:cheesy:

I wasn’t making any comment about VA care, quality or availability. Just stating that since I have Tricare I choose not to add to the burden of the VA system which as we all know has its share of problems.

PO

 

[PessOptimist]

Re: TriCare Prime retiree medical care

TRICARE Prime is the way to go unless it is not available in your area or you are not entitled. If you go to VA, Tricare reimburses the VA. When you sign up for VA, you have to sign paperwork agreeing to allow them to bill Tricare. I've signed up but have never been to VA. I still use my Tricare.
Also, as far as care, I have never been happy with any of the doctors in Family Practice ..seems all they have are Nurse Practitioners. The best care I've received has been from Internal Medicine. That's where the real doctors are. At least out here where I am at.

In the Air Force system the real doctors are in flight medicine but if you never got any shiny wings you can’t see them. At least where I am at. Of course the base is a fighter pilot training base and they do have their priorities. I promise I will say nothing about zipper suited sun gods. I promise.

OK, I lied.

Based on your location your MTF may be AF or Navy. Just being nosy.

I find that family practice will refer me to other clinics and for testing but the results are almost always inconclusive or show a minor problem that we should “wait and see” what happens. My last two PCMs have been MDs. The current one is brand new to military care and can’t seem to find any history of me. That might be because when I look for her in the MTF list of PCMs, she is not there. Give it time, she has only been there two months.

Enough of my whining. I did get my appointment rescheduled by e-mailing Relay Health USA which is also referred to as micare I think. This is a portal to actually contact one of your PCMs minions. I mean associates. Since I couldn’t find my current PCM listed I sent it to my prior PCM who has retired and got a reply from a SrA who made me an appointment. Five days after the cancelled one but at least an appointment. I am getting tired of having to work around the Tricare system.

Perhaps the title to this thread should have not free for life put in quotes or removed so as to make it seem like a discussion of Tricare and not PO whining.

PO