Tricare vs State Health Benefits for PDRL

M

MSG_Raven2-3

Well-Known Member
PEB Forum Veteran
Registered Member
Recently Retired ArmyReserve-PDRL


Due to PDRL I qualified for Tricare. After researching, found Tricare Select was better option, we live about 1:15 from MTF. Plus I hate having to get referrals for specialist.

However, I still have another 6 years with my state job (for total of 25) for me to qualify for state health insurance (Blue Cross Blue Shield). But I can retire next year (20 years) and receive a pension but NO health insurance from the state.

Based on medical conditions for PDRL staying 25 might be doable, however work isn’t really supportive. At this point I might have to get a lawyer involved to see if I can get accommodations, but work is really against the whole “accommodation” stuff which might be way more stressful than actually just retiring at 20.

I am at a decision point and was wondering:

Is Tricare Select a similar or comparable insurance to Blue Cross Blue Shield? I know the copays are higher etc. is Tricare a legit insurance for major treatments etc? As a point of example, BCBS has chiropractor care, Tricare does not.

Any input would be appreciated.
 
Yes it is good insurance, and with a TriCare supplement or Medicare many of the deductibles are manageable.
 
I'm in a similar situation. Medically retired last week, and now have Tricare, but starting back to my CIV job in about 6 weeks. I am also a provider. Our personal experience has been more providers take BCBS, but the premium is pretty high. A lot of the providers we want to go to no longer accept Tricare (thanks DHA). So we are going to switch to BCBS when we return to our CIV job in OCT.

Tricare is good when providers accept it. However, the reimbursement is so bad that a lot of providers are no longer accepting it. I would recommend you ask the majority of your providers if they accept Tricare. For me that's my wifes PCM, and our kid's pediatricians. If anyone in the family receives or may receive other specialties, like mental health, physical therapy, ortho, etc, do your homework.

Good luck.
 
MSG_Raven2-3 said:
Recently Retired ArmyReserve-PDRL


Due to PDRL I qualified for Tricare. After researching, found Tricare Select was better option, we live about 1:15 from MTF. Plus I hate having to get referrals for specialist.

However, I still have another 6 years with my state job (for total of 25) for me to qualify for state health insurance (Blue Cross Blue Shield). But I can retire next year (20 years) and receive a pension but NO health insurance from the state.

Based on medical conditions for PDRL staying 25 might be doable, however work isn’t really supportive. At this point I might have to get a lawyer involved to see if I can get accommodations, but work is really against the whole “accommodation” stuff which might be way more stressful than actually just retiring at 20.

I am at a decision point and was wondering:

Is Tricare Select a similar or comparable insurance to Blue Cross Blue Shield? I know the copays are higher etc. is Tricare a legit insurance for major treatments etc? As a point of example, BCBS has chiropractor care, Tricare does not.

Any input would be appreciated.
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My entire family uses Tricare Select. It is the best because it is a PPO plan. $36 copay for regular doc visits and $50 co pay for specialist. No referrals and my family can see who they want. You just want to make sure you use an in network provider because if out of network the costs are higher. There is a $150 deductible before anything kicks in per person and $300 total for the family. So your first couple bills to start the new year you will pay the negotiated rate until you reach that deductible. From then on its mainly copays. Well worth it if you value choice and being in control of your family's health.
 
Warren G said:
I'm in a similar situation. Medically retired last week, and now have Tricare, but starting back to my CIV job in about 6 weeks. I am also a provider. Our personal experience has been more providers take BCBS, but the premium is pretty high. A lot of the providers we want to go to no longer accept Tricare (thanks DHA). So we are going to switch to BCBS when we return to our CIV job in OCT.

Tricare is good when providers accept it. However, the reimbursement is so bad that a lot of providers are no longer accepting it. I would recommend you ask the majority of your providers if they accept Tricare. For me that's my wifes PCM, and our kid's pediatricians. If anyone in the family receives or may receive other specialties, like mental health, physical therapy, ortho, etc, do your homework.

Good luck.
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Thanks, man that was really helpful. In fact I already checked and my primary care outside VA guy does take Tricare. Now it’s about finding a pediatrician my wife and kids like. That makes a lot if sense. BCBS is def more “availability” of providers.
 
Provis said:
My entire family uses Tricare Select. It is the best because it is a PPO plan. $36 copay for regular doc visits and $50 co pay for specialist. No referrals and my family can see who they want. You just want to make sure you use an in network provider because if out of network the costs are higher. There is a $150 deductible before anything kicks in per person and $300 total for the family. So your first couple bills to start the new year you will pay the negotiated rate until you reach that deductible. From then on it’s mainly copays. Well worth it if you value choice and being in control of your family's health.
Click to expand...
Thanks for that explanation it helps
 
MSG_Raven2-3 said:
Thanks for that explanation it helps
Click to expand...
The beautiful thing with Tricare Select is that you can see providers that don't accept Tricare too. So if really wanted to see a specialist that was out of network you could be reimbursed for some of the costs. There are caps on payout and they don't pay 100% but still that is a great option to have. My wife has a chronic condition that won't get better. If we find an amazing specialist who is out of network at least its an option for us even if it costs more out of pocket.
 
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