Tri-Care Prime or Standard?? (Blacksburg, Leesburg: dermatologist, insurance, home)

[msrodz]

We are new to the area and trying to decide between Tri-Care prime or standard. We live in Ashburn area which is limiting on us providers. We are a retired family with 3 teenage kids; 2 live at home and one is away at collage in Blacksburg/Christianburg area.

I've been told Blacksburg area it's better to go standard due to limited providers. But the college offers basic medical care so outside providers would only be needed occasionally, if at all. He can always schedule to be seen when he comes home, right? Anyone have experience with this situation?

With the other 2 being older (not under 10 when doctor visits can be more often) is standard a better option allowing more choice of providers? AS well as for my husband and I?

Lastly, can you recommend a medical clinic provider in the Ashburn/Leesburg or near surrounding areas.

Thanks!!!!

[HEATHER72]

I don't live in that area, so I can't comment on providers. You can look that up online. Prime is nearly free. Certainly you can find a PCM that takes Tricare Prime? I have never had a issue with Tricare Prime.

[djplourd]

Your best option would be to go to a Tricare office (maybe the one at Fort Belvoir) and ask them. I vaguely remember having something (maybe it was standard) for my son years ago when he was in college. His college offered some medical care too but the extra cost to keep him with tricare wasn't that much. It paid off when he had an accident and had to go to the emergency room in an ambulance! After I retired we kept prime but live close enough to belvoir that we get all of our routine appointments at the MTF. The occasional off post referral is only a $12 co-pay.

[Ben 'n Jen]

Costs and benefits to both. We've been Prime and standard. I can tell you that with standard, you are paying for convenience. With Prime we had to go to the PCM, get a referral, then go see a specialist. In a case with our son's ringworm from wrestling, it took weeks to see the referred dermatologist. With standard, we just find the specialist that takes Tricare and book the appt ourselves without having to get a referral from our PCM.

We didn't like our PCM when we arrived. With Prime, our options were limited. But now on standard, we can pick our own, but it does cost a little out of pocket.

[slduvall]

I agree with Ben 'Jen. We are retired now and use standard...I have my own insurance thru my company. But husband and dd use standard. Both are relatively healthy so we go for quite awhile with no appts at all. And as a retiree with standard you can use the emergency at any MTF. Which was the last time my husband needed treatment. If there had been follow on treatment he would need to go his own dr, which is fine. Not that Prime cost too much ($520 a family) we don't pay that much in deductibles/copays etc a year, using Standard. We like not waiting for that referral.

[pamnbam]

We have standard as a secondary to Blue Cross for the whole family. DH is retired so it's completely free. Having a good primary is key with having Tricare Standard as the secondary--little to no cost for anything. Prime is good but works more like an HMO in my opinion. If you don't have another primary insurance and don't want to do Prime, try Standard and the Supplement (minor extra cost per month)--works similarly to having a good primary+Standard.

[HEATHER72]

By the way, hubby is retired and we do not use a MTF. We were told when we moved here to find a private doctor that takes Tricare Prime. I have always chosen the doctor I want to see. All you have to do is look them up online. Referrals have always been quick, a week or less. Depending on the situation, we just told the front desk person to write up the referral for what we needed. With every referral, again I just looked up who I wanted to see and told the PCM. All you have to do is follow the rules, which are very simple. Any emergency, I just go to the local ER. Any monthly prescriptions, I use express scripts. Most of mine are free that way and shipped right to my door. Multiple surgeries for my son with only a $25 copay, which is honestly kind of a joke, but if that's what they want... then OK.