Retiree/VA Medical Coverage

Mongo

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A couple of comments made on another thread which portray an unfair picture of military retiree medical care:

Pima said:
To state Tri-Care is doing its job, when not in the program is like me stating Medicare is working (I am 45). I have no working knowledge of Medicare. If he thinks it is working so well, I would love to talk to him, since as a newly retired spouse, Bullet and I do everything humanly possible to stay away from tri-care. We actually pay out of pocket for primary insurance so we don't use it. AND YES, retirees pay for tri-care, thus we pay 2 insurance payments. The irony is under Tri-Care we pay 128 a month, with 20% co-pay, referrals, no vision and no dental. Under Bullet's office we pay 133 a month, no co-pay, no referrals, and have both vision and dental. We have kept Tri-Care because it picks up the difference for prescriptions from our other insurance.

These comments are unfair to the Tricare system. I think Pima is describing Tricare Prime, which, if she doesn’t like, should change to Tricare Standard. This is an outstanding system when combined with a supplement. Most retirees in this category have a maximum of less than $1000 annually out of pocket including all physician and medication copays and supplemental premiums. Additionally, they select their own MDs in the private sector. To me, an outstanding plan.

js3486 said:
Perhaps you have heard of them they're called VA Medical Centers. It is where the government sends those that have been for lack of a better term broken or damaged by military service. Quite honestly the day I got private health insurance was the last day I ever stepped foot in one. Why because unless you are bleeding or about to die it takes 4 or 5 months to get an appointment. Yes that is here in America... and yes that is what we are headed to nationally.

I keep meticulous records. I have had 67 VA appointments. I can count on one hand the number of times I have been seen more than 10 minutes after my appointment time. Most of these were emergency scheduled overbooks a day or so prior. Actually, I show up 15-30 minutes early depending on the clinic and I am seen more often before my scheduled appointment time than after. On a few occasions I am actually on my way home at my scheduled time. With one single exception, where the MD attempted to be more stubborn than me, have I not had an ideal experience. Appointments have been very timely. Same day or over night for emergency critical and a couple of weeks for routine appointments. I have never felt rushed in a VA office. The doctors have time for you, are thorough, competent, and professional. Truly outstanding. Don’t listen to the ancient horror stories. Things have changed in the last few years.

While on active duty, you will also have outstanding medical service. The MDs may be a little younger and less experienced but they will order a lot more testing than private sector where they rely more on experience and are concerned about insurance coverage.
 
I've never dealt with tri-care before, so I'm not qualified to comment on its effectiveness.

However, it is an interesting question on how the health care law, if enforced, will effect military coverage. Will civilians be able to go to military doctors if they wish (this excludes retirees and the injured).

Personally, I feel that our government should be controlling the lack of inflation of prices of medical and dental care instead of saying "it's free for everybody with taxes" :thumbdown: For instance, on most dental programs you get $1000 per person before you have to pay out of pocket. That's been the same since 1960. I think prices have risen since then, don't you?
 
I can't see civilians being allowed to see military docs, because for one they will have difficulty getting on base.

Military docs are very good docs. The best part of these docs is they understand military life. They have an insane amount of compassion for the military members. I can't tell you how many times a doc has seen myself or my family at the last minute, or how many times they have checked up on us after seeing us.

As far as tri-care it will be a part of your life soon enough Sam, and it is a very large system. When Bullet first entered we use to call the doc directly for apptmts now you call an 800 number. (Flyers quickly get around this because they know the direct line to the flight surgeon).

Mongo, maybe in your part of WV you have easy access to docs with Tri-Care, however, in NoVA that is not the case. The docs don't ask which Tri-Care plan you have when you ask if they take Tri-Care. They take it or they don't. I have traumatic arthritis and see the number 1 ortho in VA...he does not accept Tri-Care. You stated this:
This is an outstanding system when combined with a supplement
. In other words another insurance company. Our Aetna plan does not need a supplement, except occasionally for prescriptions. Why should I pay more money for the higher level plan as you have suggested, if I still need a SUPPLEMENT? Take the lower because it saves you money, and you don't need to jump through Tri-Care hoops as the primary insurance.

Also, every military base in our area (Andrews, Bolling, Belvoir, Quantico and supporting satellite sites in Fairfax and Woodbridge) no longer accept retirees. I also know that SJAFB no longer accepts retirees either.

To place tri-care as a great model for health care is pushing it. If the military cannot take care of their own on this small level how in god's green earth can we do it as a nation? There simply aren't enough medical professionals. Something that even tri-care enrollees know.

Now let's also discuss tri-care as an AD family member. If you injure yourself that requires a specialist (like me with traumatic arthritis). 3 things happen.

1. You will be referred out to a choice of 2 docs for you to choose from. These are their picks, not yours. Additionally, you may have to drive up to 70 miles to see them, even though there is a specialist in your town.

Why? Because they don't accept TRI-CARE or are unwilling to accept Tri-Care's reimbursement payment.

2. You will probably wait weeks for that apptmt. and it could be months.

Why? Because Tri-Care is a huge bureaucracy. First you need an approval for the referral, than you need to get the referral letter with the doc choices to make the apptmt.( you need the authorization code from Tri-Care to make the appt) Depending on how in demand that doc is and your own personal schedule, it can tally up to weeks.

3. Tri-Care will only authorize "X" amount of appointments within an allotted time period for that specialist. If you need more, you then must have the doctor show proof and request it.

These examples, should be understood that this is for AD family members, not AD members themselves. I state this because Mongo's experience is from the military member's view, mine is from the AD.

OBTW, this not only happened to myself, and my friends, but for our DS when he was 4. It took us 2 months to see a pediatric cardiologist through tri-care. Time warp yourself 10 yrs...you have just been told after seeing your 4 yr old hooked up to an EEG that they must see a heart specialist, but because to them it is not priority the soonest they can see you is 2 months from now.

Sorry, but that is not a health care system I can write glowing reviews for.

As you can see js and I have had to wait months for apptmts using tri-care.

I also agree with JS. It is interesting how Americans were appalled at the conditions of Walter Reed Hospital, but have quickly forgotten it when they want to use the military health care system as a model. How can you be outraged, but say that is good and we should do it their way?

I have friends that have remained on Tri-Care after they retired, HOWEVER, all of them were not shut out of the military hospitals. People who were shut out have a completely different opinion regarding Tri-Care as a retiree.

We have multiple military friends here in the NoVa area, all retired within the same time frame as Bullet. All of them went on to govt (GS-15+) or contracting world. None of them use Tri-Care. Even in Bullet's office at the Palace, where there are at least a half dozen retired military officers, NOT ONE kept Tri-care as their primary.

Like I said earlier to Mongo, alot also has to do with where you retire. WV probably has less retirees than No VA. Supply and Demand. Or it could be the fact that Mongo, like my friends who retired in the late 80's/early 90's don't rely on outside health care. They have not been kicked out of the system because the base is no longer accepting new retirees and think Tri-Care is great. My boss loves the system. He retired in 1990. His wife loves it. They go to Bethesda if their nose is running. They don't see "outside" docs unless referred and very serious. Actually because Bethesda is so big they have yet to see an "outside' doc. He even has had major cancer surgery done there. I will never have that option because they do not accept new retirees.

As for Bullet, he goes insane with the VA. He had to submit multiple times his final medical exams for disability (minor) because the VA kept losing them. It took them about 6 months before they agreed they had it on file. Even forcing him to take a day off from work to repeat the exam at Andrews when he had done it months earlier at Bragg. If you don't know he was AF, but because of the VA system he could not have his out process exam done at SJAFB, he had to drive 70 miles to do it at Bragg. How is that a great system, if they even have limited places for out processing a military member? So limited they sent him to a sister service hospital to have it done?

Mongo, I do get it that you have no complaints, and I respect that. However, JS and I have had the exact opposite, and I hope you will respect that too. We should use this forum to show both the good and the bad when it comes to Tri-Care.

Tri-care is like any form of insurance, some providers accept it, some don't. For example, our Aetna vision policy is not accepted by Pearl Vision. They accept one type of Aetna, but because ours is known as the Cadillac version, they don't accept it. Insurance is not clear cut.
 
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I can't see civilians being allowed to see military docs, because for one they will have difficulty getting on base.
Yeah, this won't happen. There are a few hospitals that currently see civilians for various reasons including Brooke Army in San Antonio which sees Level I trauma for the area


When Bullet first entered we use to call the doc directly for apptmts now you call an 800 number.
It was also known as CHAMPUS back then. There is really no difference in the partitioning of appointments between then and now. Instead of having the person making appointments sitting in my office space they now sit down the hall or in a central appointments booking office. You can also make appointments 24 hours a day now online

Mongo, maybe in your part of WV you have easy access to docs with Tri-Care, however, in NoVA that is not the case. The docs don't ask which Tri-Care plan you have when you ask if they take Tri-Care. They take it or they don't.
This is due to horrendous reimbursement rates when it comes to Tricare. Many doctors take a loss when seeing Tricare patients.


To place tri-care as a great model for health care is pushing it. If the military cannot take care of their own on this small level how in god's green earth can we do it as a nation?
I agree that it is likely not the best option, but then again no socialistic approach is in my eyes. However, I do think the military takes care of their own in this respect. The number 1 priority for military healthcare providers is the active duty service member (including reservists on active duty.) The military healthcare is set up to ensure the readiness of our troops and to return to service those who have been injured. A secondary benefit of this is the ability to take care of other beneficiaries during our "spare time."


Now let's also discuss tri-care as an AD family member. If you injure yourself that requires a specialist (like me with traumatic arthritis). 3 things happen.

1....

2. You will probably wait weeks for that apptmt. and it could be months.

Why? Because Tri-Care is a huge bureaucracy. First you need an approval for the referral, than you need to get the referral letter with the doc choices to make the apptmt.( you need the authorization code from Tri-Care to make the appt) Depending on how in demand that doc is and your own personal schedule, it can tally up to weeks.
This is where you stray a little. The way referrals work is: the doctor places the consult, the consult is then received by the referral center and a referral is sent to the outside doc/docs. Those doc's then review the consult and decide what priority that appointment needs. If it is a routine need they will say "book for next available new patient 'routine' slot". They may only have a few new pt appointments per day or for surgical services maybe per week. If that's the case it will take a bit to get in. If the doc thinks it is more emergent they will be seen sooner. So as you see this isn't a product of TRICARE, but rather more a product of "what does the patient actually need".

3. Tri-Care will only authorize "X" amount of appointments within an allotted time period for that specialist. If you need more, you then must have the doctor show proof and request it.
This is not just Tricare. This is set by the primary doctor, not the insurance company (although some will have a say based on the diagnosis). Here is the reasoning: When I send a pt to a specialist it is usually for one question. Let's take your diagnosis of traumatic arthritis. I would send a consult asking them to see you and recommend a course of treatment. Likely that course of treatment can be started by them, but in reality managed by me, so there isn't a need for "unlimited" visits with that provider. I am much cheaper to the insurance than the specialist, therefore, if I can do it I should which also allows that provider time to see other patients. Even for surgical cases: they do the surgery, see you a couple times, and then you come back to me as the primary doc.


OBTW, this not only happened to myself, and my friends, but for our DS when he was 4. It took us 2 months to see a pediatric cardiologist through tri-care. Time warp yourself 10 yrs...you have just been told after seeing your 4 yr old hooked up to an EEG that they must see a heart specialist, but because to them it is not priority the soonest they can see you is 2 months from now.
Unfortunately patient/parent angst doesn't make a problem more urgent. If it had been something the (I'm assuming you meant EKG or echo, otherwise EEG = neurology) cardiologist thought was urgent you would have been in his office much sooner. Not a reflection of insurance there.

I also agree with JS. It is interesting how Americans were appalled at the conditions of Walter Reed Hospital, but have quickly forgotten it when they want to use the military health care system as a model. How can you be outraged, but say that is good and we should do it their way?
Agree with you here, you can't have it both ways. Either you like it or you don't.

He even has had major cancer surgery done there. I will never have that option because they do not accept new retirees.
You actually do. You can petition the CO for enrollment, or if you have a major case such as cancer surgery you could potentially be brought in because surgeons need those kinds of cases.

As for Bullet, he goes insane with the VA.
Remember DOD healthcare and VA healthcare are two completely seperate entities which until recently barely talked to each other. There are a few joint ventures, a la Pensacola, but they are rare.

Even forcing him to take a day off from work to repeat the exam at Andrews when he had done it months earlier at Bragg. If you don't know he was AF, but because of the VA system he could not have his out process exam done at SJAFB, he had to drive 70 miles to do it at Bragg. How is that a great system, if they even have limited places for out processing a military member? So limited they sent him to a sister service hospital to have it done?
Military hospitals don't do VA disability exams. We do retirement/seperation physicals to ensure that someone is medically fit for seperation, but that is only for the military side. The VA will do a seperate physical to evaluate for possible VA benefits.
 
However, I do think the military takes care of their own in this respect. The number 1 priority for military healthcare providers is the active duty service member (including reservists on active duty.) The military healthcare is set up to ensure the readiness of our troops and to return to service those who have been injured. A secondary benefit of this is the ability to take care of other beneficiaries during our "spare time."

1000% agree! That is why I placed the caveat, my experience is from a spouse. Without a doubt IMO the military takes care of the member. They are on top of it from start to finish. Additionally, they know the military regs and that is very important. I could never ever say anything negative about military docs.

I also agree it is a secondary benefit for family members to have this luxury.

The way referrals work is: the doctor places the consult, the consult is then received by the referral center and a referral is sent to the outside doc/docs. Those doc's then review the consult and decide what priority that appointment needs. If it is a routine need they will say "book for next available new patient 'routine' slot". They may only have a few new pt appointments per day or for surgical services maybe per week. If that's the case it will take a bit to get in. If the doc thinks it is more emergent they will be seen sooner. So as you see this isn't a product of TRICARE, but rather more a product of "what does the patient actually need".

I do understand your point of the referral system regarding TRICARE, however, I think you are missing my point regarding traditional insurance, like Aetna, BCBS. I go to a doc, they refer me, I call and get in. For example, as I stated I have Traumatic Arthritis, believe it or not, but TRICARE referral doc misdiagnosed me, even with an MRI and 6 mos of allotted specialist apptmts. We retired, move to VA, and I called this doc. I called with no referral, just stated my medical complaints and they said can you come in on X day at X time. Aetna, was my primary insurance, TRICARE was not a part of this since they did not accept it. He is a specialist and I was in within a week. He looked at my hand carried Xrays, and MRI, took some of his own, and said if you behave yourself you won't need a knee replacement until you are close to 50. :eek: Why? Look at this, because when it occurred the referral doctor misdiagnosed you and now 2 yrs later you have traumatic arthritis...THANKS TRICARE. Had that accident which caused the initial referral happened under AETNA, I MAY not be in this predicament.

Unfortunately patient/parent angst doesn't make a problem more urgent. If it had been something the (I'm assuming you meant EKG or echo, otherwise EEG = neurology) cardiologist thought was urgent you would have been in his office much sooner. Not a reflection of insurance there.

I agree that they did not see it as urgent. However, this also goes back to TRICARE (it was actually CHAMPUS, but I didn't want to muddy the waters). I was young (28), and 7 mos pregnant, the only thing that kept me calm, was that exact thought...if it was really bad, we would be in the hospital now! That being said, if I was on Aetna, the plan we have now, I wouldn't have had to wait months, it would have been days. I will never forget that day with the cardiologist and seeing blood flowing between the lower chambers on the ultrasound. I could see it myself that there was something wrong. All of the sudden it made sense why when he swam at the beach he would come out with blue lips.

I fought for 4 yrs saying something isn't quite right, and I was poo-poo'd. Our DS had ASD, in other words to the layman the flap that is suppose to close in his heart at birth didn't. Fortunately, it did close at 5 yrs old. I am thankful to Champus, for their care during that yr.(4 to 5) It might have taken months, but our DS was seen by a DUKE pediatric cardiologist who was an Army reservist. He was the greatest. I will never forget his words to me at his 5yr old check up...The hole has closed and if he ever wants to join the military he is good to go. Those words comforted me because as a military spouse of a flyer I knew medically that the military was very very strict. It meant to me everything was okay. This goes back to how military docs can calm you in different ways than a traditional doc can.

You actually do. You can petition the CO for enrollment, or if you have a major case such as cancer surgery you could potentially be brought in because surgeons need those kinds of cases.

This is not my goal, as much as I trust and believe in military docs, I have no desire to fight the system. Bullet and I have private insurance. My point was new retirees are not in the same boat as old retirees like Mongo. We can't get into the system because the military hospitals are no longer accepting new retirees. Mongo retired @20 YRS ago. we retired @18 MONTHS
ago.

To stress the fact even more as you stated
This is due to horrendous reimbursement rates when it comes to Tricare. Many doctors take a loss when seeing Tricare patients.

Mongo believes that it is as simple as Prime and Standard. My point was that it isn't that simple.

Thank you for your clarification. Thank you for your service. IMHO KP is the only one to truly listen to regarding this subject. Mongo, JS, and myself are posting opinions. KP is the one that has "true" feet on the ground.

Here is my final point reiterating your response of horrendous reimbursement rates...if Docs aren't taking TRICARE because of reimbursement rates, don't you wonder if TRICARE patients are losing out from the best docs out there? If you do, can you now understand why JS and I opt to pay for private?
 
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Here is my final point reiterating your response of horrendous reimbursement rates...if Docs aren't taking TRICARE because of reimbursement rates, don't you wonder if TRICARE patients are losing out from the best docs out there? If you do, can you now understand why JS and I opt to pay for private?

I think they do miss out on some good docs, but they are also missing out on some of the "bad" docs as well. I've known some pretty prominent physicians who accept Tricare because they feel they are "doing their part" even though they aren't in uniform.

I'm a realist when it comes to Tricare. It does a decent job. Could it be better, absolutely. It's all a trade-off between "Bullets & Butter". The more health care costs the less money there is for the new fighter, ship, missile, etc. DoD healthcare costs are soaring and there is no end in sight with the increase in service disability and the ever increasing numbers of retiree's.
 
Pima said:
Here is my final point reiterating your response of horrendous reimbursement rates...if Docs aren't taking TRICARE because of reimbursement rates, don't you wonder if TRICARE patients are losing out from the best docs out there? If you do, can you now understand why JS and I opt to pay for private?

My understanding is that Tricare reimbursement rates are very similar or exactly the same as Medicare rates. In my area there are two major medical systems. Both take Tricare. I have never been involved with an MD who would not accept Tricare.

With referrals for specialists for Standard Tricare, one can either go through their primary care physician or do it on their own. The only problem with doing it on one’s own is that some specialists, due to other insurance company rules, assume Tricare will not reimburse unless referred and are hesitant to make appointments. So it is easiest to go through one’s primary care physician.

Pima said:
We can't get into the system because the military hospitals are no longer accepting new retirees.

With Tricare Standard this is not an issue.

Pima said:
Mongo, maybe in your part of WV you have easy access to docs with Tri-Care, however, in NoVA that is not the case. The docs don't ask which Tri-Care plan you have when you ask if they take Tri-Care. They take it or they don't.

I have never lived in WV. You must have me confused with someone else. However, you may have a point. Retirees might want to research medical conditions when planning a retirement area.

Pima said:
Why should I pay more money for the higher level plan as you have suggested, if I still need a SUPPLEMENT? Take the lower because it saves you money, and you don't need to jump through Tri-Care hoops as the primary insurance.
You stated that you payed $120 PER MONTH for Aetna through your company. I pay less than that PER QUARTER that when combined with Tricare Standard, pays 100% of everything. The physican’s billing office manages the dual billing. Paying the quarterly premium is my only input. No hoops at all.

I think what we see here is that perhaps there are areas in the country where medical coverage is not equal. It is kind of a stretch to blame it on Tricare though.
 
I'm a realist when it comes to Tricare. It does a decent job. Could it be better, absolutely. It's all a trade-off between "Bullets & Butter". The more health care costs the less money there is for the new fighter, ship, missile, etc. DoD healthcare costs are soaring and there is no end in sight with the increase in service disability and the ever increasing numbers of retiree's.

You may be, like Pima, attempting to project Tricare Prime across the board to falsely disparage the entire system. DOD does have input on the Tricare Prime budget. They have none on Tricare Standard. I just checked with the Tricare website. Tricard Standard reimbursement rates are, by law, tied directly to Medicare. Therefore, a retiree, with Standard, has total control over his medical plan. He chooses his own physicians. He chooses his own supplement to cover copays. And Tricare reimburses the physicians based on Medicare rates.

So if you don't like what Tricare reimbursement rates are doing to the availability of physicians, blame Medicare, not Tricare. They have absolutely no imput on the rates.
 
I'm well aware of the difference in the various Tricare iterations. Don't forget Tricare Remote...

Tricare rates are tied to, but not necessarily the same as Medicare. If DoD wanted to they could get the laws changed or make the reimbursement rates a certain percentage higher than Medicare reimbursement rates. It is also my understanding that there is quite a bit of paperwork involved with Tricare as compared to other policies (all programs have a bunch, it's all relative).

Therefore, a retiree, with Standard, has total control over his medical plan. He chooses his own physicians. He chooses his own supplement to cover copays. And Tricare reimburses the physicians based on Medicare rates.

This isn't necessarily true. With Tricare Standard you still have to find a doctor willing to accept Tricare patients. This is not the same as the doctor being "in network." If the doctor doesn't want to deal with Tricare they can make you file the claim or they simply won't take Tricare patients. You do however, have the right to go to whatever specialty you want to without referral as it's a "Fee for service" program as opposed to a "Managed Care" program.
 
kp2001 said:
I'm well aware of the difference in the various Tricare iterations. Don't forget Tricare Remote...

And Extra, and For Life, and Overseas, and a few others, none of which would have any effect at all on Pima’s dissatisfaction with Prime and transferring it to the system in general.

kp2001 said:
If DoD wanted to they could get the laws changed or make the reimbursement rates a certain percentage higher than Medicare reimbursement rates.

They can probably get away with changing the copay percentages and the deductibles, but since the reimbursement rates are set by law (Congress), could you imagine the hue and cry if Congress gave Tricare a higher rate than they did Medicare. They would be, in essence, telling the American public that Medicare rates are insufficient. And the various military groups have sufficient enough lobbying that Congress would never undercut Tricare in relation to Medicare. The rates are what they are and will likely stay that way.

kp2001 said:
With Tricare Standard you still have to find a doctor willing to accept Tricare patients.

Of course. And I wonder how big a problem that it really is. And how widespread it is. There are independent practices which, of course, can do what they want. However, most hospitals seem to be a part of a medical group with a full range of services, including primary care facilities, docs in a box, and all specialists. When 40% of the emergency room patients have no insurance at all, can these medical groups turn down anyone with insurance, no matter how much paperwork it requires? Also, imagine a letter to the editor of the local newspaper stating that XYZ Medical Group will not treat military retirees.
 
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Mongo,

I am extremely happy you found and continue to find satisfaction for your health care needs through the Tricare system. But as your succinctly and vehemently argued on other threads here on these forums, this is a place for young men and women interested in pursuing the military professions to come and LEARN about ALL the details involved in a military career. Where you lose me is your insistence that any opinion that doesn't fit your world-view is inherently wrong.

This case in point. You are allowed to state that you find the Tricare health insurance system satisfactory to your needs based on your experiences. In a likewise manner, Pima and I are allowed to state that we do not find the DoD's retiree health insurance and provider needs systems satisfactory to OUR needs, based on OUR experiences.

The mixing of the issues of retiree health insurance and health providers within these arguments is perhaps a little confusing to those unfamiliar who frequent these threads (especially the young men and women and their parents), and perhaps some clarification is in order:

First off, Tricare (in it's many forms). The DoD's health INSURANCE system. Like many health insurance systems, there are several options available, with the customer (the retiree) responsible for choosing the one that best fits their particular needs and desires. You have selected (and continue to champion) Tricare Standard. As KP mentioned, a "pay for service" based insurance system, usually with lower monthly costs, but with higher co-pays than the other Tricare products available (thus your own mention of the benefits of having a supplement). No need to make appointments weeks in advance that you would need to do in a Health care MANAGEMENT system (like Tricare Prime). But there are issues with this system (as also mentioned by KP); with finding a PROVIDER willing to take this insurance due to the lower pay out to the doctor. You are correct, getting seen at an emergency room and using Tricare Standard is pretty easy. Seeing a Private Practitioner or Specialist? A little tougher, especially in areas without a large military retiree population. Bottom line, you MAY not get to see the Doctor of YOUR choosing because they won't take Tricare standard. And if you do see them, it can cost you more out of your pocket if you don't have supplemental insurance.

Tricare Prime? As it was stated, a "health care management" system, like an HMO. You sign up, and our placed in a "network" of providers, which are the ONLY doctors the system will pay for you to see. Usually costs more than Standard, but with smaller co-pays. Also limits which doctors you can choose from (and more and more practitioners are leaving the system due to lower pay-outs to them for service than other systems).

As to Providers? Well, as a retiree, you have the right to be seen at a VA health care provider for your medical needs, if you choose. Again, you are correct when you state these are very competent and courteous PROFESSIONALS, proud to give of their time to the men and women who served our country. But it comes down to convenience for the patient; VA centers are not everywhere. Depending on where you live, going to a VA medical center can mean hours of travel to get to one. Also, some areas with large retiree populations (such as the DC area where Pima and I live) will find huge crowds and long waits for appointments at the nearby VA medical centers. In fact, many military retirees will select a retirement location based on being close to a VA center. The situation is bad (in my opinion), and only getting worse with more care required for more injured veterans from the current conflicts and increases in the retiree population due to longer life spans. And please don't get me started on the administrative bureaucracy! Pima mentioned how they lost my retirement physical evaluation records (twice!), and it was only through my own tireless efforts, meticulous record keeping, willingness to travel THREE times to a VA facility to conduct this evaluation, and constant checking up on the system that finally got my benefits correct (after nearly a year!).

As to getting medical care on military facilities like in the old days? Again, it has been stated before that most DoD medical facilities have stopped taking new retirees because of the stresses of too large a population needing medical care combined with too few doctors available due to commitments to the current on-going conflicts. Most retirees now have to choose between the VA system for free medical care (which is an endurance test for your medical needs due to an overwhelmed system), or seek private insurance through Tricare for their needs (and as I stated before, also has some issues involved).

OK, this post is officially "long-winded", but I'll get to the important point. These young people are interested in learning about the military in all its facets. Why they care about retiree medical benefits is beyond me (as it is so far away for most of them, and most likely to change several times over before they get that far), but it none the less deserves correct data and HONEST opinion from those who participate here, on ALL aspects and experiences, both good and bad.

Mongo, you may find the Tricare system works for YOU (and again, I am happy that is your case). But for Pima and I, we found it is not the best fit for US. Luckily, I had a great job that gave me FANTASTIC medical coverage at a reasonable price. A "Cadillac" plan that Pima got spoiled by (and the years of the family being seen directly by our wonderful flight Docs when I was on active duty). Fortunately, now that I am a Federal employee, I have the opportunity to look again for a plan that meets OUR needs (to include type and convenience of health care). Tricare may be a choice, but I doubt it based on where I live and the level of convenience I desire...

Bottom Line: our needs and desires are different than yours. Neither is "correct", and stating that Tricare didn't (and perhaps still doesn't) meet our specific needs is NOT disparaging the system. It is providing the young people on this forum (and their parents) our experiences and OPINION, and you may not like it, but it is just as valid and valuable as yours.

Now, feel free to counter-point to your hearts content. But I'd prefer if my post was QC'd by KP, a DoD Medical professional more familiar with the system.

KP, feel free to correct any mis-quotes on my part. We are, after all, in the search for truth for those young men and women interested....
 
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Mongo,

I am extremely happy you found and continue to find satisfaction for your health care needs through the Tricare system. But as your succinctly and vehemently argued on other threads here on these forums, this is a place for young men and women interested in pursuing the military professions to come and LEARN about ALL the details involved in a military career. Where you lose me is your insistence that any opinion that doesn't fit your world-view is inherently wrong.

This case in point. You are allowed to state that you find the Tricare health insurance system satisfactory to your needs based on your experiences. In a likewise manner, Pima and I are allowed to state that we do not find the DoD's retiree health insurance and provider needs systems satisfactory to OUR needs, based on OUR experiences.

The mixing of the issues of retiree health insurance and health providers within these arguments is perhaps a little confusing to those unfamiliar who frequent these threads (especially the young men and women and their parents), and perhaps some clarification is in order:

First off, Tricare (in it's many forms). The DoD's health INSURANCE system. Like many health insurance systems, there are several options available, with the customer (the retiree) responsible for choosing the one that best fits their particular needs and desires. You have selected (and continue to champion) Tricare Standard. As KP mentioned, a "pay for service" based insurance system, usually with lower monthly costs, but with higher co-pays than the other Tricare products available (thus your own mention of the benefits of having a supplement). No need to make appointments weeks in advance that you would need to do in a Health care MANAGEMENT system (like Tricare Prime). But there are issues with this system (as also mentioned by KP); with finding a PROVIDER willing to take this insurance due to the lower pay out to the doctor. You are correct, getting seen at an emergency room and using Tricare Standard is pretty easy. Seeing a Private Practitioner or Specialist? A little tougher, especially in areas without a large military retiree population. Bottom line, you MAY not get to see the Doctor of YOUR choosing because they won't take Tricare standard. And if you do see them, it can cost you more out of your pocket if you don't have supplemental insurance.

Tricare Prime? As it was stated, a "health care management" system, like an HMO. You sign up, and our placed in a "network" of providers, which are the ONLY doctors the system will pay for you to see. Usually costs more than Standard, but with smaller co-pays. Also limits which doctors you can choose from (and more and more practitioners are leaving the system due to lower pay-outs to them for service than other systems).

As to Providers? Well, as a retiree, you have the right to be seen at a VA health care provider for your medical needs, if you choose. Again, you are correct when you state these are very competent and courteous PROFESSIONALS, proud to give of their time to the men and women who served our country. But it comes down to convenience for the patient; VA centers are not everywhere. Depending on where you live, going to a VA medical center can mean hours of travel to get to one. Also, some areas with large retiree populations (such as the DC area where Pima and I live) will find huge crowds and long waits for appointments at the nearby VA medical centers. In fact, many military retirees will select a retirement location based on being close to a VA center. The situation is bad (in my opinion), and only getting worse with more care required for more injured veterans from the current conflicts and increases in the retiree population due to longer life spans. And please don't get me started on the administrative bureaucracy! Pima mentioned how they lost my retirement physical evaluation records (twice!), and it was only through my own tireless efforts, meticulous record keeping, willingness to travel THREE times to a VA facility to conduct this evaluation, and constant checking up on the system that finally got my benefits correct (after nearly a year!).

As to getting medical care on military facilities like in the old days? Again, it has been stated before that most DoD medical facilities have stopped taking new retirees because of the stresses of too large a population needing medical care combined with too few doctors available due to commitments to the current on-going conflicts. Most retirees now have to choose between the VA system for free medical care (which is an endurance test for your medical needs due to an overwhelmed system), or seek private insurance through Tricare for their needs (and as I stated before, also has some issues involved).

OK, this post is officially "long-winded", but I'll get to the important point. These young people are interested in learning about the military in all its facets. Why they care about retiree medical benefits is beyond me (as it is so far away for most of them, and most likely to change several times over before they get that far), but it none the less deserves correct data and HONEST opinion from those who participate here, on ALL aspects and experiences, both good and bad.

Mongo, you may find the Tricare system works for YOU (and again, I am happy that is your case). But for Pima and I, we found it is not the best fit for US. Luckily, I had a great job that gave me FANTASTIC medical coverage at a reasonable price. A "Cadillac" plan that Pima got spoiled by (and the years of the family being seen directly by our wonderful flight Docs when I was on active duty). Fortunately, now that I am a Federal employee, I have the opportunity to look again for a plan that meets OUR needs (to include type and convenience of health care). Tricare may be a choice, but I doubt it based on where I live and the level of convenience I desire...

Bottom Line: our needs and desires are different than yours. Neither is "correct", and stating that Tricare didn't (and perhaps still doesn't) meet our specific needs is NOT disparaging the system. It is providing the young people on this forum (and their parents) our experiences and OPINION, and you may not like it, but it is just as valid and valuable as yours.

Now, feel free to counter-point to your hearts content. But I'd prefer if my post was QC'd by KP, a DoD Medical professional more familiar with the system.

KP, feel free to correct any mis-quotes on my part. We are, after all, in the search for truth for those young men and women interested....

Shack! :thumb:

Steve
USAFA ALO
USAFA '83
 
My $.02 as a child of a parent with a serious chronic illness who relied on Tricare......

When my parents retired they lived near an AF Base. All was wonderfull back in the day of "free" healthcare on base.
Then the base closed. My parents joined a Health care provider through Tricare Prime - the "dreaded" HMO. The former base was made into a Tradeport with space available for new businesses including healthcare. The clinic was comprehensive, including a pharmacy and located at the former base.

Shortly thereafter - prior to qualifying for Medicare - my mother was diagnosed with a serious, progressive chronic illness. Her physicians, Tricare Prime and specialists were all amazing and worked together seamlessly. She received excellent care - even with an HMO, even needed the services of many specialists including cardiologists and pulmonologists. My parents never had to worry about the bills being paid. Never had to worry about her multiple and very expensive prescription medications being covered.
In fact, I vividly remember visiting her in the ICU - one of many visits - and speaking with the nurse about transitoning her to the floor and home. She told me that she would probably be moved out of ICU in a few hours (it was afternoon at that point) then backtracked and said - "Oh yeah she has Tricare; she will stay here another day".
My mother was sick for 16 years. She lived in two states 1500 miles apart. Her medical care was amazing.
Anyway, my point is ..... is it possible to receive excellent medical care through Tricare. My parents never had to worry about "donutholes" or high deductibles. They never had to worry about the bills getting paid. The notion that if you can't "pick" your physician you will receive inferior care is just false.

As for retirees receiving care on base - I am not so sure that is the BEST care for older retirees. Military hospitals are very good at caring for a younger population. Older people have different needs and need different care. Very possibly, their "best" care will be found in the civilian world.
Bullet - it's great you have excellent affordable insurance on your job. Not everyone does and not every retiree does. Some retirees retire from their second career before they are Medicare eligible and need insurance. They don't necessarily need to fear that they won't get or be able to find care. They are better off with the safety net of Tricare.
Of course, as with all insurance YMMV.
 
Bullet - it's great you have excellent affordable insurance on your job. Not everyone does and not every retiree does. Some retirees retire from their second career before they are Medicare eligible and need insurance. They don't necessarily need to fear that they won't get or be able to find care. They are better off with the safety net of Tricare.

JAM, I'll be the first to admit that I was VERY fortunate in my situation, able to select and afford a wonderful plan that very many would envy. And please dont believe for a second that I think the medical provider system that Tricare insurance allows for is not a wonderful level of health care. However, I was lucky enough to have the opportunity to participate in an INSURANCE system that Pima and I thought (and still do) fit our needs.

And that is the bottom line point that I'll mention again. It all comes down to individual desires and needs. In my case, I had the good fortune to have a system where my DESIRES could out weigh my NEED for only Tricare, with the inconveniences we found within the system in my area.

Again, Tricare is a great system, with flaws. EVERY insurance type has their own flaws to deal with. You just got to find the one that best meets your needs, and hopefully you have the opportunity and ability to get a plan that perfectly balances all of your needs and desires (convenience, cost, ease of getting specialized medical care, coverage, etc...). In Pima's and my case, Tricare came in second to my company plan (but I still carried Tricare prime for the reason you mention: life time guarantee of coverage). Now that I'm a Federal employee, I'll search again for a plan that best fits my need. Perhaps Tricare, perhaps not. I'm still lucky enough to have good choices and the means to pay for better service (IMO). Perhaps when my Federal plan becomes guaranteed for life in 5 years, I'll drop Tricare.

Again, it's a personal choice based on desires and needs. And from our personal experiences, we would rather spend extra than rely on Tricare or the VA. Just our $0.02.
 
The notion that if you can't "pick" your physician you will receive inferior care is just false.

In many cases, this statement is correct.

However, if you had the opportunity to pick between one doctor, or the doctor who not only taught him, but everyone else in that specialty uses his textbook, whom would you choose?

Now, what if the world renowned doc doesn't take Tricare? Wouldn't you feel a little less secure in your medical care?

The majority of doctors and medical professionals are all OUTSTANDING. But given the opportunity to choose, I was happy that I could pick the the health care I was most secure with.

Besides, in our case, the family doc 5 minutes away took my company's insurance, but not Tricare. The nearest Tricare provider was an additional 30 minutes away. Convenience was part of our insurance selection process. And because my insurance company paid some of the highest rates to the Doc, we were treated like royalty by the place. Yep, I was VERY lucky...
 
However, if you had the opportunity to pick between one doctor, or the doctor who not only taught him, but everyone else in that specialty uses his textbook, whom would you choose?
Either one. Your care and outcome would most likely be similar. How do you know that one is not better than the other.
It is comforting to pick one's own physician. However, that doesn't mean your own physician is the "best" physician.
In health care one always needs to strike a balance between risk vs benefit and cost vs benefit.

I understand your ability and desire to pay extra for a Cadillac - good for you guys. This doesn't mean that Military retirees who are "stuck" with a Chevy face inferior care. I just wanted to offer some reassurance to those who are or may be retiring in the future that Tricare is not always the "devil". Another point of view.
 
Bullet said:
But as your succinctly and vehemently argued on other threads here on these forums, this is a place for young men and women interested in pursuing the military professions to come and LEARN about ALL the details involved in a military career. Where you lose me is your insistence that any opinion that doesn't fit your world-view is inherently wrong.

Bullet, please go back and read the original post. I didn’t start the disparaging remarks about Tricare and VA and the posters were not simply stating their preferences, they were stating that the systems are broken. Apparently, on a later post, you even agree with me so I am not sure what the purpose of your criticism of my post is:

Bullet said:
And please dont believe for a second that I think the medical provider system that Tricare insurance allows for is not a wonderful level of health care.

My thoughts exactly. And all I was attempting to relay.

Medical benefits is one of the prime benefits of a military career. I would hate for a prospective candidate to discount a military career because they believe a few “inherently wrong” posts stating that the system is broken.

Surely you have told the young E-7 who is contemplating leaving the service that, should he be layed off from that lucrative civilian job for which he is leaving, that COBRA premiums while he is looking for another job, will probably cost him and his family $12,000 or so per year. That should he want to retire before Medicare kicks in at 65, medical insure will be in the same range or higher for just him and his wife. Yes, retiree medical benefits are a major reason to make the military a career.

Pima bemoans lack of choice but has never been under Standard which promotes choice. I too like choice, have been enrolled in Prime in two locations and standard in three locations, one a major military area, one with a small military presence, and the other with none. No problem in any with finding physicians who will accept Tricare. I was in Prime when the system was initially installed. A few growing pains but very convenient. And no problem with referrals on either. I am sorry. I just hate to see a system besmirched by someone who has never really experienced it. And I really hope it will not negatively affect a career choice;
 
I keep meticulous records. I have had 67 VA appointments. I can count on one hand the number of times I have been seen more than 10 minutes after my appointment time.

67 times...ten minutes wait or less each time?

Ruby Slippers time :shake:
 
I never said that. However, ask for the first appointment of the day, show up 15 minutes early as directed, be friendly and understanding, be appreciative, occassional flowers, and a letter or two of appreciation to the head of the department and, not only will you be seen early but the female doctors will come out to the waiting area to get you and give you a hug and kiss.
 
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I never said that. However, ask for the first appointment of the day, show up 15 minutes early as directed, be friendly and understanding, be appreciative, occassional flowers, and a letter or two of appreciation to the head of the department and, not only will you be seen early but the female doctors will come out to the waiting area to get you and give you a hug and kiss.

Oh I get it, ask for the first appointment! Damn that makes perfect sense! :thumb:
 
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