Tricare & Tricare Supplemental?

Discussion in 'Air Force Academy - USAFA' started by 2018DAD, Aug 23, 2016.

  1. 2018DAD

    2018DAD Member

    Joined:
    Feb 18, 2015
    Messages:
    104
    Likes Received:
    87
    Thought I'd toss this out there again because several on here might be in the same situation (searched old thread but it soon went in another direction!):
    Now we are past Commitment, DS doing exceedingly well, in top % of his class; so, barring a complete and utter reversal of present "flight vector", we are considering (upon suggestion of present insurance representative) to dropping DS from our present health policy. Uncharted but expected (!) territory here, as older non mil DS is soon to be 26 so we are looking at this from multiple angles.
    While we do not wish to waste money, and the health needs of our 21yr old male C2C are somewhat non- eventful up until this point (save one HS Tommy John surgery!), we do want him to be adequately covered and able to access any specialty care that one might encounter or need. Both myself and DW are products of medical families so we are a little bit sensitive on what can be available, and what those costs can be uncovered!
    Anyone care to shine some light on current/future Tricare, supplemental offerings, and what decisions and factors led you to your present health insurance setup?
     
  2. DTrain1986

    DTrain1986 Member

    Joined:
    Aug 3, 2016
    Messages:
    16
    Likes Received:
    18
    He is covered by Tricare Prime as is my C2C daughter. As long as his medical care is covered and authorized, it costs him nothing.

    The only reasons I can see to keep him on your policy is if there's a medical issue that he needs addressed is not covered by Tricare but is covered by your policy. Or, he's home on leave and doesn't want to have to go through the Tricare authorization process for "routine" (non-emergency) care.

    Supplemental insurance is not used/needed with Prime. It's an option to consider if you opt for Tricare Standard or Tricare Extra in the future.

    S/Fi,

    DTrain
     
  3. Capt MJ

    Capt MJ Member

    Joined:
    Sep 27, 2008
    Messages:
    2,343
    Likes Received:
    1,810
    TRICARE Prime for active duty is a comprehensive plan. Even when I was not near a military medical treatment facility (MTF), and needed non-urgent care, say, when driving XC from one duty station to another, I just called the 24-hour number to let them know there would be a claim and the details of injury/illness and treatment facility, and used my ID card as my health insurance card. I brought copies back to be scanned into my record. No money out of pocket, no dealing with bills. The TRICARE phone people know how to talk to hospital billing staff at any hour.

    A USNA sponsor daughter of ours broke a collarbone while skiing in Telluride, got top flight surgical care there, used her ID (CAC) as noted, called TRICARE 24-hour. Everything authorized. No follow-on administrative issues, no issues about payment, no money out of pocket, no co-pays or caps, no messing with payment paperwork.

    I had no problems with TRICARE Prime during my active duty time, and there was never a problem getting specialty referrals to civilians if an MTF didn't have the specialty or capacity.

    Over our 20 years of sponsoring USNA mids, we have seen: multiple broken parts, cervical cancer, melanoma, brain cancer, diabetes Type I, Crohn's, and so on. All received treatment easily and relatively seamlessly from TRICARE, though sadly, some were medically discharged.

    It's not perfect, but it's there when needed. Healthcare providers, in my own experience, have been excellent, with well-respected schools and training. They are not overburdened with Big Insurance looking over their shoulder. If they think you need a test, you get it, and it's paid for. Overall, good experience for me, and, as a military retiree still using TRICARE Prime, I am still positive.

    I realize before commissioning it's a slightly different situation, because Stuff Happens, but you have to weigh your risks vs. outlay.
     
  4. MN-Dad-2016

    MN-Dad-2016 Member

    Joined:
    Mar 30, 2012
    Messages:
    438
    Likes Received:
    131
    I agree with MJ (albeit her experiences outnumber ours). We hosted a lot of WOB USAFA members when they traveled to AZ to train (we winter in AZ). Civilian doctor visits were easy to schedule in pressing situations.

    To the OP. For a few years now, no preconditional illnesses can be calculated in the form of sky-high premiums. So it is just a matter of putting your son back on your plan. There is no reason to be redundant. I transitioned and pulled him off our family plan after his 1st semester. In 2016, I would recommend it the 1st day of school. Our agent said it's easy to re-add a son or daughter. As Capt MJ stated, TRICARE's coverage (good) and deductibles ($0) work in civilian and military environments.

    If your son goes to graduate school, in some instances they will have be removed from TRICARE. For instance both our DD (dental school) and DS (medical school) are temporarily off of TRICARE while going to civilian college. If I wanted to put them on our ridiculously high deductible plan (the only way to keep premiums under $10K for 2 people), I could do that with a phone call and a form. But both colleges offered their plan which had a much lower deductible for a decent price.
     
    Last edited: Aug 24, 2016
  5. 2018DAD

    2018DAD Member

    Joined:
    Feb 18, 2015
    Messages:
    104
    Likes Received:
    87
    Thanks all! Good answers for a belt& suspenders kinda person as I usually am!! I will keep in mind the grad school issue as he is more than likely headed in that direction. Knew 'my' crowd here would give good insight into this situation. Thanks again!
     
  6. Capt MJ

    Capt MJ Member

    Joined:
    Sep 27, 2008
    Messages:
    2,343
    Likes Received:
    1,810
    There is plenty of reading out there in addition to official sites. Military.com articles are usually reliable. TRICARE Prime is essentially an HMO.
     
  7. Christcorp

    Christcorp Member

    Joined:
    May 21, 2008
    Messages:
    4,963
    Likes Received:
    872
    Guess I'm missing something here. I'm retired military. My wife and kids were on my tricare prime health insurance. As soon as my son went into the academy, and we updated DEERS to reflect that he was no longer our dependent, he was dropped from our tricare prime. Now, considering the cost with dependents is the same with just a wife or with kids, (Last time I checked), there wasn't any financial change. But our son was covered under HIS OWN TRICARE as soon as he stepped into the academy. So there was no reason to try and keep him on ours. And to be honest with you, I don't believe it's possible that a person can be on 2 different tricare prime accounts. So as soon as my son started the academy, I'm pretty sure he was no longer on my account. (Whether I wanted it or not)

    When my daughter finished college, she was no longer allowed on my tricare prime insurance. (This was before Obamacare - 2009). Until she got settled into a decent job with benefits, we simply bought her catastrophic health care insurance. For a 22 year old, it's very cheap. If she felt she needed to go to the doctor for something routine, like a checkup, sick, broken finger, etc. it would come out of our pocket. (It was so much cheaper than traditional insurance; and so much better than Obama care).

    But for our son, tricare is pretty organized. Everything works off of social security numbers. As soon as he went to the academy, HE had his OWN tricare prime. He was no longer on ours. Whether we liked it or not. And because we had to go to MPF and update DEERS and (And I think turn in is Dependent Military ID Card), he was no longer on our Tricare.

    Now, if I wasn't retired military with tricare prime, and I had private or company provided health care, I would do the same thing. As soon as s/he went to the academy, I would take them off of my health care. They have health care at the academy. (They ARE IN THE MILITARY). I also did take them off of my car insurance. My insurance allows me to loan my car to licensed drivers; and he is no longer a dependent at home; so no sense paying it. What if my kid would have quit or let go from the academy? What about health insurance then? Well, if you have private/company provided health insurance, you can always add him/her back on. If you had tricare, you check to see what the obamacare rules say. But tricare prime for me doesn't cost more or less for multiple dependents. So it didn't bother me either way.
     
  8. MN-Dad-2016

    MN-Dad-2016 Member

    Joined:
    Mar 30, 2012
    Messages:
    438
    Likes Received:
    131
    Most grad schools get 2nd lieutenant pay. I know medical (HPSP for docs, nurses, and dentists) do NOT get 2nd lieutenants pay. I THINK this is the same for a Jag. Hence, they are "civilians" (note the quotation marks as I realize they are 2nd lieutenants). They get a stipend which amounts to about $26K before tax and Uncle pay for the schools healthcare option. The quality of school healthcare plans varies and Uncle doesn't pay for a deluxe plan IF there are more than one offered. So our DD coverages is "good" but not great (AZ). If your DS goes to Harvard (several top students do) I can tell you that their healthcare is THE best I've ever observed. I had to call and ask 3 different ways if their printed coverage was correct; crazy good. DS pays ZERO to take his plates out of his arm at Mass General (ranked #1 hospital in the world). It's a BCBS plan but if you go to one of the Harvard hospitals, they cover the difference. That is assuming there is a deductible on Tricare (probably not).

    I also know many of the MIT students. They get paid 2nd lieutenant pay and COL and therefore on TRICARE. As a side note, there is no COL for HPSP. Some of the frugal students are already banking some coin. I on the other hand am still helping him with living expenses (COL in MA is beaucoup $$'s). UG was zero so I don't mind...much.... :)
     
    Last edited: Aug 24, 2016
  9. DTrain1986

    DTrain1986 Member

    Joined:
    Aug 3, 2016
    Messages:
    16
    Likes Received:
    18
    Christcorp, you are not missing anything.

    All SA cadets/mids are covered by Tricare Prime.

    I'm retired military, Tricare Prime. I got the same ltr you did after my daughter arrived at USAFA. Makes sense.

    On the "civilian" policy side, if you want your kid "double covered" by your (parent policy) and Prime, up to you.

    Based on the title of the op's post: "Tricare and Tricare Supplemental" I think the op might be interested in knowing what happens upon commissioning.

    Your active-duty Lt will still be enrolled in Tricare Prime. In fact, he must enroll. Done deal.

    If he marries a non-active duty member, his spouse will have the option of enrolling in Tricare Prime, Tricare Standard, or Tricare Extra.

    Prime is an HMO.

    Standard and Extra are not. With these two options, dependents may consider Supplemental insurance.

    As mentioned, plenty of info available on Tricare.

    My family and I have been mostly in Prime throughout my career and into retirement, though we did a short stint on Standard, including Supplemental. I have stories good and bad with both.

    Semper Fi,
    DTrain
     
  10. Capt MJ

    Capt MJ Member

    Joined:
    Sep 27, 2008
    Messages:
    2,343
    Likes Received:
    1,810
    USMMA is the exception here among SA.
     
  11. 2018DAD

    2018DAD Member

    Joined:
    Feb 18, 2015
    Messages:
    104
    Likes Received:
    87
    Thanks again all. And yes this was also a forward looking request as well!
     
  12. Christcorp

    Christcorp Member

    Joined:
    May 21, 2008
    Messages:
    4,963
    Likes Received:
    872
    And as stated, grad school is still active duty for most, with a few exceptions as noted. My son went to RAND for 3 years immediately out of the academy to get his PhD. He was a 2LT. After 2 years, of his 3 years there, he was promoted to 1LT. He went to Los Angeles Air Force base for sick call, PFE tests, TDY orders, etc. he was in the military and was covered by tricare as is all active duty personnel. No different than at the academy, no different than the captain or sergeant who's been in 8 years at a normal active duty base.
     
  13. DTrain1986

    DTrain1986 Member

    Joined:
    Aug 3, 2016
    Messages:
    16
    Likes Received:
    18
    Christcorp - spot on!

    I can't speak to the Health Services "grad school" rules or the JAGS either.

    But for all others who get sent to grad school while on active duty, they get all pay, allowances and benefits they rate per grade, time in service, location, etc including Tricare Prime.

    If you run the numbers you will find that the number of newly commissioned officers who attend grad school immediately after graduating undergrad is a very small fraction of those officers who will be sent to grad school later in their careers.

    Not sure how a topic regarding Tricare health insurance for cadets and then later as active duty members got run down the grad school "rabbit hole." I apoligize if I took it there.

    I'll stay off this net unless there's a request for specific information or experience with regarding Prime, Standard, Extra, or supplemental insurance.
     
  14. mom2mnem

    mom2mnem Member

    Joined:
    Feb 23, 2016
    Messages:
    20
    Likes Received:
    5
    My son will be applying this year. If he is admitted to the academy, my insurance company will no longer cover him and will require him to have his own policy.
     
  15. Cerberi

    Cerberi Member

    Joined:
    Nov 22, 2015
    Messages:
    453
    Likes Received:
    449
    I could be reading into it but the OP question might be more of a 'what if' something happens and they are booted from the military for some reason than if they are currently covered - what happens if they are not still on my policy.

    I had a classmate that was diagnosed with a terminal illness as a C2C (30 plus years ago). He knew as a C2C he would not be commissioned, but he was allowed to stay and graduate. Remarkably upon graduation, he was offered employment by a large defense contractor who immediately provided group health insurance. (I can virtually guarantee a senior officer at USAFA had a conversation with said defense contractor)

    Classmate lived about 3 more years after graduation.

    It doesn't answer the question, but the story always made a positive impression on me and I like to share it.

    I think that if they would be medically discharged today - the VA would also step in to provide coverage for at least the medical reasons the cadet was separated. (And VA care generally is not as poor as

    Anecdotally, I think it is more common for SA's to allow cadets/Mids to stay and graduate with their class even if they are not commissionable but have started their c2c year or later.
     
  16. 2018DAD

    2018DAD Member

    Joined:
    Feb 18, 2015
    Messages:
    104
    Likes Received:
    87
    Cerberi

    I wasn't asking so much about discharge, but would he be sufficiently covered with excellent insurance. He is grandson of two long time Drs and I am a 'belt and suspenders' guy and wondered if the supplemental gave 'over and above' coverage. I think I will investigate a catastrophic policy that would be available for military members, if there is such a thing!
     
    Cerberi likes this.
  17. Capt MJ

    Capt MJ Member

    Joined:
    Sep 27, 2008
    Messages:
    2,343
    Likes Received:
    1,810
    Three military friends of mine, sadly, have been diagnosed with glioblastomas. One was an active duty officer, one retired Reserve, one retired from active duty. One was seen at Walter Reed National Military Medical Center on TRICARE Prime, and consults were brought in as needed from top docs in the NE.

    One lived up near West Point, and his care was handled through TRICARE Prime at Memorial Sloan-Kettering Center in NYC.

    The third was seen at Johns Hopkins using TRICARE Prime; the same as I and DH use.

    Just personal examples of more catastrophic situations I know were covered in a quality way.
     
    Cerberi likes this.
  18. 2018DAD

    2018DAD Member

    Joined:
    Feb 18, 2015
    Messages:
    104
    Likes Received:
    87
    Capt
    Thanks so much! Your's finishes off some great responses. Thanks all, this information makes me and DW feel much better.
    (P.S. FIL was Navy Surgeon years ago on the carrier Shangri-La!)
     
  19. Capt MJ

    Capt MJ Member

    Joined:
    Sep 27, 2008
    Messages:
    2,343
    Likes Received:
    1,810
    Where do military docs go when they retire/separate? Right out the door to top practices.

    My Mom's internist - former Navy doc via Mt. Sinai and Mass Gen. DH's PCM - former AF flight surgeon. One of my Johns Hopkins specialists - former Army doc.

    You can look up co-pays and all that stuff. AD pay zip in premiums and out of pocket, and retirees pay exceptionally low rates.

    Sadly, some of the best trauma surgeons around right now are in the military, due to so much practice. My neighbor is a McGill-trained ortho surgeon, head of a well-regarded local university hospital surgical unit, and he takes his residents to Bethesda for observation and seminars.
     
    MN-Dad-2016 likes this.
  20. MN-Dad-2016

    MN-Dad-2016 Member

    Joined:
    Mar 30, 2012
    Messages:
    438
    Likes Received:
    131
    All true.^^ The Mayo here in MN is full of ex-military docs. In order to get a medical waiver, we had our son see a top pediatric cardiologist (he wrote several textbooks and every cardiologist knows his name) . I felt his credibility helped our son get a needed waiver for the SA. 1st words out of the Doc's mouth with a stern look: " Why not the Navy". lol. Our DS dreams of practicing at the Mayo after his military career is over. He shadowed some heavy-hitter ex-military docs at the Mayo. An ex-USAFA Harvard trained doc had him stay at his home to shadow. That time, he observed this doc train people from around the world. So yes. Military Doc's are best in class in specific disciplines. Furthermore, I'm amazed how close-knit the military community is and how many people open their homes to help a fellow member!
     
    Last edited: Aug 29, 2016

Share This Page