If there is one thing about military marriage that surprised me, it is the massive learning curve that occurs once joining Tricare.
After my husband and I got married, we hopped into our SUV and took a week long road trip from the midwest back to coastal Carolina where we lived.
I specifically remember driving through the country roads of Kentucky with the windows down. The warm September air rushed past my face, whisking my hair into the air. We were in love and didn’t have a care in the world.
After I settled into life as a new military wife, however, I began the fun and glorious process that is DEERS, Tricare and SGLI. Suddenly my care-free mindset shifted to anxious and worried.
7 myths about Tricare…debunked.
Tackling the steps to get started and understanding the benefits was overwhelming. Even still, I get overwhelmed trying to keep up with the ins and outs of Tricare benefits.
Here are some of the myths I learned in recent years:
Myth #1: Prime is always the best option.
If you are healthy, don’t mind waiting on referrals and appreciate the military choosing your provider, then Prime is a great option. There is also little to no expense associated with Prime, so long as you follow the rules. Our family uses Prime and this is a great option for us right now.
However, if you want more say over specialized care, want to choose your own doctor or bypass the need for referrals, then standard is a far better option. Your coverage is around 80% of medical costs, which means for $1,000 medical bill, you will pay $200 or 20%.
Myth #2: Urgent care visits require pre-approval and out of pocket expenses.
If you have Tricare standard, you don’t need urgent care referrals, but you will pay your co-pay.
If you have Prime, can now get two urgent care visits per person without a referral or out of pocket expense. Yay for that! After two urgent care visits, you do need to call for pre-approval to avoid out of pocket expenses.
Myth #3: Getting a free breastpump is a huge hassle.
There is one company that makes this process easy and effortless — The Breastfeeding Shop.
Because The Breastfeeding Shop works directly with military spouses, they know all the ins-and-outs of working with TRICARE.
They will make sure you get your pump without spending any money out of pocket. They also help you receive the maximum breast pump and accessories available through TRICARE. And they make sure you don’t get buried in 10 pounds of paperwork.
All you need to do is fill out your order form on The Breastfeeding Shop’s website, and follow the simple instructions from there.
Myth #4: Spouses marry service members just for Tricare.
Isn’t that the silliest thing you’ve ever heard?
Tricare recently implied that on their Facebook page, posting “You had me at #Tricare: http://www.tricare.mil/Marriage. #NationalWeddingMonth.
Like many other spouses, I had my own health insurance and this crazy thing called a job before I married my service member. If I were a gold digger, I would dig for something more than base housing, a mini-van and Tricare.
Myth #5: Well-child checks stop at age 6.
Well-child checks are now covered beyond the age of 6. In previous years, you paid out of pocket or your provider kindly ate the cost.
You can now continue taking your kids in for regular well-child checks and kids younger than age 6 continue to receive the same benefits as before.
Myth #6: You can get prescriptions filled anywhere without co-pays.
Make sure you are filling your prescriptions as a Tricare approved pharmacy! CVS is no longer an approved pharmacy. On-base, Walgreens, Walmart, Rite-Aid and a few others can fill your prescriptions at minimal cost to you for Tricare Prime. On base is typically zero cost to you. If you have standard, co-pays apply.
Myth #7: You can keep the same doctor until you PCS.
If you are seen on-base, there is a good chance your provider will PCS before your own rotation date. One of the difficult things about Tricare Prime is continuity of care.
While at our current duty station, my provider has changed three times due to PCS moves. Just something to consider when choosing between Prime and Standard.
It gets easier.
Tricare is overwhelming at first. Once you use it for a while and become familiar with how it works best for your individual health situation, it does get easier.
There are many more myths about Tricare. What’s the biggest thing you’ve learned about Tricare since using it?
This is a sponsored conversation between The Breastfeeding Shop and myself. All opinions and text are my own.
To learn more about getting a breast pump through Tricare at no cost to you, visit their website here.
Want more on military life?
- How Military Spouses Can Conquer Anxiety During High Stress
- Dear Military Spouse Who Is Tired
- How to Get a Breast Pump Through Tricare for $0
- One Simple Tool That Will Make Deployment Easier
Adrienne
Myth #4 just made me laugh. Oh boy. We are no longer active duty, but job well done on an informative post!
Candace
This helped so much! Thank you! I’ve been on tricare for a year and it’s still a lot to learn.
Amie F
If you live 30 minutes or more from a military treatment facility you can have a civilian provider. If you don’t want the change in doctors all the time make sure you live off base and at least 30 minutes away from the nearest military treatment facility. I haven’t seen a military doctor in almost 10yrs.