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dependent id/tricare HELP!!!!


Forum: Military Mommies

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  #1  
November 30th, 2012, 07:46 PM
rugby_girl's Avatar <3 my boy :)
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it took almost 22 months, but a paternity test was finally ordered, we went to court, got a child support order, he was ordered to provide a POA so I could enroll my son in DEERS/Tricare, and my son now has a dependent ID, still waiting for the first child support payment.

Now I have lots of confusion and questions, and he isn't helping or answering ANY of them.

The SGT at the ID office said that my son automatically has tricare standard, but I can change that to prime since I have a POA. The guy sent me to the tricare office, but the woman there wasn't much help because she doesn't usually deal with Active duty (it was a national guard base I got his ID at,not sure what the differences are in any of this), she actually confused me more then I was before.

Here's some of my questions...

How do I know if my son's doctor takes tricare? The lady said that there are different contracts/networks and some doctors will take one tricare but not the other? (We are not near any active duty stations, so everything will be at normal hospitals/doctors not military ones)

Does tricare cover urgent care?

Do I just give them his card and they know? Or will I need a policy number or something?

What are typical co-pays for standard? Is prime worth it?

Can my son have prime even if his father and his fathers other dependents don't?

Is dental covered?

On my son's id card, it says he has privileges? (Exchange, Commissary, MWR) what exactly does that mean?

His ID expires 12June2013... My POA expires 1Jan2013. Will I need another POA to get a new card for my son then?

I am sure I will have a lot more questions.

Thanks in advance.
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  #2  
December 2nd, 2012, 06:22 PM
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Join Date: Mar 2005
Location: Andrews AFB, MD
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I'm sorry, I can't answer most of your questions. I can tell you the difference between prime and standard though.

It is much much easier to find a doctor who takes standard than prime. If you live in an area with a lot of military you might be able to use prime, otherwise standard would be better.

Standard has a deductible of $50 for E4 and below, or $150 for E5 and above. This means the first time you use the insurance you'll basically pay out of pocket until you hit either the $50 or $150. Well baby and child visits are free until age six. Sick visits and other visits you pay 15% of the bill.

Under Standard you can go to either Urgent Care or an ER. With Prime you need a referral first, although you can of course procede straight to the hospital and call later in a real emergency.

You can look here to see if there are doctors in your area.

Find a Doctor
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  #3  
December 3rd, 2012, 09:17 AM
kjm's Avatar
kjm kjm is offline
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Quote:
Originally Posted by rugby_girl View Post

Here's some of my questions...

How do I know if my son's doctor takes tricare? The lady said that there are different contracts/networks and some doctors will take one tricare but not the other? (We are not near any active duty stations, so everything will be at normal hospitals/doctors not military ones)

Does tricare cover urgent care?

Do I just give them his card and they know? Or will I need a policy number or something?

What are typical co-pays for standard? Is prime worth it?

Can my son have prime even if his father and his fathers other dependents don't?

Is dental covered?

On my son's id card, it says he has privileges? (Exchange, Commissary, MWR) what exactly does that mean?

His ID expires 12June2013... My POA expires 1Jan2013. Will I need another POA to get a new card for my son then?

I am sure I will have a lot more questions.

Thanks in advance.
To know if they take Tricare you just call the doctor and ask them, I think that is the easiest way. They will ask if you have standard or prime and they will know which they cover. (most cover standard) Even if they don't and they are 'out of network' I believe Tricare still covers most of it (for us they cover 80% out of network and 85% in network, so not much difference, we have standard)

Tricare has covered urgent care for me before at the hospital that I took my son to. I believe most large places like hospitals/urgent care will take Tricare, if not refer to out of network costs.

I've not seen a Tricare 'card' with the actual information on it, sometimes there is a benefit number, but mostly they just use the sponsors SSN and DOB and they can look it up that way and copy your ID.

I think we pay like a $5 copay, not much, in fact we don't pay any typical copay when bringing my son to the doctor, they bill Tricare everything and then bill us what they don't cover, which is usually about $5.

I don't think Prime is worth it, most places don't take it unless you are near/on a military base.

Our Tricare doesn't cover dental, not sure if other plans or Prime does.

The privileges are the places he is allowed to go on the base.

You will probably need a new POA to get a new card
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  #4  
December 3rd, 2012, 09:33 AM
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Join Date: Mar 2005
Location: Andrews AFB, MD
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Our dental coverage is called MetLife. It is seperate from Tricare, and you have to sign up and pay for it.

https://employeedental.metlife.com/d...ic/EmpEntry.do
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  #5  
December 3rd, 2012, 03:53 PM
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I don't post here normally but I have tricare prime and think it is worth it, I have never had a problem with getting a doctor or any problems with refferals. I also have never had a copay and between my girls we have seen the doctor a lot. All er visits are 100% covered, they also see the allergist and we never pay a penny. The only thing I pay is a small percentage of there perscriptions, never more than $30.
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