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Another Tricare question!

This is a potentially stupid question, but I am new to Tricare so I apologize. I am enrolled in Tricare Prime and read this:

TRICARE Prime
The Prime program is TRICARE's version of a Health Maintenance Organization (HMO). When enrolled in Prime, the beneficiary chooses a Primary Care Manager (PCM) who is their primary doctor for as long as they are enrolled in the program.

I'm just confused because if we are moving every 3 years or so, doesn't my Primary Care Manager change? I mean I'm not going to fly back to Hawaii every time I need my annual doctor's visit. Do you get to pick a new PCM each time you move? Or do you have your initial PCM the entire time and then just see various doctors in the network as you move around? Sorry, I'm new to all of this!

PersonalMilestone Anniversary

Re: Another Tricare question!

  • You get a new PCM as you move. Also, if you are unhappy with your PCM you can change it at anytime. I changed mine because their office hours didn't work with my schedule and it was no big deal.
    Baby Birthday Ticker Ticker
  • Also, you are renewed every year into the program, so you might be able to change then as well.  When your renewal is up you can also change from Prime to Standard as well.
    imageBabyFruit Ticker
  • Good to know. The Tricare woman had me totally confused when we went in and signed up...apparently I was initially signed up under Standard but after the 20th of the month that I signed up I was to be switched to Prime. And so now I'm Tricare Prime.

    What do most have? Prime or Standard? The Tricare website was a little vague as to what the major differences were between the two programs.

    PersonalMilestone Anniversary
  • I have Prime.  If I had any preexisting medical conditions I would probably go with standard so I could go where I wanted, but for now I'm perfectly okay going to base medical for anything that comes up. 

    I do plan on switching to Standard there for when we TTC or get pregnant, because I've heard varied things about that on base.   

    imageBabyFruit Ticker
  • imageKiller Cupcake:
    imageESquared423:

    Good to know. The Tricare woman had me totally confused when we went in and signed up...apparently I was initially signed up under Standard but after the 20th of the month that I signed up I was to be switched to Prime. And so now I'm Tricare Prime.

    What do most have? Prime or Standard? The Tricare website was a little vague as to what the major differences were between the two programs.

    Everyone is automatically enrolled in standard when you enroll in Tricare. 

    I have Prime.

    With standard, you don't need referrals to see specialists but you pay a co-pay/cost share (at least this is how I understand it). With prime, you need referrals, but you pay nothing out of pocket. I prefer that. Getting a referral has never been an issue for me, so it's worth it.  

    That makes sense. I prefer that too, so I definitely would like to stick with Prime, at least for now. I was just concerned/confused with the website saying that the beneficiary has the same PCM for however long they are enrolled with the program (which could many, many more years for me) and I was wondering how a PCM in Hawaii made any sense at all if I was moving around all the time.

    Thanks girls! 

    PersonalMilestone Anniversary
  • The beneficiary chooses??? LIES!! They choose and then if you hate them, you have to jump though hoops to get a new one. If you like them, they might magically decide one day to change it even though the doctor is still there. When you ask them wtf is up, they shrug and say, meh idk, too bad so sad.

    Choose my ass.

    bwahahahahahahahahahahaghahahah ::gasp:: bwahahahahahahahahahahahahaha



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    image
  • imagednbeach12:
    Also, you are renewed every year into the program, so you might be able to change then as well.  When your renewal is up you can also change from Prime to Standard as well.

    You can change from prime to standard at any time. However, they lock you out of switching back to prime for a straight year unless you have a really good reason. Although, to be fair, to Tricare a really good reason is uhm, I stubbed my toe and my standard guy hates my face.



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    image
  • I have Prime as well and I also have a pre-existing condition. I haven't had trouble getting referrals so far. Also, I had a referral to a specialist that spoke to me like a 5 year old when I know more about my condition than she did, so I went back to my referring doc and had them refer to a diff specialist. Prime is great because between visits and tests, the co-pay would add up really quickly if I was on Standard.
    Proud Army Wife
  • imagehindsight's_a_biotch:

    imagednbeach12:
    Also, you are renewed every year into the program, so you might be able to change then as well.  When your renewal is up you can also change from Prime to Standard as well.

    You can change from prime to standard at any time. However, they lock you out of switching back to prime for a straight year unless you have a really good reason. Although, to be fair, to Tricare a really good reason is uhm, I stubbed my toe and my standard guy hates my face.

    Only if the sponsor is E-5 and above.

    Baby Birthday Ticker Ticker
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