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Tricare Prime Secondary

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  • Bobk

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    Something for you guys who are fixing to retire. If you have Tricare Prime and get another job and want your spouse/children to keep Tricare Prime as the primary insurance do not put them on your employer's medical insurance. Otherwise Tricare will become secondary.

    If you're a retiree and are forced to take the employer's insurance for yourself then Tricare will become your secondary. If your employer has prescription coverage then Tricare will additionally become secondary on it also.
    Lynx Defense
     

    tmd11111

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    I've been retired for 15 years and have never taken employee insurance. Have used Tricare prime only. I also fortunate enough to have a local military base that see's retirees. When I need a referral for a specialist it's only a $12 copay. In fact earlier this year I broke 7 ribs in a motocross accident and the er visit bill was over 13k and only cost me $12. Shortly after my back finally gave out and had a spinal fusion done total bill was well over 100k and only paid a little over $200 for the office visits
     

    Bozz10mm

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    Once I turned 65, Tricare became my secondary insurance. Medicare is the primary. So far I haven't had to pay anything out of pocket for annual check ups.
     

    oohrah

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    I'm with Bozz. But, I've never seen a situation where you were forced to take employers medical care. And I can't believe that an employers benefit would be cheaper than Tricare Prime. Does anyone still offer a free medical benefit?
     

    Bozz10mm

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    For the 10 years I was employed after military retirement, I opted out of the company's medical plan. It was not free, so it would have cost me a couple hundred bucks a month. The deductibles were also not as good as Tricare, so it was a no brainer.
     

    majormadmax

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    Is this Military only?

    Yep, which is why it's in the 'Military Vets' section! :D

    I too have kept Tricare Prime in the 10+ years since retiring. I've only worked for two companies during that time (one for most of it), but I too have never heard of anyone being forced to take a company's health care program. In fact, I just completed open enrollment with my new company and declined all the health care options offered.

    Why? As mentioned, Tricare is the best deal going if you have a military medical facility nearby that will see you. In San Antonio, there are several (Wilford Hall, BAMC and Camp Bullis Clinic). My employee health care would have been 4-5x the cost.

    In fact, since Tricare Dental sucks so bad, I had to enroll in my company's dental program and pay more for it than I do health coverage! :(

    About the only reason I've heard not to take Tricare Prime is if you're going to be living somewhere without a military healthcare facility nearby.

    Cheers! M2
     

    shortround

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    Unless the rules have changed, TRICARE was set up to be available only to retired military who did not have access to employer health care insurance. Even then, TRICARE only provided primary care until Medicare kicked in.

    The law was written that military retirees who embarked on a second career in the private sector HAD to enroll in that company's health plan if it was a part of the benefits package.

    Military retirees could still seek treatment at military health care facilities, but the first payer would be the private sector's health plan.

    It was illegal to negotiate a civilian sector job using TRICARE as a bargaining point.

    I'm on TRICARE, and I haven't seen a Quack in 18 years!

    Be well.
     

    9uc

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    I've used a combination of insurances since I retired from the AF in '93. Did Postal for 10 years with their insurance, but when I decided to retire after 10+ years of that due to health issues, I reverted to Tricare as primary because I was so close to a major AF hospital. Now at age 70+, I now use a combination of Medicare/Tricare for some issues like vascular and cardiology since I'm no longer close to a base. I also use the VA since I have a 70% service connected disability for other issues. If I don't like the treatment or service of one, I'll go for a second opinion with the other.
     

    oohrah

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    The rules changed a long time ago. Tricare became an option for all retirees, and Medicare became mandatory at age 65, if you did not have an employer plan. My prior company had so many retirees on board, they offered us $1000 NOT to take their health plan to avoid costs (this was in the 90s when they offered free health plan for the individual). Many of us jumped to Tricare Prime, paying for it with the $1000 and pocketing the difference. When I changed employers, I stayed with TP because it was still way cheaper than whatever the employer had.

    Now the irony is that I am paying more for Medicare Part B than I was for TP. And even tho the promise of lifetime medical care was taken away by Congress, we still have it far better off than most folks, especially Part D.
     

    9uc

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    ..........Now the irony is that I am paying more for Medicare Part B than I was for TP. And even tho the promise of lifetime medical care was taken away by Congress, we still have it far better off than most folks, especially Part D.

    So True! With the combination, other than the monthly "contribution" for medicare out of my SS, other than for an Rx, I haven't haven't been out a copay for years and I have eliminated most of that by converting all drugs orders from express Scripts to the VA system.
     

    Tejano Scott

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    As a healthcare attorney who frequently deals reimbursement issues from non TriCare related VA programs (Mill Bill, authorized care, Choice), I find this discussion both helpful and interesting.
     

    Bobk

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    I'm with Bozz. But, I've never seen a situation where you were forced to take employers medical care. And I can't believe that an employers benefit would be cheaper than Tricare Prime. Does anyone still offer a free medical benefit?

    I ended up having to take the employer's healthcare because it is provided by the Union. In my case I can't opt out. This is something for retirees and persons who are on Tricare to be aware of as I had never seen it mentioned in any briefings.

    Listed below are a couple of cases where you would be forced to take their coverage.

    "An employer can only force you to take the plan at work if it pays 100 percent of the premiums or if you agreed to take the plan as part of an employment or union agreement."

    http://www.insure.com/health-insurance/when-reject-health-insurance-plan-at-work.html
     
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    Wildcat Diva

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    I'm mad at Tricare right now. I work for a community mental health center (servicing children). They won't let my application to be an approved provider continue for a very stupid reason. I have been licensed in the state of Texas as a counselor for 19.5 years. No problems ever. I did what I was supposed to do, finished my 2,000 supervised hours of work and passed the licensing exam to be licensed in 1997. Every two years I pass the criteria to renew it. Well, sometime down the line the Texas Licensed Professional Counselor board changes it to 3,000 hours. Doesn't make me a difference because my license is still valid (grandfathered, you might say.)

    On the Tricare form, it asks me to say what year I completed my 3,000 hours. Well, I didn't do 3,000 hours. Did 2,000 as the board required then. Tried to talk to them about that, and they won't budge. Application can't proceed. So, anybody around my age who was licensed (as an LPC) a few years ago and had the same criteria CAN'T be a Tricare counseling provider?!? Despite a (spotless) valid LPC state license and 20 years experience!?!

    I've already treated two Tricare covered kids extensively within the past two years for free and am stopping treatment on another one because the company I work for finally wised up to us not getting paid for them. So I will stop therapy with this kid prematurely and ask them to go someplace else. Sucks.
     
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    texasnurse

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    Requirements change all the time, I.e. New Jurisprudence requirement for Nurses, and CNAS now have to obtain CEUS


    Sent from my iPhone?
     

    Wildcat Diva

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    Well yeah, counselors have to get CEU's too. And pass a jusisprudence exam every two years. And I do what's required by the state every time. But there is no way to go back in time and get more supervised work hours before your licensing test 20 years ago. And, work experience is not the issue as I have 2 decades of it (well at part time, but even still that's certainly 10-20 times what would be needed for the additional 1,000 hours, it's just not "supervised."). But assuming I've not been reprimanded or complained about, I am doing well enough for the State to keep me and other people licensed under those requirements with a valid license. They don't yank it.

    Tricare needs to go suck an egg with that one. The staff at my workplace have argued at length with them and it's doing no good. I better warn all the new counselors that they best complete supervised hours for months in excess of what is required before they test for the license lest some criteria change someday.
     
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