6 answers

Is Tricare Standard Better than Prime?

i've been hearing that standard is better than prime, becuase you can choose your own dr., but is the co pay expensive? how about prescriptions? i have prime, we go to the clinics, and get our meds free, but I worry about the standard of care.

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They are both good and bad. I liked Prime because our doctor's fall under their umbrella and the co-pay was affordable. But I HATED not being able to go to the doctor's I wanted to because the military had control over it. We now have Standard, but thats because we have another health care. We ended up buying health care through my husband's federal position. But I do like being able to pick my own doctor's, care, etc...but that may all be changing on us soon anyways. Hopefully not!

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My family and I have throughly enjoyed Tricare Prime. While we'll still go to the base for regular clinic care. I prefer to go to a specialist instead of the base doctors. With that, I've almost never found a doctor that was not on the "allowed" list. I've never had any complaints except that I have to book an appointment with the clinic doctor to get a referral into see the specialist. I simply tell them I'd prefer to go to the specialist because it's closer to my home. Never had any problem with getting a referral. Stay with it, just work the system. :)

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We just switched to standard because there are no prime providers near us. The premium is $300 a year for the family plan and then the co-pay for network doctors is 15% per visit. For non-network providers the co-pay is 20%. You don't pay the premium to tricare directly. Instead, you pay your provider the full amount of each visit until you reach the $300 premium, and then it's just the co-pay after that. For prescriptions, it's the same as it is for prime if you get your prescriptions at a pharmacy outside of the military. For generic prescriptions, it's $3, and for name-brand it's $9. Not bad, and I really like having control over who we see, as well as not dealing with the bureaucracy of the military anymore. The last place we were stationed, the clinic lost our medical records twice!! Definitely not dealing with that anymore. Good luck!

1 mom found this helpful

You have to weigh your situation and decide which will be more economically feasible for you. If you have small children that frequent the doctor or you have medical conditions that require more care, then you may find that Prime is the better option for you since you pay less out of pocket.
Go to a tricare office and talk to someone in person. They know all the details about all the plans and can probably better inform you about which plan would be better for you.
Good luck with your retirement! Enjoy!

Who says you can't choose your own doctor on Tricare Prime? We're on prime and I've always chose my family's doctors. All you have to do is call the office and ask if they accept Tricare Prime. Most doctors do. If they do then change your PCM with Tricare to the new doc. Simple. I would never go with Standard when I could have Prime. The savings on Prime can't be beat.

My husband is disabled/retired from the Coast Guard and we have Tricare Prime. We LOVE it!! I honestly don't know much about Tricare Standard. We live in Richmond, VA and while Primary Care Providers are bit harder to come by everything else has been wonderful. We had Patient First as our PCP (ughh!) but recently a Family Physician about 2 minutes from our house started accepting Tricare patients so we are switching to them. (My husband has gone a few time already and loves them!)! I see a rheumatologist every few months so I have to a referral to go there which is easy to obtain. My son's pediatrician is 5 minutes from home and we love them. He too has seen a specialist without any problems. My husband has had multiple surgeries and my son has had a few surgeries (tubes in his ears)! We pay $12 copays for ANY doctor we see - specialist or not. We pay $3 generic prescriptions and $9 non-generic. It cost us $25 for surgeries. Our premiums are $460 a year for our entire family and it comes out of his retirement pay so we never see a bill for that!! Overall, we LOVE Tricare Prime and receiving these benefits as part of his retirement package from the Coast Guard (at the ripe old age of 28!!)! has been a blessing!!!! :)

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