Tricare, as you probably know by now, is the military health insurance system.  And, as many of you have already also found out first hand, it combines the hassles of an HMO with the beaurocracy of the military.  Therefore, it is just LOADS of fun to deal with.  So, I thought I might share a few hints and observations that might help others navigate through the Tricare maze.

Our first introduction to Tricare came around the time that we got Steve's orders, when we recieved a 30+ page Tricare Information booklet specifically designed for the Reservist and National Guardsman.  Having recently selected our family's private health coverage, I was familiar with this type of information.  I found out quickly about the three “flavors” of Tricare (Prime, Extra, and Standard), with general information about what they offered, such as guaranteed waiting times for appointments.  Interesting, but not helpful.  What was NOT included was a simple chart comparing coverages and costs between the plans.  So I read further.

Tricare was also kind enough to include an FAQ sheet.  Like most such resources, it included some common questions and answers with explanations.  Helpful until the last question:

“I am not smart enough to figure this out for myself.  Who can help me?”

Excuse me?  Perhaps I misread that?  No, the FAQ sheet did just insult your intelligence.  And that, my friends, is your introduction to customer service at Tricare.

In all fairness, there are some very nice and knowledgable people who work at Tricare.  My advice is that if you find one of them, get a name and a direct phone number.  It will save you a lot of hassle and headaches and frustration.  (And on the subject of getting names, get names of everyone you talk to.  It may help later when you recieve contradictory information.)

And, now that you have picked your jaw up off the floor, you can again try to select which Tricare plan is right for you.  An important piece of information is that none of the Tricare plans (for actively serving military and dependants) requires a premium payment.  They do all, however, have requirements for enrollment in terms of time and location.  My advice on this is to determine, first of all, if you need Tricare as a primary insurance, or if you will continue to be covered under some other insurance that you already have.  If you will be using Tricare, especially as primary coverage, try to determine if your current physicians are part of the network or not.  (For this I recommend a call to your doctor's office directly.  I have found the Tricare directory to be outdated at best.  But perhaps that is only because I called 8 Tricare listed doctors before I found one that was on the list that actually accepted the insurance - who then turned out to be a nurse practitioner, not a doctor - for my own yearly medical care.)  The Prime plan offers less out of pocket expenses, but Standard might be more cost effective if your physicians are out of network.

Also remember that if you are nowhere near a military treatment facility, you may be covered under a sub-flavor of Tricare called Prime Remote.  This is a program which was initially, I think, developed to cover folks like full-time National Guardsmen, who may not be stationed at a base.  The important thing to know about this plan is that it will give you the same coverage as Prime, but with a much wider selection of providers, if you live more than 50 miles from a military treatment facility.  The REALLY important thing to know about this plan is that the zip code used for determining eligibility is your HOME zip code prior to active duty orders.  (This is specifically stated on the Tricare website.  However, it did not stop a Tricare representative from calling me and demanding my husband's work zip code to determine our eligibility.  Since this was the first week he was overseas, I did not even have an address for him myself.  After explaining this fact, and the fact that they probably had a much better idea of his current address than I did, I also explained how the system worked.  So, it is good to be at least marginally aquainted with the rules and coverages.)  There may be some other restrictions as well, particularly if you move while your spouse is deployed, so it is good to check all the requirements.  This plan does seem to be an excellent option, though, for many Reserve families.

Most likely, your military spouse will enroll you and your children as part of their inprocessing (including putting you into the DEERS system, which is required prior to Tricare enrollment), so you will probably not have to worry about that process.  However, it is good to decide on the type of coverage that you will want, so that this selection can be made at that time if possible.  (Fewer steps MAY mean fewer screwups, or at least may make the ones that do happen easier to sort out.)  Additionally, the new benefits approved for Reservists allow Tricare coverage for up to 90 days prior to the start of active duty orders of 30 days or more.  The important consideration here is that if the orders change, so does the eligibility during that period.  Also, for IRR recalls, who have no way of getting their families even into DEERS prior to reporting, this benefit really doesn't apply.

For more information on Tricare, including rules and benefits, the Tricare website is a good place to start.  There are also websites specifically dedicated to the various Regional components of Tricare, so those might help you with questions specific to your location.  And when in doubt, don't be afraid to pick up the phone.  Just remember to write everything down and get names!