Tricare Standard and Tricare Supplement questions

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susan f
Posts: 1162
Joined: 2005-10-01 21:26:14

Tricare Standard and Tricare Supplement questions

Post by susan f »

Hi,

My husband is recently retired military and I'm considering retiring myself, after which I will of course lose my healthcare benefits through work.

We have Tricare Standard and will be getting a Tricare supplement through Selman&Co.

I am currently going to a provider (Mayo Clinic) that is a Tricare contracted provider, but is out of Network, not in Network. The way I *think* it will work is that Tricare will pay 75% of the allowable charge, and the supplement company will cover the remaining 25% of charges. And then I *think* that we will be out of pocket for any charges in excess of the allowable charge.

I've talked to Tricare, Selman&Co and Mayo Clinic and no one seems to be able to confirm this. Selman&Co also has coverage for "Excess Charges" at 100%...

Anyone have experience with Tricare Standard and Supplement? I'm just trying to plan for what lies ahead and keep my current excellent medical team.

Also - anyone have experience with Tricare coverage of ostomy supplies? The Tricare rep (its managed by United Healthcare in my region) had to have me spell "Ostomy" for her... she had no clue.
UC Diagnosis 1981
J-Pouch 1988-2002
Permanent ileostomy 2002-now
Crohn's Disease Diagnosis - 2015
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Jimbob
Posts: 3583
Joined: 2007-06-18 17:40:16

Re: Tricare Standard and Tricare Supplement questions

Post by Jimbob »

Hello Susan;

I am a Retired Marine and am past 65 so I use Medicare and Tricare for Life for both myself and my wife. I never did use Tricare Standard as I worked after I retired and used my company's medical plan and Tricare as a supplement. It all worked out well for me. I think my ace in the hole here is that I live in an area which has a huge military presence and all of the health care providers are very knowledgeable about what the rules are.

This link is the basic Tricare Link that may be useful to you. http://tricare.mil/

Also for meds I generally go to the local Navy Hospital to pick up my scrips. for my wife we use Express Scrips and they are very responsive and very good. They accept Scrips directly from the docs so there is not a hassle. To my knowledge they do not handle Ostomy Supplies so I order from a supply house and use Medicare and Tricare for life as the Supplement.

If you are anywhere near a Military Hospital I would give them a call and talk to them about your situation. They all have a section to help people with your questions.

Hope this helps a little, maybe someone else will chime in. In the meantime I will try to do a little bit more research.
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susan f
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Joined: 2005-10-01 21:26:14

Re: Tricare Standard and Tricare Supplement questions

Post by susan f »

Thanks Jim,

I've looked through the Tricare and Selman&Co websites, and they have general information, but nothing very specific. It is a long drive to the one and only military outpatient clinic in the area - there isn't a hospital on base that I can tell. I currently get my meds through Express Scripts and Accredo (their specialty pharmacy), and they seem to be the contracted provider for Tricare as well.

It just seems bizarre to me that neither Tricare, nor the supplement provider, nor Mayo can answer a simple question - am I responsible for the cost of care over Tricare's allowable charge (I think that would be "yes", but no one could tell me that for sure) and can someone give me an idea of what that would be?
UC Diagnosis 1981
J-Pouch 1988-2002
Permanent ileostomy 2002-now
Crohn's Disease Diagnosis - 2015
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Jimbob
Posts: 3583
Joined: 2007-06-18 17:40:16

Re: Tricare Standard and Tricare Supplement questions

Post by Jimbob »

Good Morning again Susan;

Sorry I am not more help but I did find a link to Tricare Standard costs and coverage etc. It is http://tricare.mil/Costs/HealthPlanCosts/TSE/RET

Here is a number for Naval Hospital Pensacola. it is the Customer Care Number, Maybe they can answer your question. 850 505 6785/6434

Which Military Hospital is closest to you, Not VA.

When I try to google your question I do get sketchy information like you do.

I will keep looking.
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susan f
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Joined: 2005-10-01 21:26:14

Re: Tricare Standard and Tricare Supplement questions

Post by susan f »

I am in Phoenix area, so Luke AFB is closest, but I don't think they have a hospital, only an outpatient facility. Anywhere else is a silly distance (Yuma? San Diego?), considering that I am perfectly happy with the care I am getting from Mayo which is a 15 to 45 minute drive, depending on what location I go to. I think at this point I am just going to wait until I start using the Tricare insurance and see what that looks like. It won't break the bank.
UC Diagnosis 1981
J-Pouch 1988-2002
Permanent ileostomy 2002-now
Crohn's Disease Diagnosis - 2015
marika911
Posts: 1
Joined: 2017-02-21 05:59:08

Re: Tricare Standard and Tricare Supplement questions

Post by marika911 »

Hi Susan,

I am in the same situation, I'm retired and have Medicare and Tricare for life. I live close to Mayo clinic and have to have surgery in 2 weeks. I would like to know if Mayo clinic accepts Tricare for life and what would be my copay if any?
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Jimbob
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Joined: 2007-06-18 17:40:16

Re: Tricare Standard and Tricare Supplement questions

Post by Jimbob »

I also use Medicare and Tricare for life, Have had several surgeries stoma related and some heart attack related procedures and with the exception of the Part B deduction from my social Security I have never paid a dime. As far as meds I get them from the local Navy Hospital, my wife gets hers from the mail order. I like going to the base as I can visit old friends and tell Sea Stories. The ostomy supplies are not something the Navy Hosp supplies so I order from a medical supply house and they are covered also.

We basically have the Cadillac plan.

Semper Fi

Jimbob
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susan f
Posts: 1162
Joined: 2005-10-01 21:26:14

Re: Tricare Standard and Tricare Supplement questions

Post by susan f »

Hi Marika,

You will have to talk to Mayo. I am 54, so I won't qualify for Medicare for another 11 years. Good luck with your surgery!

Tricare Standard, Premium and ... whatever the other one is, is for dependents and Retirees under 65.
UC Diagnosis 1981
J-Pouch 1988-2002
Permanent ileostomy 2002-now
Crohn's Disease Diagnosis - 2015
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