Navigating Tricare: 5 Reasons to Enroll in Tricare Prime

b5b56b2ae93d3dc958cf0c21c9383b18.jpg

One of the benefits of being a military spouse that just about everyone knows about is Tricare. We’ve all heard of it, and most of us utilize it pretty regularly. It’s even one of the few things about military life that is pretty easy to explain to our non-military friends - it’s health insurance! But how do you pick a plan from your Tricare options?

Tricare isn’t just one health care coverage plan. It actually encompasses a group of plans that all meet the minimum coverage standards set forth by the Affordable Care Act. You can read more about the eleven different coverage plans at tricare.mil. There’s even an incredibly helpful comparison tool that allows you to view the benefits and costs of each plan side by side. Most active duty spouses, however, really only deal with two of the available plans: Tricare Standard and Extra, and Tricare Prime.

Tricare Standard and Extra (or Standard for short) is the default plan for active duty family members. Once you are enrolled in the Defense Enrollment Eligibility Reporting Systems (DEERS) you are enrolled in Standard. But should you stick with Standard? After all, Tricare Prime just sounds so much more lush and premium! Despite the allure of the word “prime”, which coverage plan is best for you is a very personal choice. Here are five reasons why Prime enrollment might be a good idea for you:

Cost Savings

Perhaps the most obvious reason to enroll in Tricare Prime is that it’s basically free! There are no deductibles, copays, or other fees associated with Prime unless you choose to see an out of network provider.

You Hate Paperwork

Paperwork is tedious and awful and no one actually likes it, but some of us find it more stressful than others. When enrolled in Prime, you’ll almost never have to file claims for your health care. Your provider will file all your claims for you, whereas with Standard (and many other plans) you often have to file claims for reimbursement.

Your Healthcare Needs are Pretty Basic

Many military spouses who require frequent specialized care find that being able to choose your own doctor and not having to wait for referrals are great benefits of having Tricare Standard. But if you only find yourself visiting your doctor for routine preventative care like annual physicals or well-woman exams, Prime might be the most sensible and convenient option for you.

You Live On or Close to a Military Installation

If you live on or near a military installation, enrolling in Prime comes with the convenience of seeing a health care provider close to home at your military treatment facility. It’s especially helpful for those last minute appointments when your kids wake up with the plague or you realize you’re about to run out of refills on a prescription.

You’re Moving Overseas

Finding a new doctor can be a challenge any time you move, but if you’re PCSing overseas the prospect of navigating a completely different healthcare system in a foreign language can be particularly daunting. Enrolling in Tricare Prime Overseas means you won’t have to worry about finding a provider at your new duty station. Although host nation healthcare is often excellent, you might be more comfortable seeing a Primary Care Manager on your military installation and having any outside referrals managed by Tricare.

It bears repeating that picking a health care plan is a very personal choice. You need to consider your health care needs and priorities carefully before deciding. The tricare.mil website is great resource for information. Your current health care provider can also provide some insights. And as always, getting the perspective of other military spouses can be a huge help too!