We have all heard one thing or another in regards to Tricare. Things that they do or don’t do. I know I have heard my fair share of myths in my eight years of being a Military Spouse. So to help a little with all the stories and ‘gossip’ you may hear, here are the five top myths I hear in regards to Tricare.
1. You get one PCM for your entire Duty Station.
If you are Standard, then probably. However, if you are Prime you more than likely won’t. Keep in mind these doctors are also service members, therefore, they to rotate duty stations. Meaning you may go through a few PCMs during your stay per station. In our three years in this location, I am on Doctor number four.
2.Getting a free breast pump is impossible.
This is very easy. There are a few companies which all they do is deal with Tricare. When I had my son, i used Target. All I had to do was email the picture of the prescription to them. However, I have heard they no longer offer this service. I know The Breastfeeding Shop is another source. All you have to do with them is fill out their order form.
3. Urgent Care Visits require Pre-Aprroval.
For Standard, there is no pre-approval needed. However, you will still be responsible for your co-pay.
For Prime, you are allowed two visits without approval per person per year. For more than two you will need an authorization, which you may get by calling the Tricare Nurse Line should your regular PCM not be available to see you.
4. You can get your prescription filled anywhere.
Simply put No. Some locations do not cover Tricare. CVS for example no longer takes Tricare. Places like Walgreens, Walmart, and Rite-Aid, are still providers. The best place to get prescriptions filled is still on base since there is no co-payment in the base pharmacy as there is with the other vendors.
5. Prime is the best option.
This is not true, and it comes down to each families specific needs. If you don’t mind waiting on referrals and having little to no say on which doctors you get, then this is a good option. There is also little to no expense associated with Prime.
However, if you want the freedom of choosing your doctor, and don’t want to deal with waiting for referrals, then Standard may be for you. Just keep in mind that Standard is a 80-20. Meaning they cover 80% of the costs and you cover 20%. So if a bill is 1000, you would be responsible for 200. I do know there is also a deductible section for Standard, but I am not aware of the logistics behind it.
So be sure to do your research and choose which plan is better for your family. For example, for my family, Prime was the best option.
Are there more myths floating around out there? Sure there is. There always will be due to misinformation and the telephone effect. The key is research. If you can’t, find the answer then ask the appropriate people. Should you have a Tricare question, ask the Tricare specialist on your base. Question on medical, ask a service member there. Do not just rely on what you hear from other spouses. Though us spouses are a source of knowledge, sometimes we hear things incorrectly or our own personal experiences may lead to wrong information.