Tricare Prime

[alexa_r7]

What is the difference between Tricare Prime and Tricare Standard? All this medical benefit stuff is pretty confusing. I just need a little incite on what's the point in enrolling into Tricare Prime.

[Jenn_NicksWifey]

Tricare Prime is a benefit where you go to military medical facilities for your health care and pay nothing.  In some cases, you can be referred out to a civilian provider, but they try to meet all your needs within the military healthcare system.  You'll have a primary care doctor, who you will see for everything and any additional services from specialists you need will require a referral from the PCM, with the exception of prenatal - you don't need a referral.  But prenatal stuff is a whole other bag of worms in and of itself, so I'll skip it for now.  If/when you need those services, it's best to find out how it works at your specific station.  All active duty are required to be enrolled in Tricare Prime, but dependents must proactively enroll.  You can enroll or disenroll at tricare.mil/bwe

Tricare Standard is more like regular health insurance.  You can choose your own provider and pay out of pocket costs based on the provider's arrangement with Tricare. Prenatal care is covered with no out of pocket costs (for medically necessary expenses) even if you have Standard.  You do not have to do anything to have Tricare Standard, you are automatically enrolled when your sponsor fills out the forms at bootcamp.  

Either route you go, there are pros and cons, you just have to decide what is right for your family.  But you definitely need to know your sponsor's social security number, everything is done via that number.

[alexa_r7]

Okay thank you! It's hard trying to decide to either stick with Standard or enroll into prime.

[Jenn_NicksWifey]

Yes, I think the lockout is a year, but e4 and below are exempted from the lockout.