Here Are Some More Things That Could Be Helpful For You!

If you have just joined a Tricare program, then you may be unaware of everything it has to offer. Active and retired military members along with their spouses and family members can receive medical assistance at no or low cost through Tricare. With so many plans within Tricare, it is easy to get confused about coverage.

With this in mind, enrollees should first review their plans to ensure they are aware of their benefits and coverage limits. It also allows enrollees to make the most of Tricare benefits.

Despite popular belief, you should not only use your Tricare coverage when a medical issue arises. There are a series of preventative services that can have long-term benefits on your dental, vision and mental health. Find below tips on how to take advantage of your Tricare benefits.

Tip #1: Get Familiar With Your Plan

The first step in using your Tricare benefits is getting familiar with your coverage. Tricare offers several health insurance plans within the program. Each plan caters to specific individuals and has strict eligibility guidelines.

For instance, Tricare for Life is available for retired service members who are older than 65 years of age. Tricare Prime Remote, on the other hand, is available for active military members and activated members of the Guard and Reserve as well as their qualified family members.

Enrollees in different plans will have differences in their benefits, costs and coverage options. Each plan will detail which medical visits require prior authorizations and referrals. With this in mind, individuals who qualify and enroll in a plan must review the details of their coverage thoroughly. This will help them prevent any confusion when using benefits and avoid unexpected costs.

Tip #2: Choose Your Primary Care Physician Carefully

Tricare enrollees can choose between in-network and out-of-network providers. The former refers to providers who are approved by Tricare and offer services covered by the program. Providers who are out of network may also be approved by Tricare. However, enrollees will have to pay the costs of their visits. As such, it may be best to choose an in-network provider and avoid additional expenses.

Finding a provider entails first finding out which region you belong to:

  • East Region
  • West Region
  • Overseas Region

This will determine which list of providers you have access to. Once you establish your region, you may look through a directory listing the available providers. Selecting a primary care provider (PCP) is a simple task that can have a long-term impact on your life. As such, it is critical that you find a provider who can meet your needs and provide the necessary support.

During your search for a provider, it is important to consider factors such as address and availability. Even if you may not require frequent medical visits, having a PCP who is within a certain proximity to you can make things easier. It makes trips to the doctor quicker and hassle-free. Their availability is also a critical factor to consider, as it may affect your ability to see him or her and discuss concerns.

Once you narrow down your options, you may book an appointment with a Tricare-authorized provider. However, the selection process is not yet complete. The second aspect involves evaluating your experience following your first visit to your PCP. It will provide invaluable information and allow you to set an expectation for following visits or re-assess your decision.

A PCP’s role is to not only perform medical examinations but also answer your questions and discuss concerns. During your initial appointment, find below a list of questions to ask yourself:

  • Is the PCP attentive and courteous?
  • Does he or she answer my answers and address concerns?
  • Do I feel comfortable with this provider?
  • Is the staff helpful and polite?
  • Is my wait time reasonable or excessive?
  • How was my overall experience?

Answering these questions will help you determine if the provider is a good fit for you. If not, then you may change your listed provider and continue your search for one who meets your needs.

Tip #3: Use Your Preventative Care Services

Tricare enrollees have access to a variety of services for mental and physical health care coverage. Although coverage options vary on each plan, they typically all include preventative care services. Many enrollees only visit health care professionals when a medical issue arises.

However, there are numerous services dedicated to improving individuals’ current health and preventing future medical ailments. For instance, benefits in all Tricare vision insurance plans include a yearly eye exam. The exam is a comprehensive vision screening that evaluates enrollees’ current vision health and addresses any issues that may require additional attention.

Moreover, Tricare benefits may also include preventative dental services. Routine visits may entail fluoride treatments, regular cleanings, X-rays and routine oral exams, all of which prevent tooth decay, gum disease and a host of other oral infections. It is important to take advantage of these services, as they are not only free but also help prevent health issues down the line.

Tip #4: Take Advantage of All Benefits

In addition to preventative care services, there are many benefits that are underutilized by Tricare enrollees. For instance, the Tricare Pharmacy Home Delivery is a covered benefit that allows enrollees to receive at-home deliveries for their maintenance medication. This cost-effective option is a reliable service, especially when military pharmacies may not be available. Enrollees can register for this service online, by phone or via mail and receive their prescriptions within a week. However, it is important to note that this service is not available for non-covered drugs.

Moreover, many covered mental health services are often underused. If you are in need of therapeutic services to treat mental health issues and/or a substance use disorder, then Tricare may cover it. Find below a list of services covered by Tricare:

  • Psychotherapy, including individual, group and family sessions
  • Psychoanalysis, if the insured meets certain eligibility requirements
  • Ancillary therapies involving art, dance and music

Furthermore, active duty service members may have access to smoking cessation programs and family counseling. However, they must obtain prior authorization and a fitness-for-duty review, as that is considered specialty care.