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Medical Plan - Tricare Or Company

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PIGHEEL

Active member
Joined
Jan 16, 2002
Posts
27
Soon to retire fm the Navy.

Was wondering what the flightinfo bd mbrs opinions were IRT using Tricare or opting to pay for the company medical plan.

Curious as to the pros and cons of each.

There will be a payroll deduction for the company plan (have a family with a wife and two small children).

Thanks. Sincerely, PIGHEEL
 
I don't know if this will help because I don't know the specifics of your situation.

A friend of mine retired from the ANG as an AGR type. Thus, he retired from active duty and was immediately eligible for pay and healthcare through Tricare. When he was hired, he told the company he did not want the medical plan they offered because it was not as good as Tricare.

They consented, but he had to sign forms giving up those medical plan benefits. His wife also had to sign saying she concurred. They had no children at home and no other dependents such as children in college.

Good luck...Fly safe!
 
[Wife of SFOA320 here, who has lots of practice dealing with medical insurance & claims.]

Don't you have the option of having both? Your company plan would always pay first & then Tricare would be secondary (for whatever Tricare covers these days).

You need to put on paper the costs of company plan premium vs. your anticipated medical costs/needs. Factor in what the company plan deductibles & co-pays and coverages are. Does the company plan pay for well-child care, annual gyn/mammography for spouse, vision care, etcetera? Are your kids regular visitors to the ER (e.g. daredevils)? Planning anymore additions to your family? Is the company plan an HMO which may change each year &/or have huge premium increases annually? (Our UAL HMO premium quadrupled from 2001 to 2002, so we dropped back into the UAL standard BC/BS coverage.) Get the complete info package on the company coverages & participating providers *before* you make final decision. It would likely be smart to carry both coverages (if allowed) at first until you are able to gather all the facts. Also, does your company have open enrollment each year so you could opt back in? (Watch out for pre-existing clauses!!)

Lastly, it has been 2 years since we've dealt with Tricare & their terrible claims problems. Lots of docs don't even participate in Tricare & you may find it tough dealing with the claims hassle of Tricare. Ever visited the Tricare site & the beneficiary forums there?

http://www.tricare.osd.mil/

Hope this helps some.

--SFOA320's wife
 
Good question...

Pigheel,

I've been looking at this myself. I think what it comes down to is the availability of provider care in your area, and if you have a Tricare provider you want to continue using. Portability and the relative health of your family (as well as composition) also plays a part.

My family is staying in place following retirement and we have Tricare Prime providers that we are happy with. I've got the proverbial nuke-lay-er family - wife, son, daughter, dog, cat, mortgage & car payment. All in pretty good health, though the missus can't seem to put down those smokey treats (i.e. cigs).

Tricare prime coverage costs $38.33 per month (though you have to pay it quarterly or annually), plus a variety of co-payments which vary from $12 to $40, depending on the service. There isn't any annual deductible. Drugs are at a reduced rate from civilian pharmacies, military facilities don't charge co-payments for service or drugs. There are some decent Tricare supplement plans available that aren't too expensive, and will pay your normal copayments. One plan I'm looking at will cost $43.67 a month and pretty much covers all co-payments, and charges resulting from out of network treatment.

The downside to Tricare prime is that is isn't very portable. I'm going with a regional airline in part so that my family can get the travel benefits. It is difficult to get treatment out of your Tricare region if you are Tricare prime. That's why a supplemental plan may make sense, though you have to balance the probability of the family needing urgent but non-emergency care out of area against the cost.

The Comair plan costs $58.20 a month for me and my family. I don't know what the cost share, deductibles, and copayments are like. There is also a question concerning portability and providers in our area.

It may prove to be more cost effective and flexible to use the no cost Champus plans (Extra and/or Standard) as a second payer, and go with the Comair plan as the primary. I'm going see if I can get a copy of the benefit book from Comair and sit down with our Tricare counselor here in New Orleans to determine which would be the better way to go.

Of course, the company dental plan at $9 a month makes a lot of sense compared with the military retiree's option (100% out of pocket).

Good luck, congrats on the retirement. I'm at 34 days and counting. It's amazing to think 22 years could go by that fast.

Travis
 

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