I was reading the reply posts to Kendall and just had to point out some incorrect information. I actually WORKED as a Patient Advocate for a military association. My job was to help benes navigate the program, so I have NO HIDDEN LOVE for TRICARE, but I dont want people to have WRONG information either.
That means they wont get the care they need.
1) TRICARE does have a Dental Option
. Just like civilian health care, it is purchased through a secondary network company, UNITED CONCORDIA - http://www.tricaredentalprogram.com/tdptws/home.jsp
The costs are $12.69 per single dependent and $31.72 for a family plan. The benefits covered and out-of-pocket costs (ie procedures) are comparable to the civilian world (ie TRICARE bought the UCCA plan that they were already offering up).
2) TRICARE IS NOT BASED ON RANK
. At least not for the Dependents (though a General's wife may have better access...but its not a legal offering).
TRICARE has two basic Plans, PRIME and STANDARD.
Prime is their HMO plan, very controlled, red tape (though Kaiser Permanente has more hoops that TRICARE), and full of referrals...but free (as in no co-pays or premiums).
STANDARD is a PPO, where you will pay a cost share of 20% if you see a doc outside fo the MTF network or 15% if your doc is in the network. HOWEVER, your fiscal year Catastrophic Cap is only $1000.
There are a few additional plans, TRICARE PRIME REMOTE for Active Duty personnel stationed
outside of an MTF catchment area, such as recruiters or Coasties, or the Reserve Select for the G&R or TRICARE FOR LIFE for those recieving Medicare.
RANK does not come into play until you are retired and have to pay premiums...but THE BENEFIT COVERAGE is the same for everyone.
3) TRICARE ACTUALLY HAS THE BEST BENEFIT COVERAGE IN THE US right now.
That is to say, TRICARE will cover almost every DX, without a financial cap, using every universally (american that is0 accepted procedure out there. This is not true for most civilian insurances, that actually disallow certain diseases, procedures or drugs for care (ie very restrictive formularies) and CAP how much they will pay out in a year or a lifetime.
4) TRICARE DOES NOT HAVE A PRE-EXISTINT COVERAGE constraint.
You cannot say that for almost any other Insurance out there.
5) TRICARE DOES NOT HAVE AN UNDERWRITTER, THE DOD and its yearly BUDGET underwrites TRICARE.
There are THREE regional companies that provide for (ie contract) the civilian providers and hospitals, with additional contractors that process the claims. However, those companies get their money directly from US Government Contracts.
Their benefits coverage and formulary are decided upon by TRICARE itself. TRICARE bases its coverage on the Standard of Practice in the civilian world. So, if you are pregnant, you will only get 2 U/S covered, LIKE THE REST OF THE CIVILIAN WORLD. However, if your at risk, they will cover more, LIKE THE CIVILIAN WORLD.
As for the DRUG. Their formulary is actually one of the most robust, since BY LAW, TRICARE MUST PROVIDE EVERY APPROVED DRUG TO ITS BENEFICIARIES. While they DO have a Generic First and Step Program Policy, they WILL give you a Third TIer Drug at the Second Tier cost if its Medically Neccessary - OR FREE if the drug is on the Core Formulary for the MTF. That means that if you get CANCER, your out-of-pocket costs for everything will never ever ever be more than $1000 a fiscal year. Can you say that about any other CIVILIAN policy?
Now, I am not saying that TRICARE is the most wonderful program ever. They do have issues, like following their legally mandaged Access Standards, providing referrals, over crowding visits and I coudl go on and on about the care overseas.....
But it is NOT the cesspool we make it out to be. The best way to make it work is to KNOW The TRUTH about how it works and demand your rights.