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tricare

L

ladybug

New member
Oh you also asked if I felt I was covered...

Well, sometimes I think it would be better if I didn't have BCBS cause when it comes to things like nebulizers or some medications that are formulary, BCBS doesn't cover such things and then, becaue BCBS covered 0%, Tricare Prime also says they won't pay cause it wasn't a covered benefit under my primary insurance.

So, I think Tricare Prime by itself would likely cover a lot more and better amounts. However, I do know that there are formulary drugs that tricare also won't cover and lots of them are reflux drugs, etc. So, Tricare doesn't automatically cover ALL our meds 100% either. You just have to play around with what they will/won't cover and ask beforehand. Another thing I was recently told by doc on base is that every base is different with regard to what they consider formulary or what they decide to carry in their base pharmacy. So, you may have awesome coverage and are able to get almost all your meds at one base (like our last duty station) and then go somewhere new who doesn't even supply albuterol on base (like our current base).... crazy, i know!
 
L

ladybug

New member
Oh you also asked if I felt I was covered...

Well, sometimes I think it would be better if I didn't have BCBS cause when it comes to things like nebulizers or some medications that are formulary, BCBS doesn't cover such things and then, becaue BCBS covered 0%, Tricare Prime also says they won't pay cause it wasn't a covered benefit under my primary insurance.

So, I think Tricare Prime by itself would likely cover a lot more and better amounts. However, I do know that there are formulary drugs that tricare also won't cover and lots of them are reflux drugs, etc. So, Tricare doesn't automatically cover ALL our meds 100% either. You just have to play around with what they will/won't cover and ask beforehand. Another thing I was recently told by doc on base is that every base is different with regard to what they consider formulary or what they decide to carry in their base pharmacy. So, you may have awesome coverage and are able to get almost all your meds at one base (like our last duty station) and then go somewhere new who doesn't even supply albuterol on base (like our current base).... crazy, i know!
 
L

ladybug

New member
Oh you also asked if I felt I was covered...

Well, sometimes I think it would be better if I didn't have BCBS cause when it comes to things like nebulizers or some medications that are formulary, BCBS doesn't cover such things and then, becaue BCBS covered 0%, Tricare Prime also says they won't pay cause it wasn't a covered benefit under my primary insurance.

So, I think Tricare Prime by itself would likely cover a lot more and better amounts. However, I do know that there are formulary drugs that tricare also won't cover and lots of them are reflux drugs, etc. So, Tricare doesn't automatically cover ALL our meds 100% either. You just have to play around with what they will/won't cover and ask beforehand. Another thing I was recently told by doc on base is that every base is different with regard to what they consider formulary or what they decide to carry in their base pharmacy. So, you may have awesome coverage and are able to get almost all your meds at one base (like our last duty station) and then go somewhere new who doesn't even supply albuterol on base (like our current base).... crazy, i know!
 
L

ladybug

New member
Oh you also asked if I felt I was covered...

Well, sometimes I think it would be better if I didn't have BCBS cause when it comes to things like nebulizers or some medications that are formulary, BCBS doesn't cover such things and then, becaue BCBS covered 0%, Tricare Prime also says they won't pay cause it wasn't a covered benefit under my primary insurance.

So, I think Tricare Prime by itself would likely cover a lot more and better amounts. However, I do know that there are formulary drugs that tricare also won't cover and lots of them are reflux drugs, etc. So, Tricare doesn't automatically cover ALL our meds 100% either. You just have to play around with what they will/won't cover and ask beforehand. Another thing I was recently told by doc on base is that every base is different with regard to what they consider formulary or what they decide to carry in their base pharmacy. So, you may have awesome coverage and are able to get almost all your meds at one base (like our last duty station) and then go somewhere new who doesn't even supply albuterol on base (like our current base).... crazy, i know!
 
L

ladybug

New member
Oh you also asked if I felt I was covered...
<br />
<br />Well, sometimes I think it would be better if I didn't have BCBS cause when it comes to things like nebulizers or some medications that are formulary, BCBS doesn't cover such things and then, becaue BCBS covered 0%, Tricare Prime also says they won't pay cause it wasn't a covered benefit under my primary insurance.
<br />
<br />So, I think Tricare Prime by itself would likely cover a lot more and better amounts. However, I do know that there are formulary drugs that tricare also won't cover and lots of them are reflux drugs, etc. So, Tricare doesn't automatically cover ALL our meds 100% either. You just have to play around with what they will/won't cover and ask beforehand. Another thing I was recently told by doc on base is that every base is different with regard to what they consider formulary or what they decide to carry in their base pharmacy. So, you may have awesome coverage and are able to get almost all your meds at one base (like our last duty station) and then go somewhere new who doesn't even supply albuterol on base (like our current base).... crazy, i know!
 
S

semperfiohana

Guest
i'm not going to knock tricare because before i had it i had bcbs and my max for meds was 3000 dollars per years. i maxed that out by march. anyways i also had to pay over two thousand dollars because my bcbs insurance didn't cover 20% of my home iv's. since having tricare i haven't had to pay a dime. we were started out on standard (i believe everyone is and you have to switch it over once you become active duty, i was with my husband through boot camp) and are now on prime. i haven't had a problem with getting a referral to anywhere. i am having one problem right now. and it's cause someone dropped the ball last time i had home iv's. someone didn't put in a referral for some iv supplies and the home health care place is trying to charge me and I WILL NOT pay because i know it's covered at 100%. the referral just needs to be put in to the right people. it's been a bit of a fisco for a few months now. both insurance and the home health care are being pains in my butt. but i know it will get sorted out. but i feel very taken care of with tricare. i don't know what we would do without it!
 
S

semperfiohana

Guest
i'm not going to knock tricare because before i had it i had bcbs and my max for meds was 3000 dollars per years. i maxed that out by march. anyways i also had to pay over two thousand dollars because my bcbs insurance didn't cover 20% of my home iv's. since having tricare i haven't had to pay a dime. we were started out on standard (i believe everyone is and you have to switch it over once you become active duty, i was with my husband through boot camp) and are now on prime. i haven't had a problem with getting a referral to anywhere. i am having one problem right now. and it's cause someone dropped the ball last time i had home iv's. someone didn't put in a referral for some iv supplies and the home health care place is trying to charge me and I WILL NOT pay because i know it's covered at 100%. the referral just needs to be put in to the right people. it's been a bit of a fisco for a few months now. both insurance and the home health care are being pains in my butt. but i know it will get sorted out. but i feel very taken care of with tricare. i don't know what we would do without it!
 
S

semperfiohana

Guest
i'm not going to knock tricare because before i had it i had bcbs and my max for meds was 3000 dollars per years. i maxed that out by march. anyways i also had to pay over two thousand dollars because my bcbs insurance didn't cover 20% of my home iv's. since having tricare i haven't had to pay a dime. we were started out on standard (i believe everyone is and you have to switch it over once you become active duty, i was with my husband through boot camp) and are now on prime. i haven't had a problem with getting a referral to anywhere. i am having one problem right now. and it's cause someone dropped the ball last time i had home iv's. someone didn't put in a referral for some iv supplies and the home health care place is trying to charge me and I WILL NOT pay because i know it's covered at 100%. the referral just needs to be put in to the right people. it's been a bit of a fisco for a few months now. both insurance and the home health care are being pains in my butt. but i know it will get sorted out. but i feel very taken care of with tricare. i don't know what we would do without it!
 
S

semperfiohana

Guest
i'm not going to knock tricare because before i had it i had bcbs and my max for meds was 3000 dollars per years. i maxed that out by march. anyways i also had to pay over two thousand dollars because my bcbs insurance didn't cover 20% of my home iv's. since having tricare i haven't had to pay a dime. we were started out on standard (i believe everyone is and you have to switch it over once you become active duty, i was with my husband through boot camp) and are now on prime. i haven't had a problem with getting a referral to anywhere. i am having one problem right now. and it's cause someone dropped the ball last time i had home iv's. someone didn't put in a referral for some iv supplies and the home health care place is trying to charge me and I WILL NOT pay because i know it's covered at 100%. the referral just needs to be put in to the right people. it's been a bit of a fisco for a few months now. both insurance and the home health care are being pains in my butt. but i know it will get sorted out. but i feel very taken care of with tricare. i don't know what we would do without it!
 
S

semperfiohana

Guest
i'm not going to knock tricare because before i had it i had bcbs and my max for meds was 3000 dollars per years. i maxed that out by march. anyways i also had to pay over two thousand dollars because my bcbs insurance didn't cover 20% of my home iv's. since having tricare i haven't had to pay a dime. we were started out on standard (i believe everyone is and you have to switch it over once you become active duty, i was with my husband through boot camp) and are now on prime. i haven't had a problem with getting a referral to anywhere. i am having one problem right now. and it's cause someone dropped the ball last time i had home iv's. someone didn't put in a referral for some iv supplies and the home health care place is trying to charge me and I WILL NOT pay because i know it's covered at 100%. the referral just needs to be put in to the right people. it's been a bit of a fisco for a few months now. both insurance and the home health care are being pains in my butt. but i know it will get sorted out. but i feel very taken care of with tricare. i don't know what we would do without it!
 
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