Tricare question

[thegunshow]

---

Members do not see this ad.

I am an active duty resident with civilian spouse. she is employed in the civilian world so has outside primary private insurance and also enrolled in tricare standard as supplemental. Tricare office told us to sign up this way and that tricare would basically pay the rest of any bills that her insurance doesnt cover. So we get pregnant, and select an OB from her primary insurances list of providers. The OB billing office tells us that her primary insurance covers 80% of the total and then tricare only covers 80% of the remaining amount, thus leaving us with a bill of around $600 out of pocket. Does this sound right? I thought tricare was suppossed to pay anything the primary insurance doesnt. Wonder if it is too late to switch my wife to tricare prime, but would we still have to pay something?
Thanks

 

[backrow]

I am an active duty resident with civilian spouse. she is employed in the civilian world so has outside primary private insurance and also enrolled in tricare standard as supplemental. Tricare office told us to sign up this way and that tricare would basically pay the rest of any bills that her insurance doesnt cover. So we get pregnant, and select an OB from her primary insurances list of providers. The OB billing office tells us that her primary insurance covers 80% of the total and then tricare only covers 80% of the remaining amount, thus leaving us with a bill of around $600 out of pocket. Does this sound right? I thought tricare was suppossed to pay anything the primary insurance doesnt. Wonder if it is too late to switch my wife to tricare prime, but would we still have to pay something?
Thanks

The best answer would come from your hospital's Tricare office; however, I'll do my best from my understanding.

The only time medical care is "free" is with Tricare Prime. Anytime someone is enrolled in standard there will likely be some sort of copay. With your wife having insurance it is my understanding that if she does enroll in Prime her insurance will still get a bill as they would still be the primary insurance, but you wouldn't have any copays.

I would imagine you could still transfer into Prime depending on the availability of the OB/GYN dept you could get further care there at no obvious cost to you.

There is always confusion with the various Tricare plans, it's a pain. I'd suggest you double check my thoughts with the tricare folks at the hospital.