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Calling all Military Spouses

My husband is in the Navy and we use tricare, they are covering my surgery. I will have to pay $100 a fill according to the surgeon office. Has anyone heard different that tricare will cover the fills? Also has anyone had to change providers yet due to a move? How do you switch after your move?

Thanks for any information :)

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My husband is in the Navy and we use tricare, they are covering my surgery. I will have to pay $100 a fill according to the surgeon office. Has anyone heard different that tricare will cover the fills? Also has anyone had to change providers yet due to a move? How do you switch after your move?

Thanks for any information :)

My husband is retired Airforce. I just got banded on Monday we have tricare prime an the only thing I have to pay is 12 dollars co pay for my fills. And I pay 25 dollars for my stay at the hospital . I wouldn't worry to much about when you move tricare always have somebody in your network. Now maybe if you go overseas could be diffrent. but they usualy make sure that can take care of you need before they send you. We live overseas twice Good luck!! And I think those people wanted to charged 100 a fill is full of caca :angry:

  • Author
25 dollars for my stay at the hospital

thats so crazy! i have to pay $250 for my stay!

thats so crazy! i have to pay $250 for my stay!

Do u have Tricare Prime? Wow I can't believe how high things are for you:( Where are you station at?

I'd call tri-care and ask them. That doesn't sound right.

  • Author

we have tri care prime, i think im going to give them a call before my surgery.

Tricare for Active Duty is different than Tricare Prime for retirees. If you go to the Triwest.com website and check the section about deductibles, it'll show you that Tricare Prime for retirees only pays co-pays, and that they have no deductibles. Other forms of Tricare pay other fees, including deductibles, which could include the cost of fills. It's tied to how you are eligible for Tricare coverage.

I'm retired Navy, on Tricare Prime, and I only pay the same co-pays Mabinty mentioned. My entire surgery cost on December 6th will be just the $12 co-pays for office visits, and the $25 surgery fee for the hospital stay. (At this point my out of pocket has been less than $50 for this process.) One of the perks for having survived the military long enough to retire from it, I guess. ;)

Dave

I have tricare prime and hubby is active duty and I dont pay anything. I didnt have to pay for surgery or hospital stay, and I havent had to pay for fills either. I think that tricare is billed and then the surgeon either take what tricare pays them or charges you the diffrence. Tricare only allows so much. I think it all depends on the surgeon.

  • 1 month later...

Greetings. I am a proud spouse of a retired Army NCO. Received approval in 2 days from Tricare. Have only had to pay for the Psych and Nutrition appointment out of pocket, $225. I know that fills will cost but have some luck in that if I go to support meetings that my doctors office offers, they give you a free fill. Guess I need to check with my doctor to see what fills run. I have yet to be banded but will be on March 7. Can hardly wait. Looking forward to the simple things like buying a dress. Check with your doctor to see if you go to support meetings, if they can give you a break on fills. Cheers :D

I am on tricare prime remote and have not had to pay a penny out of pocket. I have my first fill next week and tricare has paid every penny so far

I had Prime when I had my surgery in August, and it cost me $25 total plus my psych eval and nutritionist cost of $225. I've had 3 fills, and I haven't been charged a dime. We did switch back over to Reserve Select since Hubby is back to reserve status after a deployment. I haven't used that yet for a fill, but I do know that the doctor's office is not allowed to charge you over what they have negotiated with Tricare. We have used the RS for about 4 years, and it works the same as Standard. I had a hospital try to charge me over what they had negotiated with Tricare, and Tricare contacted them telling them they couldn't.

I am Tricare Standard and my husband is Army National Guard. I was told i have to pay 20% of the allowed surgeon cost since he was out of network (Around $300) and it would have been 15% if he had been in-network. I prepaid the $300 and havent actually seen my bill so that amount may decrease or increase based on if i had an assistant surgeon or not. All my other providers were in-network, as well as the hospital. I was told, by tricare, i would have to payy $25 for the hospital stay. I also had to pay $80 for my portion of the psych eval since we have no in-network providers around. I also have had to pay portions of the pre surgery testing; labs mostly. So i have paid around $500 so far out of pocket. Not sure what i will have to pay for fills. I am hoping only my co-pay.

  • 2 weeks later...

The only thing I had to pay for was the psych eval, and I think they will reimburse me for it if I pursue it. When Tricare called to do a follow up with me, she said I am covered for fills and to make sure I went in if I needed to because I am covered and it is already in the system. The doctors office tried to charge me a $12 co-pay and I paid it, then I asked Tricare about it and they said I shouldn't have to. I told the doctors office this, and they didn't charge me anymore co pays and Tricare mailed me a check for $12. I feel very lucky having this insurance and the process has been very easy. My husband is Active Duty AF and we are in Triwest region.

I have Tricare Prime and I'm at Fairchild AFB and my husband is active duty AF. I have had to pay $320 for the nutritionist, but everything else is covered.

My husband is active duty Army and we have prime. I'm 265 and 5'9". We have seven kids(two sets twin, hence the baby fat:) My PCM suggested banding at my last appt. I've been steady at this weight for 5 yrs. WW doesn't work. I have high BP. The MTF here at West Point offers banding. Has anyone had any experience with MTF versus civilian surgeon? I'm ready to go for it, I just don't know which way to go. Thanks!

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