Medically retiring soon and told to apply for Tricare. If I have permanent VA Healthcare, what is advantage of applying for Tricare? Also, if have both, who do I go to for a referral for IVIG treatments. Currently, while on active duty, Tricare has been paying for them when referred by my military PCM. When retired, would I have to get my treatments at VA or could I request referral from Tricare to be treated by civilian clinic which I prefer. It is my understanding that VA is primary provider and Tricare secondary so assume I would have to get treatments at VA Hospital. Sorry this is so convulted.
What is advantage of applying for Tricare if you have VA Medical benefits for 100% permanent disability?
- Thread starter soldieradvocate
- Start date
It looks like another advantage is that Tricare would provide coverage for my family. I don't think VA does. Looking at coverage, Prime seems like the best option. Does Tricare for Life really have a $3000 a year deductible?
The VA has a plan for families without other insurance. Ask the VA for details.
I have both and rarely use the VA. Exceptions are optical, eye doc, dentist, audiology. VA doesn't have as many medications on their formulary.
I have both and rarely use the VA. Exceptions are optical, eye doc, dentist, audiology. VA doesn't have as many medications on their formulary.
If you log into milconnect it will tell you your deductible 3k sounds high mine is only 150. I personally use standard so I have more say in who I see. I agree with everyone about the VA and medications they are bad in not prescribing or not offering alternatives.
milconnect.dmdc.osd.mil
milConnect: Benefits and Records for DoD Affiliates
Tricare is insurance. VA Healthcare is, well, healthcare. If you get the flu, you could go to your primary care provider at your local VA clinic and get treated. If you get into a car accident on the way to your local VA clinic and have to get airlifted to the nearest hospital, Tricare, as your insurance provider, should pay for that.
It looks like if you have Tricare for Life without Medicare, you have a $3000 deductible. If you have Medicare, part B, with TFL no deductible.If you log into milconnect it will tell you your deductible 3k sounds high mine is only 150. I personally use standard so I have more say in who I see. I agree with everyone about the VA and medications they are bad in not prescribing or not offering alternatives.
milConnect: Benefits and Records for DoD Affiliates
Actually, you can now go to community urgent care clinics if you have VA coverage for things like the flu, colds, minor injuries etc so you don't have to wait on your primary care provider.
VA.gov | Veterans Affairs
Apply for and manage the VA benefits and services you’ve earned as a Veteran, Servicemember, or family member—like health care, disability, education, and more.
I also have a 100% P&T rating. I get all of my healthcare from the VA and my family uses CHAMPVA. The only real downside that I have seen to not having a traditional insurance plan for myself is that the VA will not cover any treatment overseas that is not related to service connected disabilities. Depending on how much international travel you do this may or may not be an issue.
@soldieradvocate
You are not Tricare for Life you are either Tricare Select or Prime, you will not be Tricare for life until you qualify for medicare either through age or with SSDI. Click on the link below choose whether you want prime or select it will list all your annual costs and coverage. Its 150 for single and 300 for family the 3000 is the catastrophic cap that means if your medical bills for the coverage year exceeded lets say for example 100k dollars you can only be billed for a max of 3k.
You are not Tricare for Life you are either Tricare Select or Prime, you will not be Tricare for life until you qualify for medicare either through age or with SSDI. Click on the link below choose whether you want prime or select it will list all your annual costs and coverage. Its 150 for single and 300 for family the 3000 is the catastrophic cap that means if your medical bills for the coverage year exceeded lets say for example 100k dollars you can only be billed for a max of 3k.
Is CHAMPVA available to families of medically retired 100% disabled soldiers automatically? What are necessary steps to access it?
CHAMPVA is only for veterans who are 100% P&T but are not retired you will be retired so have to take tricare you cant have both.
If someone is are eligible for Tricare they are ineligible for CHAMPVA.
Hello,
Re: VA medical care vs. TRICARE
1. I retired 30 years ago, regular Army. I am also rated 100% P&T (actually SMC-S ) by the VA.
2. Since I qualified for Medicare long ago, I have TRICARE for Life. Previously, I used TRICARE Standard.
3. I have used VA health care only for dental and eyewear.
4. One of the attractive features of TRICARE is the ability to choose your doctors.
Ron
Re: VA medical care vs. TRICARE
1. I retired 30 years ago, regular Army. I am also rated 100% P&T (actually SMC-S ) by the VA.
2. Since I qualified for Medicare long ago, I have TRICARE for Life. Previously, I used TRICARE Standard.
3. I have used VA health care only for dental and eyewear.
4. One of the attractive features of TRICARE is the ability to choose your doctors.
Ron
How much , on average are you "Tricare Standard" users paying for routine and urgent costs. I am a Mil-Brat, this is my first venture in to non-mil healthcare and it sounds so expensive!
A great article that compares Select and Prime.
Understanding Military Medical Care
Active duty, retired, Guard and Reserves and their family members receive free or government subsidized medical and dental care called TRICARE.
Hello,
Tricare's Extra and Standard plans were into one system known as Tricare Select, thanks to legislation passed by Congress last year. [from 2017]
In 2018, TRICARE Select replaced TRICARE Standard and Extra. TRICARE Select is a self-managed, preferred provider network plan.
Ron
Tricare's Extra and Standard plans were into one system known as Tricare Select, thanks to legislation passed by Congress last year. [from 2017]
In 2018, TRICARE Select replaced TRICARE Standard and Extra. TRICARE Select is a self-managed, preferred provider network plan.
Ron
Be very careful with this. I'm 100% P&T VA, 70% AF (Med retired at 20+ years) so I have both. I was referred on 3 separate occasions to a Urgent care by the VA. All 3 occasions they never paid, and I had to pay out of pocket. The process for getting them to pay the bill is not clear, and they just ignore you. Luckily my wife is still AD and we have Tricare standard (Base stopped seeing all family members during covid, so we switched to Standard). They helped with some of it, but still cost me a few thousand out of pocket.Actually, you can now go to community urgent care clinics if you have VA coverage for things like the flu, colds, minor injuries etc so you don't have to wait on your primary care provider.
VA.gov | Veterans Affairs
Apply for and manage the VA benefits and services you’ve earned as a Veteran, Servicemember, or family member—like health care, disability, education, and more.www.va.gov
VA healthcare is horrible here in Virginia. I got the flu a few years back, their soonest appt was in 9 months. PCM appts also ~9 months, and you have to see them to get a referral for specialty care, which is another 9 months (xray, MRI, etc). I use VA for my meds, but that is pretty much it.
I also have VA dental due to a TMJ rating. The problem is, no one accepts it. I have talked to 4 different dentist here, all said they refuse to accept VA insurance/healthcre due to non-payment. They cant get the VA to pay the bills they submit. And trying to get a dental appointtment at the VA is next to impossible.
Reference: "I also have VA dental due to a TMJ rating. The problem is, no one accepts it. I have talked to 4 different dentist here, all said they refuse to accept VA insurance/healthcre due to non-payment. They cant get the VA to pay the bills they submit. And trying to get a dental appointment at the VA is next to impossible."
Your experience with the Urgent care is a nightmare. I am sorry to learn of it. Perhaps a VA patient advocate can be of help.
VA health care is not "insurance." However, the VA can provide authorization for a private sector doctor/dentist tp perform outside-the-VA care. I think that is what you are discussing. I have used it several times including last week for hearing aids. Of course, pre-approval is required AND if the VA is late in paying, then it is understandable that the private medical providers are reluctant to accept the referrals. It seems you met the pre-approval requirement since you were referred to the urgent care clinics. "VA offers urgent care services to eligible Veterans at VA medical facilities or at in‑network urgent care clinics."
Also, last week I had an an appointment with an actual VA dentist in San Antonio. He offered that there are 40,000 veterans in the area who are 100% disabled and permanent and eligible for VA dental care.
He said there were only 15 VA dentists in the San Antonio area to provide service to those veterans who needed dental care.
I have not experienced the late payments you mentioned, but other veterans I know have.
Good luck,
Ron
Your experience with the Urgent care is a nightmare. I am sorry to learn of it. Perhaps a VA patient advocate can be of help.
VA health care is not "insurance." However, the VA can provide authorization for a private sector doctor/dentist tp perform outside-the-VA care. I think that is what you are discussing. I have used it several times including last week for hearing aids. Of course, pre-approval is required AND if the VA is late in paying, then it is understandable that the private medical providers are reluctant to accept the referrals. It seems you met the pre-approval requirement since you were referred to the urgent care clinics. "VA offers urgent care services to eligible Veterans at VA medical facilities or at in‑network urgent care clinics."
Also, last week I had an an appointment with an actual VA dentist in San Antonio. He offered that there are 40,000 veterans in the area who are 100% disabled and permanent and eligible for VA dental care.
He said there were only 15 VA dentists in the San Antonio area to provide service to those veterans who needed dental care.
I have not experienced the late payments you mentioned, but other veterans I know have.
Good luck,
Ron
Last edited:
I went to local urgent care clinics here in San Antonio three times last year and didn't have any problems. They called the VA when I checked in to verify eligibility and that was all there was to it. I wonder if there was a conflict between your Tricare and the VA processing the claims? Here in TX the VA uses TriWest to process community care urgent care claims, maybe they didn't know how to process them when they saw you had tricare coverage in the system?
Last edited: