If you're a Tricare Prime user living near a military treatment facility (MTF), you're probably seen on base. But there are some of us (including myself and my children) who got lucky when we moved to our duty station. We were sent off base because the on base facility was full.
Now the Army and Navy are forcing over 27,000 of us to come back on base. They aren't asking permission. They're simply sending a warning letter telling users that they've been reassigned.
On Prime and like your civilian doctor? That's nice. Welcome back to the military hospital!
Eleven Army posts and three Navy bases are using their authority to move Tricare Prime users back into the MTF fold. Drawdown means they have more availability, they say, so it's time to fill those spots with people. Sending military families off base for care that is available on base costs money. And now is the time to save money, not spend it.
And they absolutely have the authority to do this. Tricare policy permits military treatment facilities to pull Tricare Prime users back into the MTF system if they want to. The end.
If you're seen by a private civilian provider on Standard or Prime your eyes have been open to the glory that is continuity of care. You always see the same provider, so that person knows you, your medical history and your concerns. Getting an appointment is probably a breeze. There's no waging war at 0600 to get through an appointment line to secure what seems like a handful of same-day spots for your sick kid. You call, they give you a spot, and you go. It's like healthcare magic.
The recapture is happening for families at those bases (find them in my article) who are within a 30 minute drive of the facility. So your current doctor is 2 minutes down the street? Tough.
And yes, you can appeal. But Army and Navy Medicine officials said those appeals are based on "medical necessity" and have to be approved by the base commander.
In other words: good luck with that.
Some military families I interviewed said they were going to switch to Tricare Standard rather than move to the MTF. While on Prime healthcare is free as long as you stay in network, those on Standard pay a small co-pay to move off base. In exchange they get to pick their doctor and self-refer to specialists. If you switch to Standard, however, you are not able to move back to Prime for a full year.
See more about the differences between Tricare Standard and Tricare Prime and the costs.
If you want to keep your doctor and they accept Tricare Standard (which you can research here) you can switch from Prime to Standard. But keep in mind that you are going to pay for it. How much is staying with the same provider worth to you?
The folks over at the National Military Family Association always have the backs of military families. But they also know that budget cuts are necessary. Still, they worry that moving more people into the MTFs where there are constantly complaints about difficulty getting appointments, particularly for same day needs, is going to tax the system and hurt families.
"As long as access to medical care for military families is maintained, we support the recapture of beneficiaries to MTFs," said Karen Ruedisueli, a deputy director for government relations at NMFA. "Our Association appreciates the need to optimize the use of MTF resources. We just want to make sure that it doesn't come at the expense of military families' access to care."
So tell us -- if you're on Prime and currently see off base, will you be switching to Standard to keep your doctor?
