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TriCare for Mil Retiree's in Aggieland?

736 Views | 12 Replies | Last: 10 days ago by basketaggie
Uncle Bug
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AG
Aggieland is our (first) retirement home post military career - Thrilled to be back!

If there is any insight into navigating Tricare healthcare as a retiree (under 65) here in B/CS, we would love to hear from you (DM/PM as appropriate). I believe we're being steered toward Tricare SELECT (PRIME not available unless we drive to Houston or Temple for PCM...?). TIA!

cavscout96
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Tricare select is only real option.

We use St. Joe's network.

Scott and White also sufficient. We use some of their specialists.
Love Gun
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I retired go back here in 2016 and immediately signed on with Tricare Prime. Little did I know, our closest PCM's would be Tomball or Lexington at the closest.

We haven't had an issue with driving to appointments a few times a year, but are looking at flipping over to the other one real soon.
cavscout96
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Select - $25/yr for the entire family. Very flexible.
armymom
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Select is $25 monthly or $300 annually effective 01 Jan 2021
basketaggie
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Years ago Prime was accepted here and it was wonderful! For a few years after it was cancelled we went to Lexington, but the dr there left and we don't care for the nurse practitioner. We switched to Hermann Memorial in the Woodlands and have been happy. We go in person once a year, and all our specialists are here in town. In case of emergencies we use the ER or urgent care. Every year I calculate our bills and it still saves us to take Prime even though it can be a pain to make the drive. About 2 years ago they missed up and had a local dr on the list. I quickly enrolled, but after 6 months they let me know it was an error and that I needed to chose someone else.
EBrazosAg
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Select if you value being able to use local providers. Prime is a very limited network. And getting permit be seen outside the network is incredibly frustrating and difficult. It's really that easy. You just have to decide what you value. If driving to doctors in a limited network seems no big deal, take prime. But understand that when something happens that you don't anticipate now, your options won't be options ... the decisions about who you see are already made for you by Tricare.
Uncle Bug
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EBrazosAg said:

"But understand that when something happens that you don't anticipate now, your options won't be options ... the decisions about who you see are already made for you by Tricare."
That sounds like a bottom line statement right there
Uncle Bug
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Love Gun said:

"We haven't had an issue with driving to appointments a few times a year, but are looking at flipping over to the other one real soon. "
I just read that we are now in enrollment season (through Dec 14) if you want to change to SELECT. Of course, Jan1, 2021 we'll have enrollment fees for the first time (NDA 2017). "At least you can deduct that from your catastrophic cap" if that's any consolation.
Uncle Bug
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Day one of official terminal leave and becoming a resident of CS, I had to get my girl to the ER for a bone fracture. We went to Baylor Scott & White and was pretty impressed with the practice of medicine - seemed like a new facility (but somewhat understaffed like all the military facilities). I noticed BS&W have a few clinics in town that receive good reviews for family practice. I am not familiar with St. Joseph or CHI... I'll need to research that a little more.
cavscout96
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Uncle Bug said:

Love Gun said:

"We haven't had an issue with driving to appointments a few times a year, but are looking at flipping over to the other one real soon. "
I just read that we are now in enrollment season (through Dec 14) if you want to change to SELECT. Of course, Jan1, 2021 we'll have enrollment fees for the first time (NDA 2017). "At least you can deduct that from your catastrophic cap" if that's any consolation.
$300/year for the entire family. I totally get the principle and the "boiling a frog" analogy, but this is minuscule compared to what "normal" people have to pay.
Uncle Bug
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cavscout96 said:

Uncle Bug said:

Love Gun said:

"We haven't had an issue with driving to appointments a few times a year, but are looking at flipping over to the other one real soon. "
I just read that we are now in enrollment season (through Dec 14) if you want to change to SELECT. Of course, Jan1, 2021 we'll have enrollment fees for the first time (NDA 2017). "At least you can deduct that from your catastrophic cap" if that's any consolation.
$300/year for the entire family. I totally get the principle and the "boiling a frog" analogy, but this is minuscule compared to what "normal" people have to pay.
Thanks Cavscout - the perspective of what 'normal' families pay is not beyond me, and an appearance of whining on my part is not a virtue. Like you said, the principle is not far from my mind either. I clearly remember before raising my hand to take the oath in 1983, the 'contract' was free healthcare for life if you complete a career. I guess there's a parallel to social security and other programs that are evaporating due to mismanagement. I've heard, "If you don't like something, don't complain - go fix it." Maybe I'll explore that effort as the next career (?). Either way, I will always remain grateful for my career in the profession of arms alongside the other 'non-normal' people - What a ride it has been!
basketaggie
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We've actually never had good luck with BSW billing us correctly - still like them, but just a heads up on this. We tend to use St Joseph's and they usually almost always bill correctly (I'd say 1 in 15 bills something might be off). We have several kiddos- so we for sure see our fair share of ER and urgent care doctors. As far as physician selection--- I have to say we have never ever felt limited or boxed in. We've seen specialists in all ranges and I've never ever felt our selection was limited or being forced to one person because of Tricare. One single time a specialist I saw wanted another surgeon in town to do my surgery. That specific surgeon doesn't take Tricare normally, but we filled out forms and it was taken care of no issue.

Some of the specialists in town that take Prime that I recommend to anyone are Dr Bhavsar at St Jo's for urology. Dr Lechin for cardiology, and Dr Richards at Scott and White for gastroenterology. For eyeglasses we use Dr Shini and he bills Tricare and we've never had an issue with that. Orthopedics we use St Jo's. Dr Mittan for endocrinology. I have seen some of the Dr's at Texas Brain & Spine, but my main neurosurgeon is in Houston, but he is one of the top Dr's in the field for what my issue is so that is why I stick with him over a local Neuro. If you do a search for the first specialities I listed you'll see that they tend to always pop up as recommendations of people to see around here.

You can always go to the physician finder and put in specialists for our area and they all pop up. Really the only limitations we've had was with the PCM. Although it's a bit further for us to go to The Woodlands vs Lexington, we make a day out of it since there are plenty of things to do there. Also, before when it was Dr Burkhart there practicing rural medicine-- she was fantastic! She was really good at her job and we miss her. Had she not left we would still be going there. For the Woodlands, We go as an entire family and everyone is seen, and all the yearly specialist referrals are filed. Sometimes if an unexpected specialist referral is needed (say a broken arm in the ER), we give them a call and they file it over the phone. My last appt was actually tele-doc because of covid which was super handy!

The fact that we can't see someone local for a PCM does suck to be honest. We met with Representative Bill Flores and let him know we feel this way. One of our college kids went out of state and was able to switch to a local PCM there. We are just in the bubble of no PCM's here.
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