Talk of The Villages Florida - View Single Post - Tricare Prime
Thread: Tricare Prime
View Single Post
 
Old 04-16-2013, 07:58 AM
sgiamp1 sgiamp1 is offline
Member
Join Date: Jul 2011
Posts: 63
Thanks: 0
Thanked 0 Times in 0 Posts
Default New Kind of ER may not be covered by Tricare

Quote:
Originally Posted by Dzurinko View Post
We are seriously considering moving to TV. We are retired military and currently have US Family Health Plan up here in NJ which is a form of Tricare Prime. We're looking for a comparable tricare plan in Florida. Any retired military in TV have tricare prime? I'm not 65 yet so Medicare is not an option. What do most retired military use?? Any info would be appreciated.
For all of you who may be using Tricare but not on Tricare for Life, this below information is very important.

TRICARE beneficiaries may have noticed new “Emergency Centers” popping up in their area. Free-standing emergency rooms (ER) that are not affiliated with a hospital may not be TRICARE-authorized. If a provider is not TRICARE authorized, then TRICARE is prohibited from paying it “facility fees.” That can leave a beneficiary stuck with a big bill.

Read more at: TRICARE - File Not Found.

I read the notice and decided to call Tricare to get a better understanding of what care we are entitled to. I asked where I could take my wife if she needs emergency treatment. Bottom line: The closest "in network" facility is either West Marion Hospital or Monroe Medical, both in Ocala. The Villages Hospital and Leesburg are both "out of network". The representative said if it's an emergency we can go anywhere but would pay $300 deductible and possibly 50% of charges beyond that.

I am shocked that we need to drive an hour to get authorized treatment when we have facilities closer. However I could have interpreted the information incorrectly so someone else might want to give it a try to either verify or correct what I think is fact.