Tricare standard a positive alternative for Prime

I just wanted to let you all know that Tricare standard should most definately be looked into by all who have been turned down by prime or put on a long wait list. There are out of pocket expenses to be had, but minimal at that. Once you reach you $1000.00 yearly catastrophic cap that is it. I changed myself over and left my kids on Prime, no hassle. Thus far I have only paid $470.00 out of pocket and that included fees from a surgery I had to go through from a preop finding. I chose my in-network surgeon, made all my appointments and completed them that were required by my surgeon, and then submitted to insurance. Took me just over a week to get my approval back. I was worried because the standards do say that you need to 100lbs overweight and have a co-morbidity or be 200% above your ideal body weight. My insurance girl assured me I met their standards even tho I did not fall into either category.....she said my BMI was high enough at 46.4. Well, she was absolutely right!!! Yeah!!!!!!!!! So please, just look into standard if all else fails with Tricare Prime....I by no means am saying this is a 100% guaranteed solution for all out there, I am just saying it is worth looking into!! Good luck and best wishes to you all, and may your journey turn out as well as mine has thus far!!  Hugs! Terri

I have tricare standard and i was thinking of switching to prime just to avoid the charges...but if what you are saying is true and the most i will have to pay is 1000.00 then maybe I should stick with standard...can you give me an update and let me know if thats all that was charged to you?

I do know there is a difference if you are active duty or retired.  For retirees, the cap is $3000

i am so confused as to how all of this goes. Im standard and my primary Dr recommended the surgery to me.  I've been doing alot of research and even talked to tricare regarding cost share type things. According to the tricare site, outpatient weight loss surgery was removed from the prior authorization list. They also didn't inform me of a catastrophic cap only the deductable. I am so confused!! Any new information would be greatly appreciated so maybe I can make sense of things and determine the chances of my approval for surgery (I'm praying there are no problems tho).