Question:
Tri Care Standard

My surgeon is Dr. William O'Malley/Highland Hospital and I have Tri Care Standard...my concern is out of pocket expenses...will Highland work out a pymt plan with me? Do i have to pay up front? What kind of out of pocket expenses can i expect? THANK YOU! ~Cheryl    — Sherry in W. (posted on August 28, 2002)

August 27, 2002
I can tell you what I did. I figured out that it was cheaper to joint Tricare Prime. So I did. It was definitly cheaper than the percentage that I would have to pay!!!
   — michellemark2764

August 27, 2002
You may want to consider switching to TriCare PRIME. I had my surgery in May and TriCare PRIME paid for every last cent of the $24,000 surgery.
   — Lynn H.

August 28, 2002
I paid $240 and joined tri-care prime, had my surgery 2 weeks ago, and tri-care said they would cover everything. Only took 2 days for approval. Good Luck
   — januaryrn

August 29, 2002
If your provider accepts Tricare, then you should know approximately how much your cost share will be before you go into the hospital (barring complications). The most your out of pocket expenses would be is $3,000, as that is the 'cap'. Hope this helps.
   — L. Nichols

August 29, 2002
Tricare Standard paid all but $11.45 per day for my surgery, hospital stay, and follow-up visit (civilian hospital). I was out less than $40 for the entire $30,000 procedure/hospital stay. Lap RNY 6/18/02. Good Luck!!!
   — Tina B.

August 29, 2002
I'm the post-er to this question...now i'm wondering how Tri Care Standard determines how much they will pay...i could certainly handle to pay under $100. as one question-answerer mentioned, but then someone else says they paid thousand(s) ... this is pretty stressful NOT KNOWING! Problem being right now, my primary dr. isn't a network provider with Tri Care PRIME, so to get a referral from him for surgery (as you have to with PRIME) wouldn't work out?! My appt with my surgeon is September 26 (no referral needed with Standard i've been told) so no real time to get my primary to become a part of PRIME...any suggestions/help/insights as to what to do? AGAIN, THANKS SO MUCH! ~Cheryl
   — Sherry in W.