Tricare Tips for Military Families
Understanding a few of the options.
by Brian Smith, TriWest Healthcare Alliance
TRICARE beneficiaries can trim the fat off of health care expenses by avoiding unnecessary fees and taking advantage of cost-saving programs. Here are a few tips to keep your health care budget in great shape, leaving your wallet with plenty of green to spare:
Get a Jump on Authorizations and Referrals
If your family is enrolled in TRICARE Prime (or TRICARE Prime Remote), ensure that you have the proper referrals and authorizations for specialty care from your primary care manager (PCM) and regional contractor. If you go for care from a specialist or other provider without receiving authorization, you may have to use the point of service (POS) option and pay out-of-pocket for your care. Getting the referrals and authorizations before going for care outside of your PCM will help ensure that your family does not have to pay any unnecessary expenses.
If you have any questions about what care requires a referral or an authorization, you should consult with your PCM or your TRICARE regional contractor.
Avoid Out-of-Network Hurdles
Those families using TRICARE Standard and Extra can maximize their savings, too. Using the Extra option with TRICARE-network providers and facilities requires a lower cost-share and those providers will also submit your claims on your behalf, saving you time.
Skip the Worry: Set Payments on Auto-Pilot
Check with your regional TRICARE contractor about options for automatic or online fee payments. Scheduling electronic payments will eliminate the worry of late fees and spare the time you typically spend paying bills.
Track Tax Write-Offs
Tax season is right around the corner. Maximize your annual medical expense tax deductions by tracking your explanations of benefits (EOB) received throughout the year. Every time a TRICARE claim is filed, whether or not you had any out-of-pocket co-pays or cost-shares, your TRICARE contractor will send you an EOB listing the care received and any associated costs. Don’t forget that dental expenses as well as fees for eye exams, eyeglasses and contact lenses can count toward a medical expense tax deduction. Consult with a tax advisor to determine what may be a deductible expense.
Run with Generic Medications
Your body may not be able to tell the difference, but your wallet will. When your doctor prescribes medication, ask about the availability of a generic version. The U.S. Food and Drug Administration (FDA) requires that all generic drugs have the same chemical composition and potency as the name-brand counterpart.
If your doctor has not determined that the name-brand version is medically necessary but you choose to have your prescription filled with a name-brand drug, you may be charged for the entire cost of the prescription. The Department of Defense (DoD) requires that providers prescribe generic versions of medication whenever possible.
If you use a pharmacy in your neighborhood that participates in the TRICARE Retail Pharmacy Program, a 30-day supply of a generic drug will have a co-payment of $3, while you will have a co-payment of $9 for a name-brand drug.
All family members eligible for TRICARE coverage can use the TRICARE pharmacy benefit. For those who live close to a military pharmacy, a 30-day supply can be filled there at no cost for available medications.