How fast were you approved by insurance (TriCare) or others?

[SusieC 0]

I went to see my pcm on

Thursday the 21st of this month to get a refural for a consult or a surgeon. I got call and a letter from Tricare the following monday the 25th....Less that a week after the doctord visit......WOW that was fast. and i am so happy.... Is Tricare always that fast? I hope so...

Now I just have to wait untill Oct to see the Nurse of the surgeon!!!

Is it Oct yet?

Check out my time line so far in my Sig....WOW...but now it all slows down....

[RestlessMonkey 7]

I am tricare standard. I have WAY more than 100 pounds to lose. It took 2 days.

[SusieC 0]

I am tricare standard. I have WAY more than 100 pounds to lose. It took 2 days.

I have TriCare Prime whats the difrence?

[RestlessMonkey 7]

We don't pay for tricare standard We pay a deductible then 20% of all charges up to a 3k catastrophic cap each year. We don't have to have a PCM, get referrals, etc. As long as we go to docs within network it acts like regular insurance. Tricare prime is more like an hmo.

[SusieC 0]

We don't pay for tricare standard We pay a deductible then 20% of all charges up to a 3k catastrophic cap each year. We don't have to have a PCM, get referrals, etc. As long as we go to docs within network it acts like regular insurance. Tricare prime is more like an hmo.

BUT Tricare prime we do not have decdutalble we just pay a very small co-pay and the rest is covered 100%. My huband was in the hosptial a while back and the bill was about $30,000 and all we had to pay was $80 of the bill.

[Jodi_620 37]

Less than a week with United Healthcare.

[SusieC 0]

now just the long wait untill i go see the nurse at the surgoens office...I wish they were not as booked...dang it all anyway...

[tomatogirl 0]

BUT Tricare prime we do not have decdutalble we just pay a very small co-pay and the rest is covered 100%. My huband was in the hosptial a while back and the bill was about $30,000 and all we had to pay was $80 of the bill.

You shouldn't have even had to pay that. Tricare Prime has no deductibles, unless it was something that wasn't covered.

All of my stuff has gone so smoothly. We're submitting paperwork next week and I'm one nervous nelly that my luck has run out.:thumbup:

[sherich2008 0]

4 days -- Cigna HMO

Sheila

[cobrien78 0]

Your approval to see the surgeon is not the same as approval for surgery. I have Tricare Prime and was authorized to see the surgeon and then the surgeon sent in the paperwork to Tricare for approval for the surgery. It took 2 days to get approved for surgery.

[RestlessMonkey 7]

If you have Tricare Standard (I'm starting to think I'm the only person who does) you don't have to get approval to see the surgeon, or the nutritionist, or the psych consult ... everything was covered. Approval for the surgery literally took less than 48 hours. It all just depends.

[SusieC 0]

You shouldn't have even had to pay that. Tricare Prime has no deductibles, unless it was something that wasn't covered.

All of my stuff has gone so smoothly. We're submitting paperwork next week and I'm one nervous nelly that my luck has run out.:cursing:

It was a co-pay not a deductable... like $11 a day co-pay for the hospital... or something like that.

[Mimilou2004 13]

RestlessMonkey, I am Tricare Standard, too, and am learning as I go what is paid for and what is not.

Mimi

[RestlessMonkey 7]

Mimilou2004 I'm really really lucky; the hospital where my surgeon heads their bariatric surgery department has an insurance coordinator who handles the claims for all of his patients, regardless of what their ins.

So....whatever I'm getting, tricare is covering! In fact for my first hospital go-round (8/11) they didn't even ask for money! I think i'll end up paying close to 2k (that's the balance on our catastrophic cap for this year) but that's ok with us. I actually love tricare standard. The local PCM's on Tricare prime are all doctors we don't care to use, and actually our medical bills are usually less for the year than what tricare prime would cost us anyway (except this year) but I am glad we've got it. It's been relatively pain free, insurance wise! Hopefully you'll have a similar experience!

[1000words 0]

You must be retired... because Tricare Prime does not have a cost to active duty dependents. If you were active duty Tricare Standard would end up costing quite a bit more than Prime.