Question:
Would changing from Tricare Prime to Tricare Standard help minimize the out of pocket

exspense of going with a surgeon not in network? I have been round and round with Tricare and the surgeon's office about this thing for a month now. When I first started this whole thing almost four months ago I was told by the surgeon's office that I choose that they were scheduleing appointments into April(this was back in Dec) now that I am nearing completion of all the paperwork there wait just for a consult is September. So I started looking for a surgeon with a shorter waiting list. Found one from posting here but he is not in my network but does take Tricare. The cost of this will be too much for me to afford and I was wondering if switching to Tricare Prime would make any differance as far as how much I would have to pay are the deductables and coverage the same or will they be less. I might be able to afford it if I don't have to paybut 80% of the total cost like some insurance comany's require. Thank you all in advance.    — S C. (posted on January 6, 2003)

January 6, 2003
I a bit confused wether you are tricare standard or tricare prime. I am tricare prime, and the surgeon I orginally wanted was out of network, and tricare prime told me that if (if) I did get approved for out of network 1. I would have to wait 30 to 60 days for approval and 2. If they by some very slim chance approved out of network I would have to pay 60% of all cost. I can not afford that, so I did some research and found two surgeons in my area. One surgeon does not except tricare prime and he does the lap rny and the other surgeon does except tricare prime but does the open rny, I want the lap, so tricare told me that the doc that does the lap is in tricare standard, so it is possibly that i could go to him, and it would be concerdered out of network but in tricare network so i would not have to pay. Hope this helps, and God Bless
   — cindy