Tricare Select: Better Than Private Insurance?

Tricare Select is a self-managed, preferred provider organization (PPO) plan, available to family members of active-duty service members. It is also available to retired service members and their families, family members of activated Guard and reserve members, and qualified former spouses, among others. Tricare Select offers its users the freedom to choose their healthcare provider without needing a referral. However, this freedom of choice may come with higher costs. On the other hand, Tricare Prime is a managed care option, similar to a civilian health maintenance organization program (HMO), which requires users to go through a Primary Care Manager (PCM) for all appointments and referrals. While this may limit options and require more paperwork, it generally results in lower out-of-pocket costs for the user. So, when considering whether Tricare Select is better than private insurance, it's important to weigh the benefits of having a wider choice of providers against the potential for higher costs.

Tricare Select is a self-managed plan, meaning users can see specialists without a referral

With Tricare Select, you can choose any Tricare-eligible provider without needing to visit a primary care provider first. This includes both in-network and non-network care providers. However, some patients may require prior authorisation from a Tricare regional contractor for certain services, so it's best to discuss these needs with a Tricare representative in advance.

Tricare Select users may pay an annual outpatient deductible and may also participate in cost-sharing or pay a percentage of the cost of care. When using Tricare Select and receiving care from a network provider, you pay your costs, co-pays or percentage of the cost at the time of your appointment. However, when receiving care from a non-network provider, you may be required to pay in full upfront and apply for reimbursement from Tricare later. Therefore, it is important to have funds available to make this advance payment to avoid delays in care.

Tricare Select may be the right choice for you if you live in an area where you cannot use Tricare Prime, if you have other health insurance (such as employer-sponsored insurance), or if you want to see a provider who isn't in the Tricare network and don't want to switch.

Tricare Select may be the best option if you live outside a Tricare Prime Service Area

Tricare Select is a self-managed, preferred provider organization (PPO) plan available in the United States. It is an option for those who cannot use Tricare Prime, which is only available in Prime Service Areas, usually within 100 miles of a primary care manager (PCM).

Tricare Select is a good option if you live outside a Tricare Prime Service Area. It can provide the same level of service closer to where you live. Tricare Select's freedom to choose providers also means you can include civilian providers more conveniently located to your home.

Tricare Select may be a better option if you need a provider with a specific medical specialty. You can do your own research and directly contact specialists. This is in contrast to Tricare Prime, where you must use a PCM for all appointments and referrals. With Tricare Select, you can choose any in-network medical provider without a referral.

However, Tricare Select may come with higher out-of-pocket costs. You may have to file your own claims, and if you visit a non-network provider, you will likely have to pay all costs upfront and file a claim for reimbursement.

Tricare Select is a good choice if you want to keep an out-of-network provider

With Tricare Select, you can choose between an in-network and non-network care provider. This will affect how much you pay for your care and whether you will need to file your own insurance claim paperwork. If you use a non-network provider, you may need to pay upfront and apply to be reimbursed by Tricare later. Therefore, it is important to have funds available to make this advance payment so that your care is not delayed.

Tricare Select is a preferred provider organization (PPO) plan available in the United States. It is an option for family members of active-duty service members when Tricare Prime does not meet their needs. Those eligible for Tricare Select include retired service members and their families, family members of activated Guard and reserve members, and qualified former spouses.

If you have other health insurance in addition to Tricare, such as Medicare or employer-provided coverage, Tricare will pay after your other health insurance. This means your other insurance will process your claim first, and then you or your doctor will file a claim with Tricare.

Tricare Select users may have to pay all costs upfront and file claims independently

Tricare Select is a self-managed plan, which means that users are responsible for handling their own healthcare decisions and arrangements. This is in contrast to Tricare Prime, which requires users to go through a Primary Care Manager (PCM) for all appointments and referrals. With Tricare Select, there is no need to get a referral from a PCM before seeing a specialist. However, this self-management comes with higher out-of-pocket costs.

The process of paying upfront and filing for reimbursement is relatively straightforward. Users should ensure they have proof of coverage, which is their military ID, and then pay for the service at the time of their appointment. They can then submit a claim to Tricare to be reimbursed. This process may be more work for the user than having Tricare Prime, where the PCM handles filing claims, but it gives users more freedom to choose their own providers.

It is important to note that Tricare Select users may not always have to pay all costs upfront and file claims independently. If a user visits a network provider, the provider may file claims for them. Additionally, active-duty family members, medically retired retirees or family members, and survivors of an active-duty sponsor or medically retired retiree are not required to pay an enrollment fee.

Tricare Select may be the right choice if you have other health insurance

Tricare Select is a self-managed, preferred provider organization (PPO) plan available in the United States. It is a good option for those who want more freedom to choose their own healthcare providers and don't mind paying slightly higher out-of-pocket costs. Tricare Select may be the right choice for you if you have other health insurance, such as an employer-sponsored plan or Medicare, in addition to Tricare.

If you have health insurance other than Tricare, it is considered "other health insurance" and Tricare will pay after your other insurance plan. This means that your other insurance plan will process your claim first, and then you or your doctor will file a claim with Tricare. It is important to keep your Tricare contractors and doctors informed when you have other health insurance, as Tricare will deny your claim if they receive it before your other insurance processes it. Additionally, if Tricare pays first and then discovers you had other insurance, they will take back any payments made and only reprocess your claim after your other insurance has paid.

Tricare Select gives you the freedom to choose any Tricare-authorized provider without needing a referral. However, you may need prior authorization from your regional contractor for some services. With Tricare Select, you can choose between an in-network and non-network care provider, but this will affect how much you pay for your care and whether you need to file your own insurance claim paperwork.

If you use an in-network provider, you will pay your costs, co-pays, or percentage of the cost at the time of your appointment. With a non-network provider, you may be required to pay in full upfront and apply for reimbursement from Tricare later. Therefore, it is important to prepare in advance and have funds available to make this payment if needed.

Tricare Select may be a good option if you need care providers who are not in the Tricare network and don't want to switch to an in-network provider. It can provide the same level of service as Tricare Prime but closer to where you live.

Frequently asked questions