Pros And Cons Of Tricare

Standard- a fee for service plan that offers a lot of flexibility but you may have to pay at the time for service and then file to get reimbursement. You also pay a higher out of pocket cost verse the other plans but you can choose any authorized provider for the services you need this is one of the biggest advantages to choosing standard Tricare.

Medicare Parts A and B. There is a monthly premium for this coverage (Medicare 2013 costs at

A Health care system of any country is an important consideration for the purposes of the overall development. One of the most important and essential feature of the human body is the health and the systems. In the same manner, proper management is also necessary. Furthermore, all the countries of the world have few targets and achievements to be made. On the other hand, it should also be noted down that, economic development and social welfare the two most are the two important factors. Economic welfare is connected with the increase in the wealth of the people at large (Niles, 2011).

Tricare Prime is a managed care plan similar to an HMO. This plan has Tricare Prime Remote, Tricare Prime Overseas and Tricare Global Remote Overseas. Tricare Extra is an alternative managed care plan for individuals who want to receive services primarily from civilian facilities and physicians rather than from military treatment facilities. Tricare for Life is a plan for beneficiaries who are both Medicare and Tricare eligible. Tricare Reserve Select is a premium based health plan available for purchase by certain members of the National Guard and Reserve activated on or after September 11,2001. Tricare Young Adult is a plan that can be purchased by qualified adult children after their regular Tricare coverage ends at age of twenty-one. Tricare is a secondary payer in almost all circumstances except Medicaid. The Civilian Health and Medical Program of the Department of Veteran Affairs (CHAMPVA) is the government’s health insurance program for the families of veterans with hundred percent service related disabilities. CHAMPVA provides coverage for most medically necessary services such as surgical procedures, anesthesia, chemotherapy, physical therapy, speech therapy, mental healthcare, prescription medications, maternity care, family planning, immunizations, durable medical equipment, hospice services and much more. CHAMPVA is usually the secondary payer except Medicaid and supplemental policy.

TRICARE supports the ability to cover medical costs when you are enrolled in any of the packages they offer. Under Prime, you are guaranteed an immediate appointment, often on the same day you are sick. Coverage includes preventive checks, such as pap spears, mammograms, and prostate screenings. Enrolling in the Prime program in a minimum of 12 months will establish your health care plan in TRICARE Prime. Other programs include TRICARE Extra, and TRICARE Standard; for the families who wish to seek civilian care from doctors and specialists from a select network in the local community, and for family members who wish to have civilian doctors provide their outpatient care, respectively. The latter two do not require you to enroll.

Co-pay up to 10% for people 70 years or older and low income (if qualified).

Low co-pays and zero deductibles are another advantage of having a POS plan. With a POS

Some of the pros for managed care are; Preventive care — HMOs pay for programs, they are set up and are intended at keeping one healthy (yearly checkups, gym memberships, etc.)The idea is, so they won 't have to pay for more costly services when and if one gets sick. Lower premiums — Because there are limits set as to which doctors one can see and when one can see them, HMOs charge a premium and usually they are lower premiums. Prescriptions — As part of their precautionary retreat, most prescriptions are covered by HMOs for a co-payment that also can be very low. Fewer unnecessary procedures —doctors are given financial incentives from HMOs , to provide only needed care, so doctors are less likely to

|Indemnity Plan |Able to choose hospital and doctor, Fee for service, deductible, |Individuals and Families |

TRICARE Prime is used for members who must travel more than 100 miles from their primary care doctor to receive special care. Beneficiaries are reimbursed for certain travel costs like lodging and meals. These types of expenses are reimbursed up to the government rate. The average cost for

This paper is to provide an overview of TRICARE with its history, available insurance products, organization and number of enrollees.

Tricare Standard plan allows a beneficiary to choose his or her own provider. There’s plenty of choices and individuals that have the freedom of seeing any non-network provider that they wish to consult. Under the TRICARE Standard health care plan, they will be required to make their own appointments.

Those who have Medicaid do not have to pay a monthly premium for the long-term care portion of the benefit. The PACE program pays for a portion of the monthly PACE premium and Medicare pays for the rest, for those with Medicaid (Providers & Partners, N.d.). If an individual does not have Medicaid, then the person is responsible for the portion of the monthly premium Medicaid would pay for. Those who only have Medicare will be charged a monthly premium to cover the long-term care portion of the benefit and the Medicare Part-D prescription drugs. Further, those individuals who do not have Medicare or Medicaid can join a PACE program by paying privately. In addition, the PACE program has no deductibles and copayments, which is a great incentive for qualified individuals to participate in this model of care (Shi & Singh, 2012). Overall this program has a great cost savings compared to other forms of long term care delivery systems, while providing quality health

Medicare: Medicare, the primary insurer, increased its reimbursement levels, extending full coverage for lightweight standard models to $850, up from the old $650 coverage for standard models. This made the space more attractive.

The Federal Employee Health benefit program is the largest employer health insurance program in the United States, insuring about 3 percent of all Americans. There are 133 plans, offering 188 coverage options that are participating in the FEHBP as of 2003. Preferred provider organization (PPO), fee-for-service plans, and Health Maintenance Organization (HMO) all offer options. The government’s contribution toward the cost of the beneficiary’s premium is “lesser of 72 percent of the average FEHBP plan premium, weighted by enrollment, or 75 percent of the premium for the plan chosen” (Karen Davis) .