Why I Love My TriCare Medical Insurance

Written By:  Andrew Eide

I wish to tell you why I love my current medical insurance which is TriCare which is part of my benefits for being Retired from the United States Navy. Before I go into the benefits of TriCare medical insurance I wish to tell you how most standard medical insurance works. I will use my personal example which was from July 2006 to November 2008 when I worked for Three Angels Broadcasting Network in Loma Linda, California. At that time we had United Healthcare medical insurance.

With United Healthcare each insured person on the policy had to fulfill a $2,000 out-of-pocket payment, equivalent of a deductible you have with your automobile insurance. Once you have met that $2,000 out-of-pocket expense then United Healthcare would pay 80 percent of the balance and you would pay the remaining 20 percent.

Here is an actual example. My list wife, who passed away in July 2009, had cancer and one of her treatments cost $10,000. After I fulfilled the $2,000 out-of-pocket expense United Healthcare paid 80 percent of the remaining $8,000. In this case United Healthcare paid out $6,400. That left a balance for me to pay of $1,600. In this one medical exam I paid out $3,600.

The requirement to pay the $2,000 out-of-pocket was a yearly thing. Over the course of 3 years my last wife had many of these $10,000 procedures and I had to pay many of the $3,600 charges. Even after the $2,000 was met for that year, if another $10,000 treatment came in I still had to pay 20 percent of the bill or in this case $2,000.

We had CD's, IRA's, Savings, you name it, and in a three year period we lost everything due to the pathetic state of medical insurance.

Starting in November 2008, when I lost my full-time job and became full-time retired I was able to get enrolled in TriCare due to being Retired Military. Now you are asking why I didn't enroll before and that is a good question. The Law in the State of California states that if your employer offers you medical insurance you are required to accept that medical insurance and it becomes your Primary Medical Insurance. Even if I was enrolled in TriCare it would only serve as a secondary insurance. Even if I refused the United Healthcare medical insurance the State of California would still only recognize my TriCare as a secondary insurance.

Here is why I love TriCare medical insurance. Our total annual premiums to have full coverage medical insurance for my family of three persons is less than $600 per year while most people with conventional medical insurance pay over $600 per month.

I have no out-of-pocket expenses. I have no cost-shares. I have no monthly, yearly, or lifetime caps, where once those are reached no further payments are made by the insurance company. Most conventional medical insurance will cut you off when those caps are met

Office visit co-pays are $12 or less. Prescription co-pays are $10 or less. And TriCare pays the entire billing from the medical facility or doctor and if they don't pay the total amount billed the medical facility or doctor cannot charge me for the difference.

Using Keira's recent hospital visit the total bill to TriCare for Keira's evaluation and treatment was $1,600 and TriCare paid $1,300 of the claim. The medical facility and doctors are not allowed to charge me the $300 difference but if they wanted to they are allowed by Law to charge me 10 percent of what wasn't paid which in this case would be $30. For the 7 years I've had TriCare never once has any doctor or medical facility charged us for the difference.

I am truly blessed especially when I hear our friends tell us they pay $800 or more per month for medical insurance premiums and still they have to much out-of-pocket, deductibles, cost-shares, and monthly, yearly, and lifetime caps on what the insurance company pays out.

And there is one more perk. When I turn 65 years of age and the Government "forces" me onto Medicare, then my TriCare insurance, for myself, changes from TriCare Prime to TriCare Prime for Life and it will serve as my Medicare Supplement Insurance so I don't have to purchase any Medical Supplement Insurance plan. At the same time Becx and Keira remain on TriCare Prime.

Thanks to my Government for finally doing something right. Thanks for rewarding me for serving 20 years in the United States Navy supporting and protecting the United States, our Constitution, and our Freedoms.