How does us health insurance work

how does us health insurance work

1 Answer

For the most part, military health insurance works the same as any traditional HMO. You are assigned a primary physician who you see regularly. That physician then acts as a gatekeeper, choosing what specialist care you need and referring you to specific caregivers as deemed necessary. Unlike most HMO policies, military health insurance does not include deductibles or copays for active service members.

United States Service members are covered by a special type of worldwide health insurance known as Tricare. Active duty members and their dependents are automatically enrolled in Tricare, while military retirees are eligible for Tricare Prime. A third type of Tricare, Tricare Extra, is available for service members and their dependents that prefer to choose their own doctors over those available through the standard coverage.

Tricare Standard is automatic and free of cost to all active duty members. Typically, the care is provided by base physicians and medical staff, but you may be referred to off-base associates if the type of treatment warrants it. Tricare Standard is an

HMO-style health plan, where you are provided a primary care physician who is responsible for referring you to any specialists you need to see. Unlike a traditional HMO, your choices of network professionals may be much more limited in Tricare, as the medical care will be kept within the military medical offices as much as possible.

If you would prefer a PPO-style health plan. Tricare Extra may be a better choice. With Tricare Extra, you pay an annual deductible along with paying a per-visit cost-share, the equivalent of traditional copays. The advantage of this plan is that you are allowed to choose your own physicians, bypassing the gatekeeper primary care provider of Tricare Standard.

For military retirees, Tricare Prime is available. Tricare Prime is similar to Tricare Standard in that you see a primary physician who refers you to others specialists, but it is like Tricare Extra in the way that you will be required to pay an annual fee as well as the per-visit cost-share.

answered Sep 23, 2013 by anonymous


Category: Insurance

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