Why I Chose Tricare Select, but why it might not be right for you
In full disclosure, I am the spouse of a military physician. While I wholly support that military physicians are equally as qualified and as compassionate as their civilian counterparts, there are some key aspects of the military medical system that are harder to navigate than the civilian world. In Tricare open enrollment season or during the eligible time period after a qualifying life event, it comes down to deciding between Tricare Prime and Tricare Select. There are pros and cons for each option, but after having experienced both, here is why I personally opted to go with Tricare Select instead of Tricare Prime.
Why I Chose Tricare Select Over Tricare Prime
I wanted to choose who I see
There are some great physicians at military hospitals. They have excellent knowledge and great bedside manner. Only once in 10 years on Tricare Prime did I run into a physician at a military hospital that I felt was not a suitable provider based on interaction with him. (And it is worthwhile to note that he wasn’t a military physician, but rather a civilian physician who was contracted for that hospital.)
When you are a Tricare Prime patient you are assigned to a physician at the closest military medical facility that has availability in their patient load. While this typically isn’t a problem, where I experienced frequent frustration was in two areas: being able to see “my” doctor and having a consistent doctor assigned.
I’d like to see “my” doctor
The sheer volume of patients assigned to a military physician is mystifying. There is no way possible for a patient to have easy access to care with their PCM due to the daunting load of patients that these military doctors carry. And since Tricare Prime requires you to see your PCM to have a referral to any other type of physician, then you are always waiting to be seen. Often I would call to schedule an appointment with my physician only to be told he or she didn’t have appointments for weeks on end but that I could be seen by another provider who had availability. At one duty station I don’t think I ever saw my actual assigned PCM the entirety of the few years we were there.
I’d like to have consistency of care
Another problem I’ve run into on Tricare Prime is that frequent PCSing of the doctors I’m assigned to. I find this problem exists most frequently when you are assigned a PCM at an MTF with a residency program where your PCM may be a resident who is carrying their own patient load during the last year of their residency and then PCSing. When we were seen at National Naval Medical Center in Bethesda, I would be notified of my PCM changing nearly every 6 months due to PCSing physicians or shifting patient loads. As a patient I was constantly having to redo a full history and get to know a new doctor. It was exhausting and eventually I was like “why bother trying to establish care with someone?” Totally frustrating.
With Tricare Select, I am able to pick not only what PCM my kids and I go to, but I’m also able to choose whatever specialists I would like to see.
I didn’t like being on the phone
I can’t tell you how much time I spent listening to the phone system of Walter Reed National Military Medical Center in the time I was pregnant through the end of my son’s first year of life. Constantly on hold. Call to schedule an appointment, then the appointment is canceled. Must call back to reschedule. (Yes, I am aware that military treatment facilities now use an online scheduling system, yet I know how frequently you still have to call.)
For me, the ease of being able to schedule myself and my children for their appointments online or through an app is amazing. Being able to reach out to a nurse or a doctor via the same technology is so helpful. To not have to sit on a neverending hold on the phone is worth the Tricare Select copay in my world.
I hated waiting
Perhaps it’s the non-stop culture we live in, or maybe its a personality flaw, but I find the older I get the more impatient I am. Waiting for weeks for an appointment, waiting days for a call back, or sitting a long time in a waiting room all bother me far more than they used to.
All of these issues are a part of the military medical system simply because there are not enough providers for the quantity of patients assigned. I understand that logically, but it doesn’t make me increasingly more patient. When I considered the value of my time and having less waiting and less stress, I took it and made the switch to Tricare Select.
One other, more personal, reason I was ready to switch
While the factors above were what really led me to move away from Prime and toward Select, there is one other aspect that came into play in my decision. The military medical community is actually quite small so we have personal friendships with many military medical providers. When I was on Prime, these same friends were my doctors.
There’s just something a bit awkward about conversation over dinner in a group with your gynecologist and your dermatologist. So for me, it is nice to have separation in my backyard barbecues and my vaginal care. Just sayin.
Why Tricare Select Might Not Be Right For You
If you don’t want to have a co-pay, skip Tricare Select
If your budget is tight, an easy way to save on co-pays for medical care and medication is to stick with tricare prime. You can have quality medical care for free.
You will frequently read complaints from military spouses about the things I mentioned above, but in reality, not having to pay for medical care is a huge benefit. Don’t believe me? Simply ask anyone in the civilian world who is paying for insurance, prescription medication, or privately paying for medical care. Tricare Prime truly is a wonderful benefit for military families.
If you or your child have special therapy needs like occupational therapy, physical therapy, or speech therapy you will likely want to stay with Tricare Prime. On Tricare Select every therapy appointment requires a copay which can become quite the financial burden for a family to cover these weekly or even multiple times a week. You can receive the same care on Tricare Prime without the deductible and copay.
If you see a lot of specialists, stay Prime
If you or your child see a lot of specialists then you may want to stay on Tricare Prime. While you will need a referral from your PCM to see the specialists, you will more than likely be referred to a civilian physician in your area as the military medical specialists are also overloaded. When you are referred out in town by your assigned military PCM, Tricare Prime will cover that care completely. That means you will be receiving the same care as someone on Tricare Select, but you will not be paying anything out of pocket. No deductible, no copay.
Don’t see many (or any) specialists and just need medical care for well-visits and the occasional illness or injury? Then Tricare Select may be the right fit for you!
Research what is best for your family’s needs
The decision to go with Tricare Prime or Tricare Select does take some serious consideration. After spending 10 years on Tricare Prime, the negatives outweighed the positives and I was ready to make the switch to Tricare Select. It has been great for us, but we have friends and family who have never felt the need to leave Prime or have been Select and opted to go back to Prime.
You may find that your decision to switch from one option to the other changes with your needs and access to specific care every time you PCS.
While you may want to weigh the thoughts and experiences of others, the decision is ultimately what is best for your family. Take your time to research both options, but don’t miss out on the window to change if that is what you desire!
The next TRICARE Open Season is Nov. 14 – Dec. 13, 2022. Enrollment changes made during TRICARE Open Season will go into effect on Jan. 1, 2023.
