Will Mail Handlers plan plus Tricare be enough?
November 20th, 2009 | TriCare Help | Posted by Military Times
Q. My wife and I have long had Mail Handlers Standard but now are considering Mail Handlers Value. We also have Tricare. I am concerned that the Value policy and Tricare won’t be enough insurance. Can you provide any thoughts or sources of information?
I’m disadvantaged because I don’t know what benefits are provided under various plans available through the Federal Employees Health Benefits Program (FEHBP). I am aware that Mail Handlers is one of the better plans available for federal employees, but I don’t know how Mail Handlers Value differs from Mail Handlers Standard. I must leave that analysis and its applicability to your needs to you alone.
Let me talk briefly about what I do know.
I can tell you that Tricare Standard is a full service, stand-alone plan that, when it was created in 1966, was modeled after the FEHBP’s High Option Blue Cross and Blue Shield Plan. That plan was considered to be one of the best available in the nation at the time. Because of its generous and broad coverage, it was the most expensive plan available to federal employees. It is no longer available, perhaps for that reason.
Over the years, many beneficiaries have had Tricare Standard as their only health insurance. It’s greatest deficiency as one’s only coverage is its $150 deductible and 25 percent copayment (cost share). Tricare has always recommended a good Tricare supplement, when possible, for those enrolled only in Tricare Standard.
In my experience, and having corresponded with several thousand Tricare beneficiaries, I believe that when Tricare Standard is combined with a good Tricare supplement — or much better, with a good primary plan such as any of the FEHBP plans — beneficiaries find that most of their health care costs are paid in full or almost in full. The latter would be my choice for coverage.
That is particularly true because all Tricare beneficiaries are automatically eligible for, and are enrolled in, the free Tricare Pharmacy Program, which is one of the best prescription drug plans available. A Tricare beneficiary does not need any other pharmacy insurance.
Note: The Tricare Pharmacy Program has a new, combined information center at 1-877-363-1303, toll-free.
By federal law, Tricare is always last payer to all other health insurance plans. Whatever commercial plan you choose under the FEHBP, Tricare will serve as second payer, and it will usually pay most, often all, of what the primary FEHBP plan does not pay.
The FEHBP doesn’t offer any “junk” plans. Although they differ in the kinds and amounts of coverage, all the FEHBP plans are solid, legitimate plans. Tricare Standard is a good choice as your second payer for any plan under the FEHBP.
Thus, your decision must be based on your reading of the fine print in your two Mail Handlers plans, to decide which of the two provides more adequately for you and your family. With Tricare Standard as second payer, only the details of the two Mail Handlers plans and their application to your particular family needs to concern you
Tricare Prime, on the other hand, is in my opinion the plan of first choice as an individual’s or a family’s only coverage. But I do not recommend Tricare Prime for any beneficiary who has other health insurance. Tricare Prime functions as a Health Maintenance Organization, or HMO — a plan under which the beneficiary must receive all his care from providers who are under contract with the plan, and he usually pays a fixed fee which is the same for each doctor visit.
Because you may use only plan providers, an HMO limits your choice of physicians to those on a list of certain providers in one specific geographic locality. Because of those requirements under Tricare Prime, it is not a good choice to be second payer to any other health insurance. It has a potential for too many problems when benefits are coordinated between the two plans. That invites errors and, especially, misunderstandings.
Tags: FEHBP, Tricare Prime, Tricare Standard
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