Active Duty Servicemembers can't use other medical insurance?

SGT Kristin Wiley — Tue, 15 Sep 2015 10:42:02 -0400

I have been looking at using a different medical insurance plan because the military treatment facility I have been getting seen at has straight up refused to consider other possibilities for some of my medical symptoms. Instead of continuing to be a guinea pig for medications that don't work, I'd rather get an outside opinion. That's when I stumbled upon this on the Tricare website. Located here: http://www.tricare.mil/Plans/OHI.aspx

So active duty aren't authorized to use any other health insurance? What happened to America, the land of the FREE! I feel like my freedoms have been stripped away and the more I look into the less freedom I actually have. Does anyone know if the Tricare website is accurate in this regards? It seems ridiculous that I should be forced to accept sub-standard care.

Using Other Health Insurance

If you have any health insurance other than TRICARE, it is called "other health insurance." This insurance can be through your employer or a private insurance program. By law, TRICARE pays after all other health insurance, except for:

Response by TSgt David L. made Sep 15 at 2015 10:57 AM

TSgt David L. — Tue, 15 Sep 2015 10:57:00 -0400

Unfortunately unless you can get a referral downtown there is no other option. I think it has always been that way SGT Kristin Wiley. Hopefully they can get this repealed so folks can seek alternatives.

Response by MSG Brad Sand made Sep 15 at 2015 11:13 AM

MSG Brad Sand — Tue, 15 Sep 2015 11:13:35 -0400

I would say 'No' you cannot? Not sure why you would if you are Active Duty because they are supposed to pay all your medical expenses...unless things have changed that much since I retired?

I think you need to remember there is a difference between care and insurance...or as the Supreme Court likes to refer to it medical tax.

Response by Sgt Aaron Kennedy, MS made Sep 15 at 2015 11:21 AM

Sgt Aaron Kennedy, MS — Tue, 15 Sep 2015 11:21:17 -0400

"Tricare" is the just the name of "Military Medicine" (insurance). It pays 100%, therefore there is no reason to have "other health insurance" for active duty.

It's not a lack of freedom, it's a pragmatic approach to remove Administrative Problems which could arise from having more than one provider. Since Health Care is a comprehensive benefit you receive as service (Military Medicine), which is "administered" by TriCare all this does is prevent some third party from screwing it up. That's all.

It would be akin to preventing you from having a secondary payroll provider other than the Department of the Treasury, since they handle all our pay. That's it.

Edit: You can get Health Care elsewhere. And Tricare will pay for it. You just can't have other Health Insurance that will compete with the one provided by the Government since it is both redundant & completely unnecessary.

Response by SGM Steve Wettstein made Sep 15 at 2015 11:41 AM

SGM Steve Wettstein — Tue, 15 Sep 2015 11:41:32 -0400

SGT Kristin Wiley you need to keep getting in their asses. Demand a second opinion or get a different PCM. If that doesn't work go to the hospital administration. They all have patient advocates. If that doesn't work go through your CoC and the hospital CoC. It can be a bitch but it does work. I have had to do it myself.

Response by MAJ Private RallyPoint Member made Sep 15 at 2015 12:08 PM

MAJ Private RallyPoint Member — Tue, 15 Sep 2015 12:08:44 -0400

You can't use Tricare AND another health plan as Active Duty. If you are seeing a civilian provider and paying for your own plan, nothing to stop you.

Response by LTC Kevin B. made Sep 15 at 2015 7:49 PM

LTC Kevin B. — Tue, 15 Sep 2015 19:49:49 -0400

I don't think that's accurate; I believe it's a poorly worded website. I believe that you can use OHI, but that you can't use OHI as your primary health insurance (specifically at military facilities and with network partners). I did a quick search on the web and found a number of network partners that specifically mentioned how they handle claims involving active duty military who have OHI. Here's one website:

https://www.hnfs.com/content/hnfs/home/tn/common/claims/TRICARE_and_OHI.html/pp/content/hnfs/home/tn/bene/auth

How TRICARE Works with Other Health Insurance

All other beneficiaries with OHI (excluding Medicare) only require a prior authorization for inpatient behavioral health services.

Response by SA Harold Hansmann made Sep 16 at 2015 12:53 PM

SA Harold Hansmann — Wed, 16 Sep 2015 12:53:16 -0400

Try going to medical at a different base.

Response by 1LT Private RallyPoint Member made Oct 8 at 2015 12:03 AM

1LT Private RallyPoint Member — Thu, 08 Oct 2015 00:03:39 -0400

Yes you have to under Code of Federal Regulations

32 CFR 199.17 (c)(1)

(1) Active duty members. Active duty members are required to enroll in Prime when it is offered. Active duty members shall have first priority for enrollment in Prime. Because active duty members are not CHAMPUS eligible, when active duty members obtain care from civilian providers outside the military medical treatment facility, the supplemental care program and its requirements (including § 199.16) will apply.

When you look for other opinions , you are looking for doctors in your network depending on your type( PPO, HMO, EPO, ACO).Healthcare.gov is a good website to learn about health insurance.

Response by PO3 Private RallyPoint Member made Jan 6 at 2020 3:11 PM

PO3 Private RallyPoint Member — Mon, 06 Jan 2020 15:11:10 -0500

I agree. I didn't realize until I got out on my wife's insurance plan to try and get my knee problems fixed by someone more competent. Only to be told I need to be referred by Tricare. It's an absolute disgrace.