Posted on Sep 15, 2015
SGT Kristin Wiley
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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.
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Responses: 9
SGM Steve Wettstein
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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.
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SGT Kristin Wiley
SGT Kristin Wiley
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I've had 3 different PCMs. I've been to patient advocacy, who was unwilling to do anything, and my chain of command is not supportive. If anything my CoC has used my medical issues against me.
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SGM Steve Wettstein
SGM Steve Wettstein
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SGT Kristin Wiley - At last resort you can go to the IG.
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PO2 Corey Ferretti
PO2 Corey Ferretti
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Wow never knew that. What comes to mind is squeeze wheel gets the grease. I don't understand how people have issues getting transfered to a civilian doctor. I guess I was lucky and was stationed in the middle of no where so they had to had to send you out.
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MAJ Security Cooperation Planner
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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.
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SGT Kristin Wiley
SGT Kristin Wiley
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MAJ (Join to see) I believe that should be the policy, but as you can see on the Tricare website it says I can't use other health insurance. Maybe I'm understanding it wrong, but if I am then Tricare needs to clarify what they put on their site.
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MAJ Security Cooperation Planner
MAJ (Join to see)
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You can't use Tricare and something else. If you are not at a military facility, and do not use Tricare, then Tricare rules do not apply. Your treatment facility could have your commander order you not to go outside the MTF system, but only if it comes up.

There were lots of people seeking outside TBI and Mental Health treatment when I was at Carson.
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SGT Kristin Wiley
SGT Kristin Wiley
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MAJ (Join to see) Then why doesn't the Tricare website say that instead of what I posted above. You would think they'd say something more reasonable like "Active duty service members are not authorized to use other health insurance with Tricare." Or something along those lines.
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TSgt David L.
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Edited >1 y ago
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.
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Active Duty Servicemembers can't use other medical insurance?
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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.
SA Harold Hansmann
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Try going to medical at a different base.
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SGT Kristin Wiley
SGT Kristin Wiley
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I'm stationed in Hawaii, there are very limited options and where I can receive medical care. That's why I want to use my private medical insurance to get a second opinion from a civilian doctor.
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SA Harold Hansmann
SA Harold Hansmann
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You could try going to a Navy Dr. Or any other branch of the services. It will definitely give you your second opinion. And a civilian Dr. Should accept your military "insurance".
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LTC Kevin B.
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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
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LTC Kevin B.
LTC Kevin B.
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SGT Kristin Wiley
SGT Kristin Wiley
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LTC Kevin B. That seems more reasonable, but it still makes me wonder why their official website chose this wording to display.
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Sgt Aaron Kennedy, MS
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Edited >1 y ago
"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.
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SGT Kristin Wiley
SGT Kristin Wiley
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Sgt Aaron Kennedy, MS Tricare won't pay for Health Care elsewhere unless you get a referral that can't be handled within the military treatment facility. I've asked Tricare to see a specialist in the field I require that isn't available at the MTF and it was denied. Additionally, there are multiple treatment options that are recommended for my medical issues that MTF policy prevents me from receiving.
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Sgt Aaron Kennedy, MS
Sgt Aaron Kennedy, MS
>1 y
SGT Kristin Wiley That's not a "Tricare" specific issue. That's an "Insurance" issue. Getting the referral is the issue. Once you have the referral, it forces the insurance company to pay the bill.

The issue with military medicine adds a layer of complexity.

Now if Tricare, or your doctor are refusing to give you referrals for specialists you require, as in need, not want. Escalate. Don't let a bureaucrat push you around. Talk to the doctors. Get them to give you a referral. Tricare is Insurance. Doctors are Health Care. There's a world of difference. If you're not liking the answers they're giving, Escalate. You have to live with your Health for the rest of your life. They deal with your medical record until they ship it to the Archives.
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MSG Brad Sand
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Edited >1 y ago
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.
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PO3 Boatswain's Mate
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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.
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