If an active duty soldier chooses to purchase private healthcare insurance, is it punishable by UCMJ?

SGT Private RallyPoint Member — Wed, 28 Oct 2020 18:56:27 -0400

I understand that Tricare’s website says that active duty must only use tricare prime, just wondering what the implications are.

Response by CPT Private RallyPoint Member made Oct 28 at 2020 7:22 PM

CPT Private RallyPoint Member — Wed, 28 Oct 2020 19:22:59 -0400

I don't know about UCMJ actions, but I don't think Uncle Sam is giving you back the insurance premium in your pocket. So at best you'd still be Tricare covered in the face of paying for very expensive private insurance.

Now, imagine you are injured looking to get a profile or rated and the process for such is expecting documentation from a military doctor or facility. Try working that into the system.

I don't see the financial gain, and I only see administrative complications.

Response by SGM Bill Frazer made Oct 28 at 2020 8:26 PM

SGM Bill Frazer — Wed, 28 Oct 2020 20:26:26 -0400

I doubt it, but it could be hell for you. You can be forced to go to Military Hospital- not a civilian one. The Service does not and normally won't talk any paperwork/recommendations for private practice unless it was an emergency. Private can't give valid profiles or consults at a Military hospital. And I guarantee that you would not get any fess/costs back for using private care.

Response by LTC Jason Mackay made Oct 28 at 2020 9:05 PM

LTC Jason Mackay — Wed, 28 Oct 2020 21:05:21 -0400

What article? They always ask if you have other insurance when you go to the MTF. If the soldier wants to give Tricare a freebie, go for it. As soon as you have other insurance tricare is secondary.

Response by SFC Private RallyPoint Member made Oct 28 at 2020 10:43 PM

SFC Private RallyPoint Member — Wed, 28 Oct 2020 22:43:55 -0400

Legally, other health insurances won't cover active duty troops. I don't know why anyone would say that's punishable by UCMJ, but if you ever talk to an insurance company they'll tell you that they are not allowed to cover service members. This very same question came up because my wife has excellent Healthcare insurance and asked about covering me under hers for things that Tricare may not cover in some areas like chiropractor. Apparently it's written into the law somewhere that they are prohibited, which means that you can purchase it, just not for yourself

Response by SSgt Christophe Murphy made Oct 28 at 2020 10:51 PM

SSgt Christophe Murphy — Wed, 28 Oct 2020 22:51:29 -0400

You are misinterpreting the statement on the website. Tricare isn’t the military and tricare has no ability to punish you. What the statement means is that active duty can’t use other versions of care via Tricare such as Tricare select/standard/etc.

With that said I would recommend against it because private healthcare is quite expensive. Especially on E5 pay. Tricare covers emergency care so if you don’t want to go to sickcall you can always go to the local ER.

Response by CPT Private RallyPoint Member made Oct 29 at 2020 12:50 AM

CPT Private RallyPoint Member — Thu, 29 Oct 2020 00:50:38 -0400

You can have other health insurance but they will not cover you for military related injuries. I had a Soldier that used private insurance for a few different things. He ended up popping hot on a UA due to the Meds for a surgery. He just gave our BDE Surgeon the medical records and he was cleared. There was no issue with it. He hurt his ankle on a ski trip and he wanted to use a private doctor so he jumped on a family plan with his parents and paid for it. In reality if you got your own insurance and used it outside the military you should be fine.

Response by SSG(P) Private RallyPoint Member made Oct 29 at 2020 9:00 AM

SSG(P) Private RallyPoint Member — Thu, 29 Oct 2020 09:00:50 -0400

I don't know what the legal subtleties are on this, but even if you go to a civilian provider, you would still have to take that documentation to your MTF for integration into your medical record. Your MTF might not even accept it. Why would you even go through that hassle? If it was something nearly life-threatening that the military won't cover, there is some logic in that circumstance, but otherwise, I wouldn't even put myself in that position.

Response by MAJ Javier Rivera made Oct 29 at 2020 9:00 AM

MAJ Javier Rivera — Thu, 29 Oct 2020 09:00:53 -0400

Punishable? No. Lost of money? Yes.
By law (32 CFR § 199.17 - TRICARE Program), you are required to be treated by military practitioners or refereed, unless is an emergency of course.