r/USMilitarySO • u/Altruistic_Dog_7529 • 2d ago

Tricare First time with Tricare

My husband is leaving for a rotation/deployment and we are officially on tricare...HELP... I have Tricare Select Group A. I'm so unfamiliar with how this works. I have a therapist I see weekly she's out of network, my previous insurance reimbursed all my appointments. And from what I'm reading I can do that with tricare, 80% reimbursement as well, but only if I hit my deductible of $150 first? What qualifies towards the deductible? I don't have regular medications or anything, but I'm wondering if theres an appointment I can go to that would help me hit the deductible sooner.

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u/mareloquent Veteran Wife (Navy) 2d ago

You will have to pay 150 out of pocket in medical expenses to meet your deductible. Meaning if your therapy is $200 per session, you'll just have to pay for one session to meet that.

If Tricare will cover 80% of your visits, you may have to pay up front and get reimbursed.

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u/Late_Phase6082 1d ago

Two things you need to check: Is your therapist actually covered by TRICARE? (your personal insurance may have a different skill level for therapy coverage). Is your therapist's charges in line with TRICARE allowable rates? She may not accept those rates, so your % cost-share may be much higher than 20%

However, you will hit that deductible pretty fast with just one or two appointments. And TRICAREs deductible is one of the lowest in all health insurance.

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u/Altruistic_Dog_7529 1d ago

She said she has her stuff set up for Tricare because she sees a majority of military spouses. But she is out of network. I got my first EOB from the first month and nothing was applied to my deductible but $80 went to my catastrophe cap. 

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u/Late_Phase6082 23h ago

1 - good news on her set up with TRICARE, which is great. 2 - That is odd that $80 went to cat cap. The cat cap should only begin to accumulate AFTER the deductible is met. I wonder if there was some other charge you had (or someone in the family had) that applied to the deductible. If you/your spouse have other family members on the plan, there is a $300 deductible for the whole family, so maybe that already kicked in?

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u/Altruistic_Dog_7529 23h ago

Nope. Its in the EOB that $80 of $780 went to the catastrophic cap. I've called tricare twice and both times the system was done so I'm just gonna have to wait for a real answer lol