<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>Nicole</b></i>
My husband is active duty, so I cannot tell you how Tricare works (or does not work) in the reserves. Like Julie, we have Tricare Prime and we don't have any copays as long as we receive care at the MTF (military treatment facility). For our son's CF care we do not get care from military docs so we have to get a referral to see a civilian provider. We don't have any co-pays for those visits as long as we have the referral. As far as meds, if you fill the rx at the MTF, again no co-pays. We get Pulmozyme form there. We chose to use a regular pharmacy for most of his other meds though, just because it has been such a hassle to get them at the MTF (long story). We have a $3 co-pay for gererics and $9 for brand name. If you have any other questions feel free to ask and I can try and find out some more info for you.</end quote></div>
Nicole,
We are also active duty AF. Have you tried the Tricare Express Scripts? My biggest hassle was getting all of Erin's meds from the MTF. I was going in all the time for her enzymes, then the ADEKS aren't covered, etc. We had quite the time getting TOBI at first. Anyway, I finally tried the Express Scripts & LOVE IT!!! You refill by phone & they mail it all to you, even Pulmozyme. My co-pays are the same as yours & they automatically charge it to my debit/credit card when I call in. It has really helped me out a lot. Also, does your son get pediasure? At first, it was a rx, but then they denied it. Now, I get it through his pcm as durable medical equipment. Don't know if this applies to you, but maybe it can help. Also, I had a hard time getting a year long referral for her CF appointments, but talked personally with a case manager & they gave me one referral number lasting for one year w/up to 12 visits. It only took a couple of minutes & I don't have to get new referral every 3 months. Again, don't know if this helps, but wanted to share my mini triumphs with another military member.
My husband is active duty, so I cannot tell you how Tricare works (or does not work) in the reserves. Like Julie, we have Tricare Prime and we don't have any copays as long as we receive care at the MTF (military treatment facility). For our son's CF care we do not get care from military docs so we have to get a referral to see a civilian provider. We don't have any co-pays for those visits as long as we have the referral. As far as meds, if you fill the rx at the MTF, again no co-pays. We get Pulmozyme form there. We chose to use a regular pharmacy for most of his other meds though, just because it has been such a hassle to get them at the MTF (long story). We have a $3 co-pay for gererics and $9 for brand name. If you have any other questions feel free to ask and I can try and find out some more info for you.</end quote></div>
Nicole,
We are also active duty AF. Have you tried the Tricare Express Scripts? My biggest hassle was getting all of Erin's meds from the MTF. I was going in all the time for her enzymes, then the ADEKS aren't covered, etc. We had quite the time getting TOBI at first. Anyway, I finally tried the Express Scripts & LOVE IT!!! You refill by phone & they mail it all to you, even Pulmozyme. My co-pays are the same as yours & they automatically charge it to my debit/credit card when I call in. It has really helped me out a lot. Also, does your son get pediasure? At first, it was a rx, but then they denied it. Now, I get it through his pcm as durable medical equipment. Don't know if this applies to you, but maybe it can help. Also, I had a hard time getting a year long referral for her CF appointments, but talked personally with a case manager & they gave me one referral number lasting for one year w/up to 12 visits. It only took a couple of minutes & I don't have to get new referral every 3 months. Again, don't know if this helps, but wanted to share my mini triumphs with another military member.