we are about to start lyme treatment. Does anyone have TriCare military insurance? How has the coverage been?
Posted by Catgirl (Member # 31149) on :
Most lyme docs don't take insurance because insurance companies try to dictate how to treat. The docs know the right course of treatment, the insurance companies do not. Insurance covers basic blood tests, and out of area coverage for some (PPO) regarding dr's visit. Sorry, I am not familiar with TriCare.
There is a good book you should read: Cure Unknown (Weintraub). It explains a lot.
Posted by TF (Member # 14183) on :
I believe that TriCare tells you what doctor you must go to. So, when you go to a lyme doctor, they will not reimburse you anything for that visit.
You need to find out if TriCare will pay for the prescriptions and blood tests that the lyme doctor will order. Ask TriCare if they will pay for such things ordered by a non-Tricare doctor.
I have friends with TriCare and they have always given me the impression that TriCare is something like an HMO--meaning that if you don't use their system of doctors, you must pay for your care yourself. But, check on that to be sure.
You don't have to give them the name of the doc you are going to see. (Be sure you don't!) Just ask them what happens if you pick a non-TriCare doctor to provide your medical care.
If they don't have a doctor in their network that covers the specialty you need, they may consider paying for the doc you want to see. However, for lyme disease, the assigned medical specialty is Infectious Disease specialist. So, I believe you will hit a brick wall there.
Our lyme doctors are generally NOT infectious disease specialists but often internists. And, TriCare will certainly have in-network internists for you!
So, you may want to inquire of your lyme doctor's office as to his medical specialty. I don't think you will get any of this covered. But, you may as well inquire.
Posted by poppy (Member # 5355) on :
There is a yahoo military lyme group you could join also. Don't know how active it is, but they will know a lot about your question.
Posted by rkal7 (Member # 35708) on :
I have Tricare for retirees and have only used this for all of my treatment so far. My LLMD is out of network for obvious reasons and this doc only does self pay. So I have to fill out the proper reimbursement form with a copy of the bill in order to receive some compensation. I would say from doctors visits I have received roughly 50-70% of what was paid out. This is due to the fact that most LLMD's do extended visits and Tricare will only cover a small portion of the extension. All blood tests and prescriptions have been covered just like my primary care doc visits. None of the Lyme specialized testing has been covered like IGeneX or mold testing. Herbs and supplements like Abab, Abart, etc. are not covered as well. This was all paid out of pocket. Hope this gives you a general idea of what to expect and I would like to thank you or whomever your sponsor is for their service