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Standard Vs. Prime

Posted by on Jul. 25, 2014 at 11:27 AM
  • 11 Replies

 I've never actually considered switching from Prime to Standard before, but lately I've had nothing but issues with being seen on post. There are no issues with the kids being seen at this point. They can get in to be seen in a timely fashion, get referrals out when needed, etc. I on the other hand, can not be seen in a timely fashion or get referrals processed to save my life. So now I am considering the switch.

I know that often people make the switch when pregnant, and then switch back to Prime. Is there anyone in the group who hasn't switched just for the purpose of maternity care?

What has your experience been with Standard if you've used it?

What can you tell me about it? What are the benefits and the downsides to Standard? In your experience, is it worth it to make the switch?

Thanks :)

by on Jul. 25, 2014 at 11:27 AM
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Replies (1-10):
mandaschelle
by Bronze Member on Jul. 25, 2014 at 9:31 PM
I switched to standard in 2009 for similar reasons
There are many more options this way as far as choosing a dr. Nice because you're not stuck with one you hate. Difficult deciding who to try.
Costs are minimal with a $150 deductible for individual and $300 for family. With the kids on it we meet the deductible quickly. Well woman and well child visits are free. There is a cost share after the deductible is met. My most recent was $14. Generic meds are $5-$10
It is less organized than using an MTF. I had civilian insurance before marrying DH so that has helped me navigate a little.
Hope this helps.
SusanD
by Silver Member on Jul. 25, 2014 at 9:39 PM

 

Quoting mandaschelle: I switched to standard in 2009 for similar reasons There are many more options this way as far as choosing a dr. Nice because you're not stuck with one you hate. Difficult deciding who to try. Costs are minimal with a $150 deductible for individual and $300 for family. With the kids on it we meet the deductible quickly. Well woman and well child visits are free. There is a cost share after the deductible is met. My most recent was $14. Generic meds are $5-$10 It is less organized than using an MTF. I had civilian insurance before marrying DH so that has helped me navigate a little. Hope this helps.

So with the cost share, is there a catastrophic cap or anything that it maxes out at? If you were to need to have surgery, would there be potential to end up with a massive bill?  

mandaschelle
by Bronze Member on Jul. 25, 2014 at 9:42 PM
The family catastrophic cap for 1 year is $1000 I don't remember the individual. But logic says if the individual deductible is half the family deductible the the cap should be too.

Quoting SusanD:

 


Quoting mandaschelle: I switched to standard in 2009 for similar reasons There are many more options this way as far as choosing a dr. Nice because you're not stuck with one you hate. Difficult deciding who to try. Costs are minimal with a $150 deductible for individual and $300 for family. With the kids on it we meet the deductible quickly. Well woman and well child visits are free. There is a cost share after the deductible is met. My most recent was $14. Generic meds are $5-$10 It is less organized than using an MTF. I had civilian insurance before marrying DH so that has helped me navigate a little. Hope this helps.

So with the cost share, is there a catastrophic cap or anything that it maxes out at? If you were to need to have surgery, would there be potential to end up with a massive bill?  

SusanD
by Silver Member on Jul. 25, 2014 at 9:49 PM
Thanks :)



Quoting mandaschelle: The family catastrophic cap for 1 year is $1000 I don't remember the individual. But logic says if the individual deductible is half the family deductible the the cap should be too.

Quoting SusanD:

 


Quoting mandaschelle: I switched to standard in 2009 for similar reasons There are many more options this way as far as choosing a dr. Nice because you're not stuck with one you hate. Difficult deciding who to try. Costs are minimal with a $150 deductible for individual and $300 for family. With the kids on it we meet the deductible quickly. Well woman and well child visits are free. There is a cost share after the deductible is met. My most recent was $14. Generic meds are $5-$10 It is less organized than using an MTF. I had civilian insurance before marrying DH so that has helped me navigate a little. Hope this helps.

So with the cost share, is there a catastrophic cap or anything that it maxes out at? If you were to need to have surgery, would there be potential to end up with a massive bill?  

JMmama
by Kara on Jul. 25, 2014 at 10:10 PM
I switched for my pregnancy but was so happy I stayed (the baby is almost 1) and put my 5 kids on standard. I love being able to pick my own doctor and not have to deal with MTF bullshit to be seen. I love being able to research and choose my kids pediatrician and not play ped roulette at the base. The most payment I've had was pre meeting the deductible and I didn't really understand but now I've got the hang of it and we pay about $12-$20 a visit. Recently, I needed to take my oldest to urgent care and it was so nice to be able to just go and not have to worry about referral bullshit. I just got the bill for our portion of that visit the other day and it was $12. You never pay more than $1000 in a year.
SlapItHigh
by Platinum Member on Jul. 26, 2014 at 12:36 AM
We've stayed on prime the whole time but every now and then I consider switching. MAybe it's time to consider again.
gunsgirl
by Silver Member on Jul. 26, 2014 at 1:10 PM

I have been on stadard for 3 years- I had surgery 4 months after switching- the surgery total was 19,000 dollars I paid 267.00 for the entire thing.

my office visits for Primary care are 12.85, my specialist visits are 25.00 my Labs run from 3.00 -25 dollars

my annual chest xray runs about 85,

Acute care visits are either 25 or 45 depending on where I go and for an ER Visit it is 25 dollars.

I spend about 300 a year out of pocket - it is completely worth it  so I do not have to use the base here.

mom2jessnky
by Dedi on Jul. 26, 2014 at 1:22 PM

If we had been told I would have to go to Balboa for me OR the kids when we moved here I would have switched to Standard. Thankfully the MTF's were full so I avoided the switch and the hell hole. :)

But if they came at me with a "you now have to go to Balboa" I'd tell them to pack sand and switch to standard. I LOVE my doctor.

darbyakeep45
by Darby on Jul. 27, 2014 at 11:07 PM
1 mom liked this
I honestly didn't know much about Standard until reading this...we have Prime.
SlapItHigh
by Platinum Member on Jul. 28, 2014 at 12:15 AM
I've been thinking more about it and I'm going to stick with prime, at least for my kids. I can't find a good civi ped around here.
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