Certain members may also choose to visit an eye care professional who is not on the approved list of providers, but the member is required to pay for the visit out-of-pocket and then submit a claim to be reimbursed for the charges.
If you have Medicare and a Medicare supplemental policy, Medicare pays its share of the bill and the supplemental policy will pay your share of your health care costs, reducing or eliminating your out-of-pocket expenses.
The Pre-Paid plan is typically a health plan where members pay a certain lump-sum into the plan at the start of the year, and this total covers co-payments and other "out-of-pocket" costs incurred throughout the year.
Plan members should review their policy documents carefully so they understand which services are covered under the policy and how much, if anything, they are required to pay out-of-pocket towards their dental care.
In many cases, recipients with an approved referral can visit a civilian provider with no out-of-pocket expense or deductible, and co-payments on prescription drugs filled at civilian pharmacies are relatively low.
This is because the more you are prepared to pay out-of-pocket, the less the insurance company will have to put out when something happens to you since you are willing to accept a larger portion of the costs.
Before choosing this option, make sure that the higher deductible is not so high that it would cause financial hardship to pay the money out-of-pocket before the insurance company will pay out on a claim.
This program has a high out-of-pocket expense when compared to TriCare Prime, but it does allow for a great flexibility when the insured person wants to seek care from an alternate health provider.
Sometimes employer-provided coverage is sufficient if you plan on paying for some costs out-of-pocket, but with families the cost of checkups can become high in a relatively short period of time.
Although dental discount companies often tout their plans as being superior to insurance plans, it is important to realize that with a discount plan there will always be an out-of-pocket expense.