Omega Pediatrics is a leading pediatric primary care practice in Roswell-Alpharetta Georgia. We provide the most accessible care with hours of service up to 9 pm on weekdays as well as telemedicine access for the convenience of busy families. Omega Pediatrics is one of the pediatricians that accepts Tricare. These are some of the benefits of Tricare Health Insurance packages.

Introduction

Tricare is a military-based health insurance company managed by the Tricare Management Activities, a subsidiary of the United States Department of Defense Military Health System. It provides civilian health benefits for the U.S Armed Forces military personnel, veterans, and their families. Tricare was formerly known as the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). The Tricare’s military health insurance plan covers every active military personnel, retirees, and their families. The plans come in different varieties including Tricare Prime, Tricare Extra, Tricare Standard, and Tricare for Life, among others

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Tricare Prime

The Tricare Prime plan is similar to the health maintenance organization (HMO). If you enroll for the Tricare Prime, you will be assigned to a primary care provider (PCP), which is usually a military medical facility (on-base hospital or medical clinic). The primary care providers (PCP) takes care of most of your healthcare needs. However, like most HMOs, to receive care from a specialist, you must first obtain a referral from your PCP. If you live close to a military base, the Tricare Prime plan is the most cost-effective Tricare option you can take advantage of. This plan requires that you pay an annual enrollment fee. You will also pay a small fee known as a cost-share in the military each time you receive medical care. Once you receive medical care under Tricare Prime, the provider automatically files a reimbursement on your behalf.

 

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Tricare Extra

For additional costs, the Tricare Extra plan gives you more flexibility than the Tricare Prime. Unlike the Tricare Prime where you have to enroll in advance before you start to enjoy the benefits, you don’t need prior enrolment with any primary care provider before you start to benefit from the Tricare Extra once you’re eligible for the Tricare benefits. Your enrollment is automatic the first time you present your military or dependent ID card as an insurance card to any Tricare network provider (TNP) when seeking medical care. The Tricare Extra plan allows you to pay an annual deductible including 20 percent of the medical expenses while Tricare pays 80 percent. Like the Tricare Prime, the provider will also file a reimbursement on your behalf if you are using the Tricare Extra option.

Omega Pediatrics remains the only clinic in Georgia that is open routinely for primary care up to 9 pm on all weekdays. We also are providing telemedicine facilities to blend into the DNA and culture of Atlanta.

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Tricare Standard

The Tricare Standard program provides you a higher flexibility compared to the Tricare Extra. The cost of this plan is expensive given the fact that the program allows you to seek just about any medical provider you so desire. As with Tricare Extra, you pay an annual deductible and a 25 percent of your medical expenses. Tricare pays 75 percent of your medical expenses. You can find out the Tricare allowable cost for a particular medical procedure on their costs page. However, under the Tricare Standard, there are two types of medical providers; the participating providers and nonparticipating providers.
Participating providers: Although there are many providers that provide the service, there is no particular national list of participating providers. Participating providers are those that will help you to file claims, accept payment from Tricare, and as well accept the Tricare allowable charge as full payment for their services.
Nonparticipating providers: The nonparticipating providers do not accept any obligation of paying the Tricare allowable charge for services or file your claims. The law permits nonparticipating providers to charge up to 15 percent above the Tricare allowable charge for their services. The money charge by the nonparticipating provider is paid by you and won’t be shared with you by Tricare.
You are enrolled automatically the first time you use any benefits with Tricare Standard. So, ensure that you check with your provider to be certain whether they are participating or nonparticipating providers.

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Tricare For Life

Tricare For Life was introduced in 2001 to cater for retirees and their family members. In order to benefit from this plan, you must enroll in Medicare Part B. The plan includes monthly payment of premiums in exchange for receiving medical care from authorized Medicare providers. Under the Tricare For Life program, Tricare acts as a secondary insurer to Medicare providers. So, Tricare pays any costs that Medicare doesn’t cover. The plan does not include annual deductible or cost-share.

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To summarize, the various Tricare plans cover most inpatient and outpatient medical care. However, some limits may be attached to certain types of health care. Thus, it is important to visit the Tricare website for more information on coverage.

 

 

WE ACCEPT ALL INSURANCES

 

Omega Pediatrics Difference: At Omega Pediatrics in Roswell we understand the challenges that parents face when their children develop symptoms late in the day or after hours. Many pediatric offices rarely see patients after 4 pm however we are open every weekday up to 9 pm for both appointments and walk-ins. We also have telemedicine via evisits for our known patients. Our clinic is one of the easily accessible pediatric primary care clinics in Roswell and Alpharetta. We provide pediatric primary care to families in the North Fulton area and beyond, serving families that live in Milton, Sandy Springs, Johns Creek, Duluth, Cumming, Woodstock-Canton and beyond.

Immunizations and checkups after-hours: One advantage of switching to Omega Pediatrics for your child’s primary care is that you can bring your child in for immunization or annual checkup after regular business hours. We provide this service because we have a passion for what we do and we want to be a comfortable and convenient service, not the ordinary pediatric doctor’s office.

470-485-6342

1305 Hembree Road, Suite 203
Roswell, GA 30076

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