As military families, we have a love-hate relationship with Tricare. Every military family has an opinion and the topic comes up quite easily in group settings. Prepare for the onslaught of Tricare talk at your next gathering as the program may completely change as early as 2017.
The Military Compensation and Retirement Modernization Commission recently released its 302-page final report that outlines recommendations to “modernize the Uniformed Services’ compensation and retirement system.” This report includes a complete overhaul of the Tricare program.
Here are the ins and outs of the proposed changes to Tricare.
Currently Tricare offers health care programs, such as Tricare Prime and Tricare Standard. You choose a program and are locked into its rules.
The Military Compensation and Retirement Modernization Commission has decided, based on surveys and town hall meetings, that military families would like more options and to be able to have more say in their medical treatment. The commission’s proposal therefore would completely do away with every Tricare plan except Tricare for Life. Tricare for Life would remain exactly the same.
A new program, Tricare Choice, would replace the current system. According to the report, Tricare Choice would
increase access, choice and value of health care for active duty family members, reserve component members and retirees by allowing beneficiaries to choose from a selection of commercial insurance plans offered through a Department of Defense health benefit program.
This being said, the proposed privatized program would allow families to choose a health care plan from a list similar to that of federal employees. The level of care and costs associated with that would be determined by the plan chosen. Options would include:
- traditional fee-for-service plans
- those offered by health maintenance organizations
- preferred provider network options from some of the biggest names in the industry, including Blue Cross/Blue Shield, United Healthcare, Kaiser Foundation and more.
There would be new benefits such as chiropractic care, fertility treatments and acupuncture that are not covered under the current system; of course each would come at a cost.
The Tricare Young Adult program would be cut and adult dependent children under the age of 26 would be covered under their parent’s Tricare Choice plan no matter their circumstances. Unlike the current program, this would allow these dependents to stay in the program even if they are “married, not living with their parents, attending school, financially independent or eligible to enroll in their own employer’s health care plan.”
Related: Commission Recommends Combining Commissaries, Exchanges
Tricare dental plans would remain the same with a few Tricare Choice options including partial dental care coverage.
What does the Tricare Choice proposal mean to you?
For active duty members, everything remains the same. Active duty and reserve family members as well as retirees would choose a plan during annual open enrollment and be able to pick the doctors they prefer including military treatment facilities if the plan allowed it. They would pay 5 percent of premiums initially and it would increase each year until it topped out at 20 percent of costs or until they become eligible for Medicare or Tricare for Life. Co-payments would be made, even when visiting a military treatment facility. They would also pay an annual enrollment fee. The report estimates that “retirees with families would see their average total out-of-pocket costs increase from about $2,000 a year to $3,500.”
How will these new costs be covered?
The commission recommended that a basic allowance for health care, BAHC, be created to completely cover premiums, cost-shares and co-payments. The money would be directly paid to the insurance company in part and the rest would go straight to the service member. If a plan is chosen that costs less than the BAHC, the family could actually make money.
The government, of course, could potentially save money as well. The Defense Department currently has a $49 billion annual health budget. The MCRMC report estimates that this new plan would cut personnel spending for the departments of Defense and Veterans Affairs by $12 billion a year.
The report is now headed to Congress where they will decide the future of Tricare. There are 9.2 million military beneficiaries who will be waiting to hear the outcome.