The Pentagon’s FY2017 budget request once again proposes higher enrollment fees and copayments for working age military retirees and those aged 65 and older. Defense officials say the higher out-of-pocket costs will bring about better service and lower cumulative costs, but only after more details are learned can that judgement be made or disproved. One push DOD is trying to make is to get all beneficiaries to maximize the use of military treatment facilities (MTFs) and Tricare’s mail-order pharmacy. The two current Tricare programs of Prime and Standard/Extra will be renamed Tricare Select and Tricare Choice.
— Active-duty-families: Tricare Select will be available at no cost to active-duty family members provided they use MTFs or network providers. Tricare Choice will also be available at no cost to active-duty family members if they use an MTF, but will add modest copays ranging from $15 for in-network primary care to $50 for in-network emergency care. All active-duty family members would incur a 20-percent copay for using non-network providers regardless of plan.
— Retirees under age 65: The current family rate for those enrolled in Tricare Prime is essentially $565. Under the new Tricare Select, the annual enrollment fee would rise 24 percent to $700. Under Tricare Choice, the family enrollment rate would be $900, whereas the exiting Tricare Standard/Extra programs have no enrollment fee. Regardless of plan, retirees would incur no copay if using an MTF. For network care, Select enrollees would incur copays ranging from $20 for primary care to $75 for emergency care, and Choice enrollees would see copays of $25 for primary care and $90 for emergency care. Both plans would see 25 percent copays for non-network care.
— Retirees 65 and older: Retirees in the rank of O-6 and below would pay 0.25 percent of their gross retired pay to enroll in Tricare for Life, which acts as a secondary insurance to Medicare Part B. The quarter-percent enrollment fee would gradually increase to 1 percent by FY 2020. Flag officers, or those in the ranks of O-7 and above, would pay a $100 enrollment fee in FY 2017, which would gradually increase to $400 in FY 2020.
— Retiree pharmacy copays: The Pentagon is again pushing the use of Tricare’s mail-order pharmacy, since provides a three-month supply of medications for the same cost or less of a one-month refill from a network pharmacy. More about the home delivery program here: http://www.tricare.mil/CoveredServices/Pharmacy/FillPrescriptions/HomeDelivery.aspx.