TRICARE Toolkit: How TRICARE Is Transforming for You

TRICARE Toolkit: How TRICARE Is Transforming for You
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TRICARE-Toolkit-logo-draft.jpgMOAA’s TRICARE Toolkit provides insight and tips for navigating your TRICARE benefits. Have a question or suggestion for an upcoming column? Email beninfo@moaa.org. Read other TRICARE Toolkit columns at MOAA.org/tricaretoolkit.

 

As TRICARE has moved through a much-debated modernization, MOAA has fought to keep our health care benefits. Military medical costs were “out of control,” former Defense Secretary Robert Gates said during his term, and American medical insurance premiums nearly doubled between 2000 and 2010, according to a Kaiser Family Foundation survey.

 

To rein in costs, DoD stood up the Defense Health Agency (DHA) in 2013 to support delivery of integrated, affordable, and high-quality health services to each of the beneficiaries of the service’s military health system (MHS).

 

In a process among DoD, Congress, and the Military and Veteran Service Organization community, modernization of TRICARE was enacted in the FY 2017 National Defense Authorization Act (NDAA).

 

Throughout the MHS reform process, MOAA fought for beneficiaries and defeated a proposed TRICARE for Life enrollment fee and even higher TRICARE Prime and Select fees.

 

[TRICARE COST COMPARE TOOL: TRICARE.MIL/Costs]

 

Here’s a summary of the major changes already implemented and the one remaining major change that was canceled by the FY 2021 NDAA:

  • TRICARE Standard and Extra were combined into the new TRICARE Select.

  • Two groups were formed: Group A for servicemembers and their dependents who entered service before Jan. 1, 2018, and Group B for servicemembers and their dependents entering service on or after Jan. 1, 2018. Generally, Group B pays higher fees for care.

  • The TRICARE Retiree Dental Plan ended on Dec. 31, 2018. Retirees, their dependents, and survivors were given access to the same dental and vision insurance plans provided to all federal civilian employees: the Federal Employee Dental and Vision Insurance Program, or FEDVIP.

  • The pharmacy benefit also underwent significant changes. A 10-year cost schedule for 30- day initial prescriptions and 90-day maintenance prescriptions via Express Scripts mail order delivery was developed and implemented with copay increases every two years. Mail order maintenance refills for a generic drug went from $0 to $7 on Jan. 1, 2018. Those with access to a military treatment facility pharmacy continue to receive initial prescriptions and refills without a copay.

  • One of the last significant changes from the FY 2017 NDAA was the introduction of a TRICARE Select enrollment fee: $150 annual for individuals or $300 annual for family coverage that began on Jan. 1, 2021.

 

The final major change was to be the sunset of the active-duty TRICARE Dental Plan, pushing families to FEDVIP, following a similar move for retirees and their beneficiaries in 2019. Measures to supplement FEDVIP plans for active-duty families could not be resolved, so the FY 2021 NDAA terminated this programmed conversion.

 

MOAA continues the fight against indiscriminate erosion of our health care benefits.

 

Have More Questions About Your Health Care Benefit?

MOAA's TRICARE Guide answers some commonly asked questions.

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About the Author

Capt. Paul J. Frost, AFC®, USN (Ret)
Capt. Paul J. Frost, AFC®, USN (Ret)

Frost co-leads MOAA's Financial and Benefits Education program and is also an accredited Veteran Service Officer (VSO), providing VA disability compensation claim and appeal information and advice to the military community.