Connecting over TRICARE Concerns

December 7, 2017

This week, MOAA led a delegation of concerned members of The Military Coalition (TMC) in visits with both the House and Senate Armed Services committees staffs to emphasize our collective opposition to the Defense Health Agency's (DHA's) recent, and surprising, changes to the TRICARE fee structure. TMC, of which MOAA is a key member, represents a powerful consortium of over 5.5 million currently serving, retired, and former servicemembers and their families and survivors. Needless to say, the congressional staff expressed keen interest as they listened to our concerns.

As background, earlier this fall, the DHA unexpectedly implemented an across-the-board fixed-fee copayment schedule for the new TRICARE Select option. This new fee schedule was intended to replace the existing TRICARE Standard/Extra percentage based on services-used model - the model most beneficiaries have been used to over the years. 

MOAA and many of our TMC partners believe these structural fee changes undermine the intention of the FY 2017 National Defense Authorization Act, which prescribed current military members and their families and retirees were to be grandfathered from cost-share increases.  Now, however, most beneficiaries will see the cost of their health care go up, even though the grandfathering clause in last year's law has remained intact.  

This is a result of the DHA, and presumably at the request of DoD, to arbitrarily change and raise fees for those grandfathered and placed into what is now termed “Group A.” New entrants after January 2018 automatically are placed into “Group B.” These two new groups and their new fees can be viewed at

MOAA believes the grandfathering language placed in law last year was clearly stated for those currently grandfathered (now Group A) beneficiaries: “The cost-sharing requirements shall be calculated as if the beneficiary were enrolled in TRICARE Extra or Standard as if TRICARE Extra or Standard, as the case may be, were still being carried out by the Secretary.” In keeping with this provision, the DHA insists the new TRICARE Select fixed-dollar copayments represent an average of the percent cost shares beneficiaries currently pay for TRICARE Extra visits.  

However, MOAA and many other TMC partners believe the methodology used by the DHA to calculate these fees is flawed, or intentionally calculated, to result in TRICARE Select copayments that are significantly inflated as compared to current TRICARE Extra cost shares.  Our visits to the Hill are intended to reinforce our views that Congress should enforce the spirit of the commitment it made last year.



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