Here's Why No New TRICARE Fee Increases Is Only A Small Consolation

The president's FY 2019 proposed budget submission for DoD included the following statement, indicating there will be no new TRICARE fee increases for 2019: “NO compensation cost share reforms in FY 2019. Instead, the Department is focusing on internal business process improvements and structural changes to find greater efficiencies, such as modernizing our military health care systems into an integrated system.” 

This is indeed welcome news. Unfortunately, it will probably fall on deaf ears for most beneficiaries, who have discovered their TRICARE cost shares have, in many cases, drastically increased since Jan. 1. 

This past fall, DoD unexpectedly implemented an across-the-board fixed-fee copayment schedule for the new TRICARE Select option. The new fee schedule was intended to replace the existing TRICARE Standard/Extra percentage, which had been based on a services-used model - the model most beneficiaries have been used to over the years. This change was to be cost-neutral to DoD. Some TRICARE Prime copayments also increased by as much as 150 percent.

As beneficiaries receive their new explanation of benefits statements and experience the resulting sticker shock, all they can see is the cost of their health care go up. MOAA has heard loud and clear from all categories of TRICARE beneficiaries. Here's a small sampling:

“Since February 3rd my family has amassed an astounding $802.50 in medical expenses. When I contacted TRICARE to see why this was suddenly the case, they explained that many of the providers for my son's Autism services are out of network and that I'd be responsible for 20% of the allowed amount until I hit my catastrophic cap. … How is it right that with no warning I'm suddenly responsible for what will be $1000.00 before the end of the week? My family now has 30 days to pay that amount. This is a significant and unwarranted strain on military families everywhere, especially those that rely on specialty care in the [Extended Care Health Option] program.”

- an active duty Army captain from Fort Gordon, Ga.

 “I require a series of appointments with physical therapy for my back and I cannot afford to pay the $41 each time I see the therapist. … It would be cheaper for me to just get the surgery instead!”

- a spouse of a retired lieutenant colonel in N.C.

Combine this TRICARE cost share inflation with the new increases in costs for prescriptions from TRICARE, and you can understand why military retirees, active duty servicemembers, and their families are starting to feel as if the government no longer considers military health care an earned benefit of their service. MOAA believes those who are serving and have served should not be put in the position to fund the cost of readiness or their own benefits.

 

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