Premiums for TRICARE Young Adult (TYA) coverage will increase by 22% for TYA Prime users and nearly 13% for TYA Select users as of Jan. 1, according to an Oct. 21 post at TRICARE.mil.
By law, the TYA program must pay for itself, requiring premiums that cover the full cost of the program. To meet that law in 2021, premiums for TYA Select will rise to $257 per month, up from $228, while TYA Prime users will pay more than $80 extra per month ($459 per month, up from $376).
Military families wouldn’t face these high rates (and rate increases) if TRICARE eligibility aligned with private-sector plans that maintain coverage of young adult children up to age 26. MOAA supports H.R. 7176, the Health Care Fairness for Military Families Act, which would allow TRICARE Prime and Select users to keep their children on their plan up to age 26, regardless of whether the child is a full-time student, married, or eligible for health care coverage from an employer or other source.
This would not only eliminate separate premiums for TRICARE young adult coverage, it would expand eligibility from the existing setup, which requires children to be unmarried and unable to secure coverage from another source. This means for many, TRICARE coverage ends at age 21 (23 if an unmarried, full-time college student).
The bill “fixes a long-standing gap between TRICARE coverage and commercial plans,” said Karen Ruedisueli, MOAA's director of government relations for health affairs. “While only about 35,000 young adults enroll in TYA each year, it’s a benefit many families – including primarily career servicemembers and those making the challenging transition out of uniform – may come to rely upon.”
This gap is particularly concerning given that young adults have been particularly hard hit by the COVID-19 economy, facing high unemployment levels and loss of employer-sponsored health coverage.
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Premium hikes are not a new phenomenon, either: TYA Prime had a $201 monthly premium in FY 2012, which has more than doubled since. TYA Select started at $176 a month that year and has increased 46% since then. As premiums grow, we are concerned TYA will eventually fail to be a viable solution for military families who need young adult coverage.
The bill has not advanced out of committee since its introduction in June and likely won’t be a part of the legislative scramble expected at the conclusion of the 116th Congress. It is critical that TRICARE evolves to keep up with commercial plan policies so military families have a coverage on par with other employer-sponsored plans. MOAA plans to pick up its fight for the change in law with the 117th Congress come January, Ruedisueli said.