TRICARE recently released comparison charts to help beneficiaries see what rates are rising in 2021, and the biggest change should come as no surprise to regular MOAA.org visitors: The addition of TRICARE Select fees for Group A members.
MOAA has worked to inform its members of this change for months, as have Defense Health Agency (DHA) officials. We’ve also fought successfully to extend the reinstatement period for beneficiaries, allowing them 180 days to seek reinstatement and secure retroactive coverage if they miss the Jan. 1, 2021, deadline.
You can learn more about the TRICARE Select fees at the links above, and you can access the official TRICARE cost-comparison documents, in PDF format, at the links below:
[RELATED: MOAA’s TRICARE GUIDE]
Catastrophic Cap Updates
Aside from the TRICARE Select fees, the largest year-over-year difference on either chart comes from the TRICARE Select Group A catastrophic cap, which jumps to $3,500 in 2021, up from $3,000 in 2020. The new annual enrollment fee ($150 for individuals, $300 for families) will apply to the cap.
The catastrophic cap for TRICARE Prime Group A members remains $3,000 for 2021. Group B beneficiaries in both TRICARE Prime and Select will have a $3,703 cap in 2021, up from $3,655 in 2020. Under both plans, Group A includes those whose sponsor entered service before Jan. 1, 2018; other beneficiaries fall into Group B.
For active duty family members, the TRICARE Prime and Select Group A cap remains $1,000, while the Group B cap increases to $1,058 in 2021 under both plans, up from $1,044.
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What Else Is Changing?
Review the charts above to check out your specific plans, but services such as medical care visits, inpatient admission, and specialty care services either went unchanged or rose in small increments, usually no more than a dollar. Primary care costs remained unchanged from 2020 for TRICARE Select beneficiaries, for example, while TRICARE Prime users will pay $21 for such visits in 2021, up from $20.
The largest of these upticks comes with emergency room visits – TRICARE Select Group A beneficiaries must pay $125 for an in-network visit in 2021, up from $118 in 2020. The out-of-network cost remains at 25%.
MOAA has provided details on other TRICARE programs in previous weeks, including a review of TRICARE Young Adult cost changes and good news for TRICARE pharmacy users. Get the full 2021 Cost and Fees Sheet at this link.
If you’re trying to figure out what these changes mean for your future coverage options, or if you have other questions on TRICARE or your medical benefits, check out these links to start your research:
- MOAA’s TRICARE Guide includes details on all types of coverage, videos answering frequently asked questions, and step-by-step guidance for beneficiaries at critical life stages – those nearing retirement from service and those nearing age 65.
- MOAA’s Health Care Resources page offers additional TRICARE materials, links to MOAA Insurance offerings, and the latest military and veteran health care news.
- Health.mil and TRICARE.mil have an array of pages with official benefit guidance, including a details on the ongoing TRICARE Open Season and a Plan Finder to help beneficiaries determine which plan (or plans) they can access.
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