‘We Just Can’t Pay for It’: Help MOAA Rein in TRICARE Mental Health Costs

‘We Just Can’t Pay for It’: Help MOAA Rein in TRICARE Mental Health Costs
Photo by Vichai Phububphapan/Getty Images

As part of this year’s Advocacy in Action (AiA) campaign, MOAA is building support for a key House bill designed to prevent military families from making painful choices surrounding mental health care.


[TAKE ACTION: Help Support Military Family Access to Mental Health Care]


A participant at an Elizabeth Dole Foundation Impact Forum outlined just such a choice: She and her children – including an 11-day-old infant – moved to Walter Reed National Military Medical Center to help care for her husband, injured by enemy forces in Afghanistan, and stayed for nearly a year.


Relaying her story to the 2019 forum attended by MOAA and other advocacy groups, the spouse, identified by just her first name, explained how a change in health care coverage made an already stressful situation even worse.


“(Our children) need therapy to deal with living with the effects of war,” Jacqueline said. “But one thing that happened recently, though, was we had to cut our son’s therapy in half because TRICARE doubled our copay. So, he’s not getting the amount of mental health care and our daughter can’t get anything beyond what she’s just getting at the (traumatic brain injury) clinic because we just can’t pay for it.”


The price hike, Jacqueline said “devastated us.”


Securing an Earned Benefit

The Stop Copay Overpay Act, H.R. 4824, would reduce TRICARE copays for mental health visits to address the financial barrier to accessing mental health care faced by military retirees and many active duty families.


[RELATED: More From MOAA's Advocacy in Action Campaign]


These copays continue to rise after more than doubling from 2017 to 2018. At $28-38 per visit for most active duty families on TRICARE Select and $33-50 per visit for most retirees and their families, TRICARE’s mental health copays are significantly higher than those in commercial plans. The average mental health copay for Federal Employee Health Benefits Program (FEHBP) plans, for example, is $20 per visit.


Servicemembers and retirees have earned a comprehensive, high quality health care benefit for themselves and their families through service and sacrifice, yet they face excessive out-of-pocket costs for critical mental health care.


DoD has made great effort to reduce the stigma associated with seeking mental health care, but these advances are undermined by cost-prohibitive copays – particularly when you consider the cumulative impact of repeated visits typical of most mental health treatment plans.


To learn more about TRICARE mental health copays and this legislative fix, please see our issue paper (PDF download) on the Stop Copay Overpay Act.


Your Action Makes a Difference

We are in the early stages of seeking a legislative fix for TRICARE mental health copays, and our current goal is widespread awareness leading to increased co-sponsors. In this way, the issue is a great fit for AiA – MOAA members have the potential to make a huge impact because nearly every office visited is a possible new co-sponsor.


We appreciate all the effort by MOAA’s AiA teams to organize participants, learn the issues, schedule visits, meet with lawmakers and congressional staff, and report back on those discussions.


Please consider supporting our spring advocacy campaign by writing your lawmakers and asking them to co-sponsor the Stop Copay Overpay Act.


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About the Author

Karen Ruedisueli
Karen Ruedisueli

Ruedisueli is MOAA’s Director of Government Relations for Health Affairs and also serves as co-chair of The Military Coalition’s (TMC) Health Care Committee. She spent six years with the National Military Family Association, advocating for families of the uniformed services with a focus on health care and military caregivers.