6 Ways MOAA Wants to Improve Your Earned TRICARE Benefit

6 Ways MOAA Wants to Improve Your Earned TRICARE Benefit
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Access-to-care issues aren’t limited to TRICARE beneficiaries, especially as the entire health care industry looks for solutions to crisis-level staffing problems. But there are specific concerns faced by the Defense Health Agency (DHA), and while MOAA understands DHA can’t fix every problem or fill every billet, we remain concerned about ongoing access challenges.


MOAA brought these concerns to a recent Military Family Readiness Council (MFRC) meeting focused on changes to health care policy and implications for military families. The June 17 event chaired by Ashish Vazirani, performing the duties of the undersecretary of defense for personnel and readiness, included a summary of recent and ongoing reforms to the military health system (MHS), short-term mitigation to constrained access, and details on DoD’s strategy to stabilize the MHS.


[RELATED: Support Military Family Access to Children’s Hospitals]


It also offered organizations like MOAA the chance to provide materials to the council as it prepares its recommendations to DHA. To benefit those who’ve earned “world-class care” – as noted by DoD leadership in a recent statement to Congress – we put forward the following steps:

  • Standardize and Streamline Appointments: DHA has yet to install such a system despite it being required in the FY 2017 National Defense Authorization Act (NDAA). Per the law, the system should be used by all military treatment facilities (MTFs) and should “ensure the needs of the covered beneficiary are met during the first … telephone call.”

  • Improve Transparency: Introduce a digital assistance system to allow beneficiaries to report barriers to access. Such a system would allow DHA to address systemic issues unrelated to capacity constraints and other issues faced by the wider health care industry.

  • Allow More Plan Flexibility: Simply put, beneficiaries must have the option to leave an MTF that does not meet their needs and seek care where it is available. MOAA recommends expanding TRICARE Qualifying Life Events (QLEs) to include pregnancy and access issues.

  • Continue Urgent Care Support: DHA must maintain referral-free urgent care for TRICARE Prime families. Civilian urgent care clinics have provided a critical relief valve as MTFs have struggled with staffing shortages.


[RELATED: Your TRICARE Urgent Care Benefit]

  • Increase Network Oversight: There are areas where providers have the capacity to support beneficiaries seeking care outside understaffed MTFs, but they aren’t part of the TRICARE network. Some network issues, such as pediatric provider shortages raised by a council member in Newport, R.I., may be addressed by the next generation of TRICARE contracts (T-5) scheduled to start Jan. 1, 2025.

  • Maintain Parity With Private Plans: DHA must ensure TRICARE keeps up with evolving technology and treatment protocols, federal health insurance requirements, and benchmarks established by high quality commercial plans. MOAA recognizes some TRICARE updates require legislation and will continue to advocate with Congress for fixes to TRICARE young adult and similar issues.


[TAKE ACTION: Urge Your Elected Officials to Fix the TRICARE Young Adult Coverage Gap]


MOAA appreciates MFRC and DoD leadership efforts to secure the health care servicemembers and retirees, as well as their families and survivors, have earned and deserve.


Have More Questions About Your Health Care Benefit?

MOAA's TRICARE Guide answers some commonly asked questions.


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.