TRICARE coverage gaps are growing, and servicemembers and their families are feeling the impact, MOAA and The Military Coalition (TMC) cautioned in a July 22 letter to Defense Health Agency (DHA) leadership.

While coverage should keep pace with Medicare and top private-sector plans, “We are concerned that TRICARE is falling short of that benchmark in some key areas, leaving service members and their families without access to commonly covered treatments,” the letter states.

TMC, a group of military and veterans service organizations, represents a combined 5.5 million-plus members. MOAA co-chairs the coalition and many of its committees, including the health care committee.

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The letter highlights the two most recent TRICARE coverage gaps to emerge relative to other government payers and high-quality commercial plans:

• Dozens of health plans, including Medicare and the VA, cover JAK inhibitors such as Litfulo for patients with alopecia areata, an autoimmune disorder that leads to hair loss. TRICARE, unlike benchmark plans, does not cover treatment for hair growth despite the documented disfigurement and emotional and psychological trauma of patients with alopecia.
  
  
• Laser Interstitial Thermal Therapy (LITT) is the standard of care for a variety of conditions, including gliomas, brain metastases, and drug-resistant epilepsy. However, unlike Medicare and many commercial payers, TRICARE considers LITT to be unproven and does not cover it, requiring TRICARE beneficiaries to undergo more invasive (and expensive) procedures.

The letter also details several long-standing gaps in TRICARE coverage, including chiropractic and acupuncture for non-pharmaceutical pain management, assisted reproductive technology/in vitro fertilization, residential treatment facility treatment for eating disorders for beneficiaries over age 21, and coverage for young adult dependents up to age 26. It urges DHA leadership to fix TRICARE coverage gaps as MOAA and other coalition members take our concerns to Capitol Hill to seek greater congressional oversight of TRICARE.

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“We understand the need to contain health care spending by the Department of Defense,” the letter states. “However, America’s military families have the right to expect a health care plan that keeps pace with commonly accepted treatments and best practices.”

TMC recently had success in ongoing efforts to ensure TRICARE coverage keeps up with evolving technologies, treatment protocols, and commercial plan benchmarks when DHA announced five-year provisional coverage for Leqembi, a drug to treat early stage Alzheimer’s disease.

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