Future TRICARE contracts could weaken overseas programs, complicate enrollment processes for military families, and continue long-standing challenges with pharmacy access, according to a recent letter to the head of the Defense Health Agency (DHA).

The April 24 letter from The Military Coalition (TMC), a group of military and veterans organizations including MOAA with more than 5.5 million combined members, addresses issues with upcoming TRICARE Overseas Program, TRICARE Dental Program, and TRICARE Pharmacy Program preparations, outlining “significant concerns” in each instance.

These concerns are at the heart of MOAA’s efforts to preserve service-earned benefits; we will continue our work alongside fellow TMC members and independently on these fronts and others to address access-to-care issues.

[READ THE LETTER]

Among the items raised in the letter to DHA Director Vice Adm. Darin K. Via, USN:

Overseas Care: Plans “to rely on artificial intelligence, third-party agents, and telehealth” as part of 2028 TRICARE Overseas Program contract preparations raised red flags for the coalition, which also took issue with a lack of protections for existing specialized services and resources.

The program is used by more than half a million beneficiaries, including retirees living abroad and servicemembers and families stationed overseas.

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Dental Care: The voluntary TRICARE Dental Program (TDP) covers more than 1.7 million beneficiaries, including active duty family members as well as reserve component members and their families. Plans for the upcoming TDP contract could make navigating this process more difficult:

• Decentralization: The TDP contract procurement documents ask potential carriers about handling their own administrative tasks, which could lead to the creation of individual websites with plan information, instead of a single, easy-to-use web portal.
  
  
• Auto-enrollment: The new contract could automatically enroll beneficiaries who do not select a specific plan – an approach designed to limit unintended disenrollments that could serve to lock beneficiaries into unwanted coverage.
  
  
• Open season changes: The new contract could establish an enrollment period outside the traditional November-December TRICARE open season, “creating confusion and an additional deadline for military families who already deal with significant stressors unique to military life,” according to the letter.

TRICARE Pharmacy: Requirements for the next pharmacy contract, known as TPharm6, do not restore the brick-and-mortar pharmacy network, which shrank from 55,000 to 42,000 after a restructuring that included about 15,000 community pharmacies leaving the network.

While the network remains above the 35,000-pharmacy threshold set by the TPharm5 contract, The Military Coalition recommends restoring a 50,000-pharmacy minimum to “reverse the cut in network pharmacy access and prevent even further pharmacy network erosion in the future.”

Keep up with the latest in MOAA advocacy, and find out how to reach out to your lawmakers on access-to-care issues and other legislative priorities, by registering at MOAA’s Legislative Action Center.