January 12, 2018

As we start off new year, it's dawning on beneficiaries - if they previously were unaware - that big changes are occurring in the TRICARE program. The key changes are:

  • consolidation of TRICARE's existing three regions into two (East and West);
  • consolidation of TRICARE Standard and Extra into TRICARE Select;
  • shifting of TRICARE operations to the calendar year (beginning Jan. 1) rather than the fiscal year (beginning Oct. 1);
  • new enrollment requirements starting with an open enrollment period in December 2018; and
  • a new cost structure for TRICARE Select and some fee increases in TRICARE Prime.

Over the past several weeks, MOAA heard loud and clear from beneficiaries who examined these new fees - especially those associated with the TRICARE Select option - and became concerned with the impacts of these fee increases.

In regards to this new cost structure, MOAA led an effort encouraging the Defense Health Agency (DHA) to be transparent in how it calculated these new fees - and we succeeded. MOAA's advocacy has resulted in some fee reductions.

As we had anticipated, the DHA used an incorrect methodology in some of its fee calculations. Upon a reexamination, several fee categories in TRICARE Select for both active duty family members (ADFM) and retirees were revised to be lower.

For example, in the “grandfathered” Group A, ADFM primary care and specialty care visits (in network) were reduced from $27 to $21 and $34 to $31, respectively. For retirees, the same visits were reduced from $35 to $28 and $45 to $41. Click here and choose your plan for more detailed information on all of the cost changes.

“We are thankful the DHA listened to us and reexamined the way they determined these new fees. As we had suspected, they discovered some flaws in their calculations, and this resulted in lower fees for our beneficiaries,” said Capt. Kathy Beasley, USN (Ret), MOAA's director of Government Relations for health affairs.

The bottom line on this story is MOAA's persistence in its advocacy pays off - for you. Keep us informed of your experiences and opinions on TRICARE via discussions on MOAA's Facebook page so we can better represent you on Capitol Hill.