TRICARE Toolkit: Comparing TRICARE With Civilian Coverage

TRICARE Toolkit: Comparing TRICARE With Civilian Coverage
krisanapong detraphiphat/Getty Images

MOAA’s TRICARE Toolkit provides insight and tips for navigating your TRICARE benefits. Have a question or suggestion for an upcoming column? Email beninfo@moaa.org. Read other TRICARE Toolkit columns at MOAA.org/tricaretoolkit.

 

Military retirees and surviving spouses and their families have experienced significant cost-share increases for their TRICARE benefits, with COLA increases of 5.9%, 8.7%, and 3.2% over the past three years.

 

Increases in pharmacy costs, copays, and catastrophic caps and a new enrollment fee for TRICARE Select users continue to erode the overall benefit. MOAA perseveres as an advocate leader in ongoing efforts against insidious and disproportional cost-sharing increases to this hard-earned military service benefit.

 

[RELATED: TRICARE For Life, Star Act, Housing Help Will Anchor MOAA’s Spring Advocacy Push]

 

To have continued success with defending and defeating battles with DoD and Capitol Hill influencers against TRICARE fee increases, it’s important MOAA members and supporters understand what their civilian counterparts pay for comparable employer-provided health care coverage.

 

In 2023, the average employer-provided family health care plan cost $23,968, a 6.7% increase from 2022. Family coverage premiums have increased 22% since 2018 and 47% since 2013. Employees covered under these plans typically pay 29% of the overall cost or $6,575 a year ($548 a month), according to the Kaiser Family Foundation and Health Research and Educational Trust 2023 Annual Survey of Employer Health Benefits.

 

TRICARE Retiree vs. Employer-Provided Family Costs (2023)

  • TRICARE Prime: $726 annual premium; $0 deductible; $3,000 catastrophic cap; $726-$3,000 min/max out of pocket.
  • TRICARE Select: $356 annual premium; $300 deductible; $4,157 catastrophic cap; $356-$4.157 min/max out of pocket.
  • Employer Provided*: $6,575 annual premium; $3,000 deductible; variable catastrophic cap; $6,575-$9,575 min/max out of pocket.


* Kaiser Family Foundation and Health Research and Educational Trust 2023 Annual Survey of Employer Health Benefits

MOAA's TRICARE GUIDE MORE ON TRICARE FOR LIFE

Health care costs are projected to increase at 5.4% a year until 2031, driven by inflation in the cost of medical services and products and an aging U.S. population, according to a 2021 Centers for Medicare and Medicaid Services study.

 

Although we will have a respite in new health care fee increases in the FY 2024 National Defense Authorization Act (other than COLA), TRICARE fee battles will remain on our radar screens for the foreseeable future. Our civilian counterparts pay significantly higher premiums and deductibles for a comparable health care benefit.

 

MOAA makes every effort to convey our shared belief that retiree, family, and survivor health care benefits were earned through long years of
service and sacrifice. Preserving a strong military health care program is critical to maintaining an all-volunteer force.

 

MEDIPLUS® TRICARE Supplement 

Works hand-in-hand with your Select or Prime Plan. Count on valuable protection. 

Enroll Now

Related Content

About the Author

Capt. Paul J. Frost, AFC®, USN (Ret)
Capt. Paul J. Frost, AFC®, USN (Ret)

Frost co-leads MOAA's Financial and Benefits Education program and is also an accredited Veteran Service Officer (VSO), providing VA disability compensation claim and appeal information and advice to the military community.