rapidfire
TRICARE Choices Retirement Living
P
reparing to retire from active duty? You might be wondering what your health care choices will be and how your TRICARE benefits will change.
In a nutshell, your choice depends on where you live and the services your family might need down the road. Retirees essentially have two plan options: TRICARE Prime or TRICARE Standard. The quick version of the differences is that TRICARE Prime is most cost-effective, while TRICARE Standard gives you greater choice. The list (below) is not comprehensive but will give
you a better idea of the most significant differences in TRICARE coverage.
TRICARE Prime has an annual enrollment fee of
$282.60 a person or $565.20 a family; TRICARE Stan- dard has deductibles of $150 a person or $300 a family, plus cost shares based on the type of care provider you see (network versus non-network). With either plan, the
catastrophic cap increases from $1,000 to $3,000 annu- ally per family. In the fiscal year you retire, any amounts accrued on active duty apply to your retired family cap. By default, retirees have TRICARE Standard — no
action required. However, TRICARE Prime follows the 20th-of-the-month rule for enrollment, meaning you must submit your application by this date for care to begin on the first of the following month. As you make your health care election, ask yourself some important questions: Are you a frequent user of the benefit? Is distance a consideration? Do you prefer select- ing your own providers? Does your family have unique health care concerns? These questions, among others, will help determine which plan best fits your needs. For additional information about TRICARE options upon active duty retirement, visit
www.tricare.mil/ lifeevents/retiring.
TRICARE Prime Versus TRICARE Standard: Cost and Benefit Comparison for Retirees TRICARE Prime $0
TRICARE Standard* Annual Deductible
Annual Enrollment Fees Office Visit Copayment Surgery (Outpatient) Care Hospital (Inpatient) Care
$150/person or $300/family
$283/person or $565/family N/A $12 per visit $25
$11 per day ($25 minimum charge)
Emergency Room Visit Urgent Care Visit Ambulance Services
$30 $12
$20 per occurrence
25% of TRICARE-allowed charges 20% of negotiated fee
$250 per day or 25% cost-share (whichever is less), plus 20% cost-share of professional fees 20% cost-share 20% cost-share 20% cost-share
*All fees listed assume in-network care
online: Find comprehensive information regarding TRICARE in retirement at
www.moaa.org/health. IMAGES: SHUTTERSTOCK
MARCH 2016 MILITARY OFFICER 23
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