washingtonscene Fee Component
Annual Enrollment Fee
Annual Deductible Doctor Visit Copays2 Rx Copays3 Yearly Total
Retiree Family of Four — TRICARE Prime 1 2018
2016
$565 None $72
$188 $825
Fee Component
Annual Enrollment Fee
Annual Deductible Doctor Visit Copays2 Rx Copays3 Yearly Total
2016 2018
In Network $700
None $310 $260
$1,270
Out of Network $700
$600 --
$260 $1,560
Retiree Family of Four — TRICARE Standard 1 2018
2018
None $300 $338 $188 $826
In Network $900
None $355 $260 $1,515
Out of Network $900
$600 --
$260 $1,760
1 Under proposal, TRICARE Prime will be known as TRICARE Select and TRICARE Standard will be known as TRICARE Choice.
2 Assumes six primary care visits, three specialty-care visits, and one outpatient surgery. 3 Assumes two brand-name and two generic prescriptions a month (initial fill retail; refills by mail-order). Source: FY 2017 presidential budget request
Fee Component
Enrollment Fee Deductible1
Network Copays2 Rx Cost Shares3 Yearly Total
Currently Serving Family of Four 2016
TRICARE Standard
$0
$300 $0
$188 $488
TRICARE Prime
$0 $0 $0
$260 $260
2018 TRICARE Reform
or Fee Increases? The president’s budget would hike beneficiary costs.
T
he FY 2017 budget request details a wide variety of fee changes and increases for TRI-
TRICARE Standard
$0 $0
$195 $260 $455
1 Under proposal, deductibles apply for out-of-network care only. 2 Assumes eight network visits a year (three primary care, two specialty care, two urgent care, one ER). 3 Assumes two brand-name and two generic prescriptions a month (initial fill retail; refills by mail-order). Source: FY 2017 presidential budget request
The charts show the effect of proposed fee changes on annual costs experienced by retired versus currently serving families.
34 MILITARY OFFICER APRIL 2016 2018
CARE, including: rebranding TRICARE Prime and TRI- CARE Standard as TRICARE Select and TRICARE Choice, respectively (for clarity purposes, we’ll still refer to them as Prime and Standard in the discussion below); changing most copayments for network- provider visits to flat fees (out-of-network care would continue to have copayments of 20 percent for active duty family members and 25 percent for military retirees and family members); establishing for all retired servicemem- bers and their families new annual “partici- pation fees,” under which those who don’t pay the fee would be denied coverage for the year; and establishing a zero deductible for Stan- dard and Prime beneficiaries who use in- network providers but a $300/$600 (single/ family) annual deductible for care from out- of-network providers; raising maximum out-of-pocket expens- es to $1,500 a year for currently serving families and $4,000 for retired families (versus current $1,000 and $3,000); roughly doubling most pharmacy copay- ments over a 10-year schedule; increasing all flat-dollar fee amounts an- nually by medical inflation; implementing a new TRICARE For Life enrollment fee (see page 36); and exempting from the higher fees and copayments medical (Chapter 61) retirees and survivors whose sponsors died while on active duty.
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92