Ask yourself if fee increase makes Tricare worth it

Since 01-05-06

From: Waspscpo@aol.com
Sent: Wednesday, January 04, 2006 1:31 PM
To: undisclosed-recipients:
Subject: Ask yourself if fee increase makes Tricare worth it


January 09, 2006
Air Force Times

U.S. Military (Ret.): Ask yourself if fee increase makes Tricare worth it

By Alex Keenan
Special to the Times

One of the first things on a new retiree’s checklist after leaving active duty is health care. Will my family be protected? How much will it cost? Do I need supplemental insurance?
Reasonable questions, and not always easy to answer.

Many retirees start a second career and enroll in their new employer’s health care plan. Others stay with Tricare and are comfortable with the process. Regardless, the one question you must ask yourself, whether you are a new military retiree or a seasoned one: Does your current health care program cover all costs?

Recently, the Defense Department drafted plans that will increase Tricare enrollment fees and deductibles for 3 million retirees under age 65 and their families to help slow the government’s increasing cost of health care. One aim of this proposal is to encourage working-age retirees to enroll in an employer’s program or switch to other available plans.

If the proposed increases occur, Tricare Prime would triple in cost by October 2008 for retired officers under age 65 and double for retired enlisted members. First-time retirees who use Tricare Standard would pay an enrollment fee in addition to their deductible.

The co-payment for prescription drugs would be raised, regardless of a retiree’s age or whether they use the Tricare mail-order program or the retail drug network to buy brand-name drugs.

Dr. William Winkenwerder Jr., assistant secretary of defense for health affairs, has said that some civilian employers are offering their retired military workers cash incentives to use Tricare instead of company insurance. Some retirees have no choice except to use the Tricare program. Others have options. As with any new program, the key is to get all the facts.

With the proposed increase, is Tricare coverage still a good deal? I recommend you get all the information you can on your own and compare prices. Some employer health care programs provide the employee with limited options. The following questions will guide you toward the best purchase:

• Must I meet a deductible before the plan begins to pay?
• Is there a maximum limit on benefits?
• Is there a pre-existing condition clause?
• Is there a waiting period before the policy becomes effective?
• Will the plan cover amounts beyond what Tricare allows?
• Does the plan pay for services that aren’t covered by the policy?
• Does the plan specifically not cover certain conditions?
• Must certain kinds of care be approved before treatment?
• Is inpatient care covered?
• Is there outpatient or long-term care coverage?
• Will the plan pay the outpatient deductible?
• Will a new plan pay the same as my cost-share under the Tricare diagnosis-related group payment system?
• Will the plan cover enrollment fees or co-payment?
• Does the plan offer reduced premiums or premium adjustments if I participate in managed health care plans?
• Does the plan convert to a Medicare supplement? If so, must it be in force for any specified length of time before conversion?
• Will the plan cover me overseas?
• How will the plan require premium payments? Monthly? Quarterly?
• Can premium payments be increased?
• Does the plan offer rates based on military retired status or based on an age scale?
• Does coverage continue for surviving spouses at no charge?
• What’s the time limitation, if any, for filing a claim?
• If I am a smoker, does the plan have higher rates?

The proposed increase for Prime enrollment users would be raised from $230/$460 to $400/$800 (individual/family) in October 2006, to $600/$1,200 in October 2007 and to $750/$1,500 in October 2008 for retired officers under age 65. Enlisted retirees under 65 would see Prime enrollment fees increase to $300/$600 in October 2006, to $375/$750 in 2007, and to $450/$900 in 2008.

The Defense Department has expressed concern over a recent influx of military retirees into the Tricare program and away from employer-provided health care. Certainly, this concern shouldn’t override the promise Congress made to its sons and daughters who wore the military uniform, protected our country, and gave their all when unique demands were placed upon them and their families. Unfortunately, our military retirees will have to dig deeper into their pockets.

Alex Keenan, a retired command master chief petty officer, served 28 years in the Coast Guard. E-mail him at retired@atpco.com.


Any man or woman who may be asked in this century what they did to make life worthwhile in their lifetime....can respond with a great deal of pride and satisfaction, "I served a career in the United States Navy."