Tricare Users May Pay More

 

Many current Tricare users will likely see higher out-of-pocket fees for care
starting in January due to a new plan announced Thursday.
Tricare for Life and Tricare Prime users are not impacted by the change.

All Tricare Standard and non-activated Guard and Reserve users will see point-of-service fee changes.
This change began on Jan. 1, 2018. The new fee system is part of other,
sweeping Tricare changes also scheduled for January.

Tricare for Life and Tricare Prime users are not impacted by the change.

Currently, both active-duty and retiree Tricare Standard users, as well as Tricare Reserve Select
and Tricare Retired Reserve users pay deductibles based on a “percentage of allowable amount” system.
The amounts differ widely and are based on several factors, including provider location and type of care.
Those fees are paid annually until a user hits his or her “catastrophic cap.”

The new system, which also combines the Tricare Standard and Extra plans into program known as
Tricare Select,” will instead shift those users to a flat point-of-service fee that will count towards
the deductible and annual caps. Those caps are $1,000 for active-duty and Tricare Reserve Select
users and $3,000 for all others.

The new fees will be $21 for primary care and $31 for specialty care for Tricare Select and Tricare
Reserve Select users, and $28 and $41 for both reserve and regular retiree Select users. The annual
out-of-pocket caps are $1,000 for active-duty and Tricare Reserve Select users and $3,000 for all others.

Additionally, some primary and specialty care will be considered “high value” and carry its own
set of lower flat fees. Tricare officials offered no additional information on what that care is
or when that fee information will be released.

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