By now the cat is out of the bag and you’ve probably heard and maybe even read about all of the changes to Tricare coverage for active duty personnel starting in 2018.
But what about the changes to plans offered to military retirees?
Much like the changes for Tricare Prime and Tricare Select (formerly known as Tricare Standard and Tricare Extra), the changes depend on the plan you use.
Yes, there are changes and increases to fees, and yes, there are also some increases in coverage for certain types of care.
The good news is that 2018 will be a transition year for the permanent changes and just as in years past, retirees will be able to switch plans as they wish. However, starting in 2018 for coverage beginning in 2019, Tricare for Retirees and Tricare for Life will see enrollment periods opening once per year and any changes to plan enrollment will need to take place during the open-enrollment period from the middle of November to the middle of December.
Will you be impacted by Tricare changes this year? What’s changing for your health insurance plan?
Changes in Prescription Fees
All beneficiaries will see a change in prescription fees starting in February 2018. A 30-day supply of name brand drugs will run retirees $28, while generics will cost $11. Ninety-day supplies via home delivery will be $24 for name brand and $7 for generics. There will continue to be no co-pay for prescriptions filled at military treatment facilities for eligible plans. Non-formulary co-pays will be $53 for both 30-day retail in-network filled and home delivery.
Changes to the Retiree Dental Plan
The current Retiree Dental Plan will be retired in December 2018. The plan will be replaced with the same plan currently offered to federal employees and more information about the plan and any additional changes will be put out later this year.
Changes to Tricare Retirees – Select
All retirees using Tricare were notified late last year about the enrollment requirement. Enrollment is required in order to continue care. Current Tricare Retirees-Standard (now called Select) will see out-of-network fees charged for any care received without enrollment, so if you use this plan and haven’t already enrolled, take the time to do so. It will save you money if you end up needing care this year.
In addition, Tricare Retirees-Select will continue to see no enrollment fees until 2021. After that an annual enrollment fee will be charged, similar to the Tricare Retirees-Prime fees already in place. These annual enrollment fees will be due in January 2021.
Medical retirees and survivors of service members killed in action using Tricare Retirees-Select however, will be exempt from the fee.
Other changes include upping the the catastrophic cap for retirees using the Standard plan staring in 2021 from the current $3,000 to $3,500.
For Select users starting in January 2018, in-network primary care visits will cost $35 and in-network specialty care will cost $45 per visit. In-network emergency room visits will run $116 per visit and urgent care $35 per visit.
Changes to Tricare Retirees – Prime
Tricare Retirees-Prime will continue to see much of the same coverage currently offered. Annual enrollment rates will see annual increases equal to COLA rates. Enrollment dates and fees will move from October to January starting in 2018.
For any point-of-service visits outside of a military treatment facility, retirees using Prime will pay $20 for in-network primary care and $30 for in-network specialty care. In-network emergency room visits will cost $60 and urgent care, $30.
Changes to Tricare for Life
Retirees using Tricare for Life will see almost no changes to their current coverage. The current $150 (single rate) and $300 (family rate) will remain the same for costs not picked up by Medicare.
Additionally, the catastrophic cap will remain the same. The only change Tricare for Life users will see is a change in the reset date for deductibles and cap. Instead of October, the plan will reset in January just like all of the other Tricare plans starting in 2018.
Tricare has done a pretty decent job of notifying its beneficiaries of the changes and more information about changes to specific plans can be found on their website.
I thought Tricare Prime was allowing urgent care visits with no referral and no co-pay. So why does this say there will be a $30 fee for urgent care?
There has always been a co-pay for urgent care visits, but it was $12.00 last year. So I’m guessing they are now raising that to $30?
For Tricare Prime (for active duty service members and their families) there is no co-pay. This is for Tricare Prime- Retiree, a plan only offered to retirees. Here’s more information about the plan: https://tricare.mil/LifeEvents/Retiring
Anything to screw the veteran
I have triage for life and medicare. I am retired Army 1SG E8. I have been using moncrief army hospital for prescriptions and also triage mail order pharmacy. I have not had to pay any CO pay yet. I have my doctor indicate it is OK to use grenic rather than brand names.
WI’ll this stay the same or am I going to have to pay copay mentioned on rxs?
Please explain why Tricare For Life doesn’t cover eye exams for age 65+ (when it is needed most), but eye exams are covered by Tricare Prime before age 65. I can’t even get an eye exam from my local Military Treatment Facility because I’m not in their care program. I’m in desperate need of an eye exam.
I have the free after you pay for it on your Social Security Tricare but they do not always pick up the co pay. I pay for 3 health insurance policy’s an still have to pay for dental an eye care particularly refraction’s an glasses. Blue Cross Blue Shield. does not pay these only a few dollars on the dental an no refraction paid. Now I have had at least 4 eye surgeries that they have on their records including cataract and lens implants plus laser later an still they deny paying refraction when they want to do surgery on one eye. I have not had the surgery done. or been to the eye doctors since they denied the refraction payment. Medicare does not pay for it an TriCare the same. TriCare also does not allow me the delivery or other perks if you will because I have a pharmacy benefit on another plan so have to go outside or the base to get my medicines and the base does not carry all of the medications so I go outside an have someone pick up my medicine since I no longer drive. Lovely pay for it an this is what you don’t get. Like they denied paying for the gall bladder an appendix done at the same time because they made one long incision instead of 2 smaller incisions How many gall bladder an appendix do you have? Have no love for insurance companies They pay until you got a claim then you really find out what you are paying for
Today I learned I was NOT enrolled in Tricare Select as I was assured I would be, and dropped into US Family Healthcare Program! And guess what? They dropped me into a plan that isn’t even covering my state! After HOURS on the phone today, I got nothing done. What a nightmare!
So much for the cost of living raise when you have two adult retirees in the family both needing multiple meds. Now we’ll be behind and not ahead even with the cost of living raise. Then you’ll do away with our Dental insurance rates in December. I was going to complain a lot more here but decided just to give this all over to GOD. He knows what sacrifices the men and women who gave 20 or more years in service to this country in the military have already given. More handouts to illegals and to foreigners who get free college educations than to our own retired military.. A real shame and black mark on the U.S.A. in my personal opinion.
We are very, very, very unhappy with the new Tricare provider, Health Net. Evidently, the people that chose this company DO NOT CARE about retired veteran and their service to this Country. On Tricare Prime, everything is worst….NOT better despite all the hype! The copay has doubled and the hospital stay charge has increased six-fold. Health Net is one of the worst rated Healthcare companies as far as patient satisfaction. Guess our elected (LOL) official care more about $$$ than the people that actually served this country!
I see a lot of questions and comments. Does anyone from TRICARE ever answer back???
Hi Lawrence,
You will have to contact Tricare directly for any unanswered questions you may have. https://www.tricare.mil/
Best,
Military Shoppers