Updates to TRICARE Programs

Last week, leadership from the Department of Defense, Health Affairs (HA) presented an executive briefing to provide updates on current programs and future initiatives. This quarterly meeting was hosted by Rear Admiral Christine Hunter, Deputy Director TRICARE Management Activity (TMA). ROA was represented by legislative director, CAPT Marshall Hanson, USNR (Ret.). Below is a review of major projects currently underway:

TRICARE Young Adult (TYA) Coverage: Nearly 6500 TYA plans have been purchased under TRICARE standard. Unmarried dependents who are not eligible for other employer coverage, can continue on TRICARE at age 21 (or 23 for full-time college students) for $186/month. Coverage is retroactive to Jan 1, 2011 if past premiums are paid, but retroactivity coverage ends on October 1, 2011. TMA takes pride in starting a new health plan in 4.5 months, claiming that learned a lot from implementing TRICARE Retired Reserve. While DoD/HA had set the goal of opening up a TRICARE Prime option by the Oct. 1, the complexity of implementing numerous health plans that are under Prime, are delaying the startup, but the option has been promised by the end of the year.

Status of TRICARE Reserve Select (TRS): ROA posed a question regarding beneficiaries having access to the Continued Health Care Benefit Program (CHCBP). CHCBP is DoD’s version of Cobra transitional health coverage which would allow Reservists to continue access to health care should the lose TRS. ROA was assured that the final federal rule has been signed and with publication the availability date will be known.

Medical Readiness: An issue which remains a challenge for the Reserve Components. The Army National Guard and Army Reserve face the greatest challenge, with the Navy and Air Force Reserves and the Air National Guard meeting or exceeding the medical readiness goal of 80 percent. TRS has helped in readiness, with enrollment increasing. Reserve Component members are better informed about this program then they were just two years ago. Ninety-seven percent of TRS enrollees would recommend TRS to others. Forty-eight percent of enrollees say TRS is a factor in their decision to remain in the Guard and Reserve. Awareness is poorest among 18-24 year olds.

T-3 TRICARE Contract: Two regions have been awarded in the North and the South and the new contract will begin April 2012. While a lawsuit was filed of the award in the South region, DoD officials are confident that it won’t change the award. In the West Region, GAO upheld the protest and United Health Group and TriWest will be submitting updated information to refresh their bids for reconsideration in August.

The Active Duty family member dental contract was awarded to Metlife, and a court challenge of the award was denied on 6-24-2011. Reserve Component members and their families can enroll in this program. The new contract will start in the Spring and will include additional coverage and benefits.

DoD ID Numbers as Primary Identification: As Military IDs are used for medical access, social security numbers are being replaced with DoD ID numbers. DoD benefits numbers will be printed on the back of new ID cards for TRICARE eligibles. The cycle to replace cards is expected to take 4 years, although retirees with indefinite expiration dates will have cards replaced as needed.

Expanded Vaccine Coverage: Beginning in Fall 2011, vaccines will become available from network pharmacies with zero co-payment. Up until now, H1NA, seasonal flu and pneumococcal vaccines were covered. Other vaccines had to be administered under medical coverage. Added to the pharmacy benefit will be Hepatitis A and B, Hib, Tetanus, diphtheria and pertussis (whooping cough), Polio, Rotavirus, Measles, mumps and Rubella, Chicken Pox, Meningitis, Shingles, HPV, and Tetanus booster. Vaccines can still be administered during physician visits under the TRICARE medical benefit.

TRICARE Pharmacy Home Delivery: The program continues to be an optimum means for maintenance medications. Participation grew by 10 percent in 2011. The service provides an auto refill, and Express Scripts who manages the contract will contact a beneficiary’s doctor to authorize a refill. TRICARE Express RX is a new app which allows beneficiaries to utilize their mobile smart phones to access home delivery services from their phones. More information of this service is available online.

For more information on ROA's legislative efforts involving TRICARE and other service member healthcare issues visit our listing of current issues.