The New Year brought several changes to TRICARE, the health care program of the U.S. Department of Defense Military Health System. Changes that went into effect Jan. 1, 2018 were briefed during a town hall at Kirk U.S. Army Health Clinic, Jan. 24.
Deb Dodsworth, Health Benefits Advisor, briefed community members in the Ortiz Training Center. She said the group most affected by the changes is military retirees younger than age 65.
On Jan. 1, 2018, The North and South regions combined into the new East Region; regional contractors changed from Health-Net to Humana. As of Jan 1, 2018 enrollment will be required for all TRICARE plans.
“You are now enrolled the same day you call or do your application on line,” Dodsworth said. “No more waiting for the twentieth of the month.”
Additionally, premiums are based by calendar year now instead of the fiscal year as in the past. This means if you are not enrolled, TRICARE will pay for one episode of health care and give you the opportunity to enroll with either TRICARE Prime, Select or Tricare for Life. Anyone who declines to enroll will pay for all medical care off post if they do not have another civilian plan.
“TRICARE is still the most affordable health care you can find; it is a phenomenal benefit,” Dodsworth said.
She added that for those paying their TRICARE Prime payment by allotment, those allotments were re-directed from Health-Net to Humana.
“If you paid by Electronic Funds Transfer from your bank, you needed to contact Humana to have your information re-routed to Humana as with credit card payments,” she said.
For more information, call 1-800-444-5445.
TRICARE Select replaced TRICARE Standard and TRICARE Extra. Tricare for Life, primarily for those with Medicare A and B and over 65 years of age or disabled, remained pretty much the same. TRICARE Select now has standardized copays for network providers who pay 20 percent of the bill for non-network providers. Dodsworth said enrollees save money using network providers.
“The TRICARE cost and fees also increased for retirees, “she said. “A good thing to remember is that KUSAHC has extended clinic hours from 6:30 a.m. to 6: p.m., Monday through Thursday. On Friday the clinic is open until 4:30 p.m. The pharmacy stays open until 5 p.m.
“So, primary care, physical therapy and the pharmacy are open and free,” she said.
Enrollees are now members of Group A or Group B. Group A is any service member who joined or was commissioned in the Armed Services prior to Jan. 1, 2018. Group B is for all other service members who joined after Jan. 30, 2018. For example, you can be Group A Prime, Group B Prime for coverage.
TRICARE Referrals and the Explanation of Benefits are now all on line. Those who want referrals mailed to their homes should go to https://www.humanamilitary.com/ and make the change or call Humana at 8 a.m. to 6 p.m. daily at 1-800-444-5445.
As of Feb. 1, TRICARE pharmacy copayments will change. For example, for Retail Network Point of Service, the copay is $11 for generic, $28 got name brand, and $53 for non-formulary; copays for home delivery in the same categories are $7, $24, and $53 respectively. Remember, with home delivery this is the fee for 3 months’ worth of medicine as compared to the one month supply at the retail pharmacy.
Active duty military are not affected by this change. For more information, go to https://tricare.mil/Plans/HealthPlans.
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According to Tricare.mil, TRICARE has also improved access to urgent care and increased coverage for medically necessary foods and vitamins.
And TRICARE Select beneficiaries now have access to additional preventive care services without copay when received from network providers.
These changes can be complicated and confusing, Dodsworth said, and everyone affected should contact TRICARE online representatives for explanations.
For more information about TRICARE changes for 2018 and beyond, visit the website at https://tricare.mil/Changes or call Humana at 1-800-444-5445.