TRICARE Troubles Looming
January 30, 2012 | Terry Howell
TRICARE Prime fee increases, limited access to military treatment facilities, and fewer civilian care providers are likely to be an issue in 2012 and beyond.
TRICARE Prime Fees for Military Retirees — As reported last week, Secretary of Defense Leon Panetta gave a sneak peak at the DoD’s proposed FY2013 budget and his long term plan to reduce defense spending by approximately $259 billion over the next five years.
According to the Military Officers Association of America, TRICARE working age military retirees will take a significant hit under the proposed defense budget.
MOAA reports that the proposed changes include tiered enrollment fees based on a retiree’s rank. This means that senior grade retirees would pay more for their health care than junior retirees. MOAA points out that this “tiered approach would make military retirees the only group of government retirees subject to health care means-testing.”
BRAC Could Impact Access to Military Treatment Facilities – The DoD’s budget proposal also asks Congress to make another round of Base Realignment and Closures in order to reduce excess infrastructure. MOAA warns retirees that more base closures would result in fewer Military Treatment Facilities and clinics, in addition to access to other valuable benefits.
Fewer Civilian TRICARE Providers – Many doctors who provide care for TRICARE beneficiaries (known as Primary Care Managers) already receive a payment rate that is significantly lower than the rate paid by civilian health care insurance companies.
To make things worse, these doctors are due to have their Medicare/TRICARE payment rates cut by 27 percent this year. As a result, many doctors have limited the number of TRICARE patients and/or refused to accept new TRICARE patients; effectively limiting patient access to TRICARE benefits.
Congress recently postponed the 27 percent reimbursement rate cut for two months. However, many fear that the short-term deal has only delayed the problem. As part of the deal to postpone the rate decrease, Congress agreed to establish a 20 member conference committee to work out a long-term extension.
According to MOAA, Congress has until February 29 to come up with an extension, but it “seems negotiations have a long way to go.”