Health & Safety

August 15, 2013

TRICARE moves forward with Prime service area reductions

FALLS CHURCH, Va. — The Defense Department will reduce the number of TRICARE Prime service areas in the United States beginning Oct. 1, affecting about 171,000 retirees and their family members.

Those beneficiaries, who mostly reside more than 40 miles from a military clinic or hospital, received a letter earlier this year explaining their options. They will receive a second letter later this month.

TRICARE Management Activity officials said changing the location of Prime service areas has been planned since 2007 as part of the move to the third-generation of managed care support contracts and will allow them to continue their commitment to making high-quality health care available while supporting DOD efforts to control the rising cost of health care for 9.6 million beneficiaries.

Health care under TRICARE Prime costs about $600 more annually per enrollee, but on average, each member of a family of three using TRICARE Standard will pay only about $20 more per month than if they were using Prime.

“The first thing TRICARE beneficiaries should know about the reduction in the number of Prime service areas is that it doesn’t mean they’re losing their TRICARE benefit,” said Dr. Jonathan Woodson, assistant secretary of defense for health affairs. “Next, it’s important to remember this change does not affect most of the more than 5 million people using TRICARE Prime, and [it affects] none of our active duty members and their families.”

All affected beneficiaries will receive a letter this month following up on their initial notification to ensure they have the time and information to make important decisions about their future health care options, officials said.

Current details on Prime service areas and the option for beneficiaries to sign for email updates are available at http://www.tricare.mil/PSA. A ZIP code tool is available on the site to help beneficiaries determine if they live in an affected area.

As always, officials noted, TRICARE beneficiaries still are covered by TRICARE Standard. For those living within 100 miles of a remaining Prime service area, re-enrolling in Prime may be an option, depending on availability. To do this, beneficiaries must waive their drive-time standards, and they may have to travel long distances for primary and specialty care.

“I urge all impacted beneficiaries to carefully consider their health care options – they should talk them over with family members and their current health care provider,” Woodson said. “Many beneficiaries may be able to continue with their current provider using the Standard benefit. Being close to your health care team usually offers the best and safest access to care.”

Those enrolled in TRICARE Prime are assigned a primary care provider who manages their health care. Retirees pay an annual enrollment fee and have low out-of-pocket costs under this plan. TRICARE Standard is an open-choice option with no monthly premiums and no need for referrals, but it has cost shares and an annual deductible.

The Prime service areas being eliminated are not close to existing military treatment facilities or base realignment and closure sites, officials said. Prolonged protests resulted in a staggered transition, they added, and all Prime service areas were retained until all three new regional contracts were in place. The West region completed the transition April 1.

To provide affected beneficiaries with enough time to plan, Defense Department officials elected to delay the Prime service area reductions until Oct. 1.




All of this week's top headlines to your email every Friday.


 
 

 

Giving life through the Living Donor Program

  As Airmen, it is our responsibility to help each other, as well as our civilian counterparts from day to day. But what if the need was greater than something as simple as a ride to work? What if it was as great as a kidney donation? Located in Sacramento, Calif., The University of California...
 
 

Spiritual doctors support Airmen

MOODY AIR FORCE BASE, Ga.  — They don’t work in hospitals, wear lab coats or fix broken bones but they can heal hidden wounds. Some people may refer to them as pastors, while others consider them counselors. But these spiritual doctors are known to the military as chaplains. Chaplains work 24/7 to help members cope...
 
 

Don’t throw a fit — get fit

LUKE AIR FORCE BASE, ARIZONA — It’s a controversial topic that has been brought up by many Airmen — changing the abdominal circumference standards on the Air Force fitness assessment test. After months of debate, it was decided by Air Force Chief of Staff Gen. Mark Welsh III that the standards will stay the same....
 

 

June is Men’s Health Month

LITTLE ROCK AIR FORCE BASE, Ark. (AFNS) — Each June, a congressional health education program is promoted to heighten the awareness of preventable health problems and encourage early detection and treatment of disease among men and boys. Screenings, health fairs, media appearances and other health education activities are held to raise awareness for male health...
 
 

TRICARE’s breast pump policy updates effective July 1

WASHINGTON (AFNS) — TRICARE’s breast pump policy was recently updated to include coverage of breast pumps and supplies, and breastfeeding counseling. These supplies and services will be retroactively covered as of Dec. 19. To get full details about this important benefit change, as well as an opportunity to ask questions, TRICARE will host a Facebook...
 
 

Drug testing: What’s fact or myth?

LUKE AIR FORCE BASE, ARIZONA — For those who have donned a military service uniform, most have heard the myths and urban legends that surround random drug testing, with the biggest question being “Is it really random?” With facts received from the 56th Fighter Wing Drug Demand Reduction, this article presents the truth about the...
 




0 Comments


Be the first to comment!


Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>