Contributed by Major Mike Dryden, AVN USAR Retired
Numerous Tricare fee change proposals in the FY 2017 DOD budget are galloping our way. If you are like me, one of the elite group that in the 1960s received an invitation from the local draft board to join the army, these new changes aren’t anything like the deal the military said our retirement benefits would be.
We all realize that we all have to do our part in tough budget times. I can’t speak for all retirees, but I wish the hit squad at the DOD would pack up and move to another department. If their efforts are half as productive in the rest of the government as they have been in the defense department, we would never see another budget deficit. However, I’m not going to be over in a corner holding my breath waiting on that to happen. Although, I am still waiting on that red rider lever action bb gun for Christmas.
I realize lists and charts are boring, but it’s your money they are taking. So, I don’t want to receive any calls or comments later saying, “Nobody told me.”
Some of the proposed changes are as follows:
• New enrollment fees and new names for Tricare Prime and Standard. I wish I could get on the name changing committee. My life would finally have some meaning.
• Means-tested fees (basing fees on your retired pay amount) are under consideration, which is one of the most offensive to me since I am nearing 70 and still working.
• Different charges for seeing in network versus out of network providers are proposed and will be a major problem in many areas not geographically close to a major military installation.
• Changing some cost shares from a percentage of the doctor bill to flat fees that vary for different kinds of providers is on the table. This special treatment is reserved for the military and not any other types of federal retirees. Once again, I can’t speak for all retirees, but I feel so special now by being singled out.
• More money can be saved by adjusting fees by a new measure of health care inflation instead of the same COLA that applies to retired pay, also more special treatment for military retirees.
• And how about the proposed change in network cost shares from a percentage of the provider’s charges to a flat fee?
When you pay a percentage of charges under Tricare Standard, your cost share rises over time by the same percentage as the payment to the doctor. Tricare payments to doctors are linked to medicare’s, and medicare payments to doctors have risen very slowly over the past decade as congress has tried to keep a lid on health costs. That means your cost share (20 percent of allowed charges for active duty families, 25 percent for retirees) has risen slowly as well.
But what if your payment is switched to a flat fee that is adjusted subsequently at the rate of 5.2 percent a year, as envisioned in the defense budget proposal?
At that rate, your cost would double in about 11 years — much faster than medicare and tricare payments to doctors have grown. No surprises here if you are a provider.
Let’s assume your doctor bill is $100. Your TRICARE Standard cost-share as a retiree under 65 today is 25 percent of that, or $25. That’s exactly the flat fee the new budget proposals envision for an in-network primary care visit in 2018.
But how would that change over time?
Let’s assume that a $100 medicare/tricare payment to the doctor grows at 1.5 percent a year — which is faster than it has grown in the past. In 10 years, the tricare payment to the doctor would be $116, but your $25 flat fee would have grown to $42, and instead of paying 25 percent of the doctor bill, your share would have risen to 36 percent.
This chart from MOAA shows the gradual increases.
No matter what you think of the initial fee changes, the biggest potential effect of these proposals, if enacted, might be how much faster they would escalate your health care costs over 20 to 30 years.
Suffice to say, time would not be on your side from that perspective.
See more of my document source at
And many thanks to Col. Steve Strobridge, USAF (Ret) for his excellent article in the latest MOAA magazine, my main source for this article.