RAO Davao City

United States Military Retiree Activities Office Davao City, Philippines

TRICARE SELECTION CONSIDERATIONS – 1 May 2008

Posted by Service Officer on April 30th, 2008

One of the first things on a new retiree’s checklist after leaving active duty is health care. With the Tricare fee increase proposals the decision on where it will be obtained from is even more critical. Factors that must be considered are extent of family protection, cost, and whether or not supplemental insurance will be required. Many retirees start a second career and enroll in their new employer’s health care plan. Others stay with Tricare and are comfortable with the process. A prime consideration whether you are a new military retiree or a seasoned one is does your current or potential health care program cover all costs? For a number of years now DoD has drafted plans that will drastically increase Tricare enrollment fees and deductibles for 3 million retirees under age 65 and their families to help slow the government’s increasing cost of health care. One aim of these proposals is to encourage working-age retirees to enroll in an employer’s program or switch to other available plans.

If the proposals are approved some retirees will have no choice except to use the Tricare program. Others have options. As with any new program, the key is to get all the facts. Depending on your options Tricare may no longer be the best deal for you. It is recommended you get all the information you can on your own and compare prices. Some employer health care programs provide the employee with limited options. The following questions will guide you toward the best purchase:

• Must I meet a deductible before the plan begins to pay?

• Is there a maximum limit on benefits?

• Is there a pre-existing condition clause?

• Is there a waiting period before the policy becomes effective?

• Will the plan cover amounts beyond what Tricare allows?

• Does the plan pay for services that aren’t covered by the policy?

• Does the plan specifically not cover certain conditions?

• Must certain kinds of care be approved before treatment?

• Is inpatient care covered?

• Is there outpatient or long-term care coverage?

• Will the plan pay the outpatient deductible?

• Will a new plan pay the same as my cost-share under the Tricare diagnosis-related group payment system?

• Will the plan cover enrollment fees or co-payment?

• Does the plan offer reduced premiums or premium adjustments if I participate in managed health care plans?

• Does the plan convert to a Medicare supplement? If so, must it be in force for any specified length of time before conversion?

• Will the plan cover me overseas?

• How will the plan require premium payments? Monthly? Quarterly?

• Can premium payments be increased?

• Does the plan offer rates based on military retired status or based on an age scale?

• Does coverage continue for surviving spouses at no charge?

• What’s the time limitation, if any, for filing a claim?

• If I am a smoker, does the plan have higher rates?

The Defense Department has expressed concern over the recent influx of military retirees into the Tricare program and away from employer-provided health care. Certainly, this concern shouldn’t override the promise Congress made to its sons and daughters who wore the military uniform, protected our country, and gave their all when unique demands were placed upon them and their families. Unfortunately, our military retirees will have to dig deeper into their pockets. [Source: Air Force Times article by Alex Keenan MCPO USCG (Ret) 9 JAN 05 ++]

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