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171K Veterans Could Lose TRICARE Prime Coverage In Less Than A Year

By: Brittany Semadeni Email
By: Brittany Semadeni Email

(November 13, 2012)--According to a report from military.com, defense officials are expected to announce that military retirees and their dependents that live more than 40 miles from a military treatment facility will lose their TRICARE Prime coverage as early as April.

As many as 171,000 veterans would lose their prime coverage and drop to standard coverage.

Currently, retirees and active duty military using TRICARE Prime are required to use the military clinic unless they live more than 30 minutes from the designated clinics on post. If outside a specified radius and a local doctor accepts TRICARE, a veteran can name that physician as their primary care physician and still receive benefits under the prime program.

Should prime members' coverage change, under the standard program a $150 per person or $300 per family annual deductible would be applied.

Office visits would increase depending on the cost-share amount as billed by the provider and inpatient care would increase from an $11 per day charge with a $25 minimum to $535 per day or 25 percent cost-share, whichever is less. Patients would be responsible for 25 percent cost-share of professional fees.

Also, eye exams which are covered every two years for patients 3 and older under the Prime coverage would not be covered for any beneficiary older than six under TRICARE Standard.

The changes are intended to reduce the cost of providing health care to military retirees by constricting Prime service areas, a military.com spokesperson said.

If implemented, the changes would kick in on April 1 in the west region, followed by the north and south regions on October 1 of next year.

Active duty military and their families will not be impacted.

Military.com is a military and veterans' organization that says it has 10 million members.

It was created to simplify access to information about service benefits and provides headline news, technology updates and user-generated stories.


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