By Sharon Foster
TRICARE Management Activity
6/20/2011 – FALLS CHURCH, Va. (AFNS) — When beneficiaries retire from active duty, they may have big plans for how they are going to spend their time. Along with choices about where to live and their next great adventure, they must make choices about their health care. Understanding these choices will help beneficiaries and their families make the best health care decisions.
“While active-duty service members must use TRICARE Prime or Prime Remote, retirees who are not eligible for Medicare may be eligible for TRICARE Prime, or choose TRICARE Standard or Extra,” said Kathleen Larkin, the director of the Health Plan Policy Division at the TRICARE Management Activity. “Each program has advantages pertaining to cost, location and convenience.”
If space is available, retirees can continue care in a military treatment facility with a primary care manager, through TRICARE Prime. This requires re-enrolling and paying annual fees of $230 for an individual and $460 for a family. If beneficiaries choose to enroll in TRICARE Prime at an MTF, they will receive care based on the same access-to-care standards as all other Prime beneficiaries.
TRICARE Standard or Extra may be the best option if a retiree moves to a location that is not near an MTF, or where Prime is not offered. TRICARE Standard is a flexible, affordable plan that gives retirees and their eligible family members a greater choice of providers, no enrollment fees, waiver of cost shares for most preventive health care services and the same low catastrophic cap as TRICARE Prime.
TRICARE Extra offers even lower out-of-pocket expense if retirees use network providers. Although there is no enrollment fee for TRICARE Standard and Extra, a deductible of $150 for individuals and $300 for a family must be met before cost-sharing begins.
Under TRICARE Standard and Extra, retirees retain the same access to pharmacy benefits through a local MTF or TRICARE Pharmacy Home Delivery. To learn more about Home Delivery, go to www.tricare.mil/homedelivery. Retirees also have the option to use the TRICARE retail pharmacy network and can purchase dental coverage through the TRICARE Retiree Dental Program. More information on TRDP can be found at www.trdp.org.
In addition to TRICARE retiree health care benefits, certain medical and pharmacy benefits also may be available to retirees from the Department of Veterans Affairs. Go to www.va.gov/health/default.asp for more information.
The TRICARE Overseas Program Standard option is available to retirees planning to live outside the United States. They and their family must meet a deductible before cost-sharing begins and generally file their own claims for reimbursement for covered health services. TRICARE also has additional country-specific requirements for care received in the Philippines.
Retirees always should remember to update the Defense Enrollment Eligibility Reporting System with any new personal information at www.dmdc.osd.mil/appj/dwp/index.jsp. Automatic coverage by TRICARE Standard and Extra or TOP Standard occurs after retirement as long as DEERS information is current.
TRICARE officials recommend beneficiaries consider all available choices before retiring. It is best to plan well in advance to ensure a smooth transition. Beneficiaries can learn more about retiree health care options at their local TRICARE service center. Other TRICARE contact information and beneficiary assistance locations can be found at www.tricare.mil/contactus.