The administration’s proposed budget would introduce a three-tier fee structure for retirees under age 65. It includes higher annual enrollment fees for Prime, new annual enrollment fees for Standard and increased annual deductibles for Standard. No fee changes are proposed for active-duty members or their dependents, or for retirees over 65 who participate in Tricare for Life. The enrollment fee and deductible changes for retirees under 65 and their families:
|
TRICARE PRIME |
TRICARE STANDARD | ||
|
Fiscal Year |
Annual enrollment fees |
Annual enrollment fees |
Annual Deductable |
| Retired junior enlisted (E-6 and below) | |||
| Current – FY 2006 |
$230 / $460 |
$0 |
$150 / $300 |
| FY 2007 |
$275 / $550 |
$75 / $150 |
$175 / $350 |
| FY 2008 |
$325 / $650 |
$140 / $280 |
$185 / $370 |
| FY 2009 |
--------------------- Adjusted * --------------------- | ||
| Retired senior enlisted (E-7 and above) | |||
| Current – FY 2006 |
$230 / $460 |
$0 |
$150 / $300 |
| FY 2007 |
$350 / $700 |
$100 / $200 |
$175 / $350 |
| FY 2008 |
$475 / $950 |
$200 / $400 |
$185 / $370 |
| FY 2009FY 2009 |
--------------------- Adjusted * --------------------- | ||
| Retired officers | |||
| Current – FY 2006 |
$230 / $460 |
$0 |
$150 / $300 |
| FY 2007 |
$500 / $1,000 |
$150 / $300 |
$225 / $450 |
| FY 2008 |
$700 / $1,400 |
$280 / $560 |
$280 / $560 |
| FY 2009FY 2009 |
--------------------- Adjusted * --------------------- | ||
* Prime and Standard enrollment fees would be adjusted each year, beginning in 2009, using the Federal Employees Health Benefit Plan (FEHBP) rates of inflation.
Proposed Changes to Pharmacy Benefit
The administration’s proposed budget calls for changes in pharmacy co-pays for all eligible beneficiaries, except active-duty members. Those affected would include over-65 Tricare for Life retirees. These changes include: no co-pays in military clinics or for mail-order generic medications, increases in retail pharmacy co-pays, and 100 percent co-pays for a few non-covered medications. The co-payment plan:
|
Generic drugs |
Brand-name drugs |
Non-formulary drugs | |
| Current co-pays | |||
| Military clinic |
$0 |
$0 |
$0 |
| Mail order |
$3 |
$9 |
$22 |
| Retail |
$3 |
$9 |
$22 |
| Co-pays in FY 2007 and after | |||
| Military clinic |
$0 |
$0 |
$0 |
| Mail order |
$0 |
$9 |
$22 |
| Retail |
$5 |
$15 |
$22 |
