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Tricare Young Adults Premiums Set to Skyrocket

Dr. (Capt.) Nicole Wilson-Hall, examines a military family member in Belleville, Ill. (U.S. Air Force Photo/Staff Sgt. Ryan Crane)
Dr. (Capt.) Nicole Wilson-Hall, examines a military family member in Belleville, Ill. (U.S. Air Force Photo/Staff Sgt. Ryan Crane)

Premiums for the Tricare Young Adult plans will jump between 25 and 47 percent January 1 thanks to new cost assessments, Tricare officials announced yesterday.

Monthly fees for Tricare Young Adult will be $306 for Tricare Young Adult Prime and $228 for Tricare Young Adult Standard staring January 1, 2016. The current fees for 2015 are $181 for Standard and $208 for Prime.

Unlike other Tricare plans, Tricare Young Adult is not subsidized by the Defense Department. Instead, by law, monthly premiums are to be based on the actual costs of the plans to Tricare, including administration costs. Tricare Young Adult has been available for purchase by dependent Tricare beneficiaries between the ages of 21 and 26-years-old since 2011.

But until now, officials said, the premiums have not accurately reflected Tricare's actual costs because officials didn't have enough data on which to base them. In the past officials instead based the yearly premium changes on their best guess as to how much the program was costing the system, said Mary Kaye Justis, director of Tricare Health Plan. Starting this year, however, Tricare actuaries had enough information on the plan's total cost to more accurately set the premiums' future price points, she said.

"We have actual cost data now that this is what it actually costs the program as opposed to the first couple years [where] it was more predictive," Justis said.

Since 2011, Tricare Young Adult fees have reminded largely steady, decreasing or increasing slightly each year. In 2013 they hit a low at $152 per month for Standard and $176 per month for Prime. About 45,000 users are currently enrolled in Tricare Young Adult, officials said.

Justis said they chose to announce the premium increases now to give users a chance to switch to a different, less expensive health care plan during open enrollment periods, which typically start November 1. For example, many Tricare Young Adult users are likely eligible for insurance or subsidies through the Affordable Care Act's health marketplace, she said, while others may have employer sponsored healthcare plans to which they may want to switch. Another option, she said, could be moving from the higher premium Prime plan to Tricare Young Adult Standard.

Beneficiaries who have employer sponsored healthcare plans available are, by law, not eligible for Tricare Young Adult. However, Tricare does not impose penalties on users who break that rule, Justis said.

Tricare officials said they plan to notify beneficiaries of the premium increases through a press campaign as well as notifications through their regional contractors.

-- Amy Bushatz can be reached at Amy.Bushatz@military.com.

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