In Contract Shift, Tricare Consolidates Coverage Regions

Pediatrician
Pediatrician

The U.S. military's Tricare health care program for families and veterans will consolidate its regions from three to two under a new pair of contracts, officials announced Thursday.

The system is currently administered in three regions -- North, South and West -- by three separate contractors.

The North region, which includes North Carolina but not Tennessee and goes as far west as Illinois, is currently managed by Health Net Inc. The South, which includes Tennessee plus the Fort Campbell, Kentucky, area and stretches west to include Oklahoma and most of Texas, is managed by Humana Inc.'s military subsidiary. The West, meanwhile, is the largest, including Hawaii and Alaska and a portion of Texas, as well as states north of Oklahoma and west of Illinois. It is managed by United Healthcare.

Starting in 2017, Tricare will eliminate the North and South regions and instead divide the national coverage into East and West. The East region will be managed by Humana, while the West will be managed by Health Net. The contracts are worth $40.5 billion for the East, and $17.7 billion for the West, officials said in a release.

Some 9.2 million military family members and retirees are enrolled in Tricare. Specific health care coverage under Tricare is set by law and does not depend on which contractor is administering the system.

The new East region will include the District of Columbia; Alabama; Arkansas; Connecticut; Delaware; Florida; Georgia; Illinois; Indiana; the Rock Island Arsenal area of Iowa; Kentucky; Louisiana; Maine; Maryland; Massachusetts; Michigan; Mississippi; the St. Louis, Missouri, area; New Hampshire; New Jersey; New York; North Carolina; Ohio; Oklahoma; Pennsylvania; Rhode Island; South Carolina; Tennessee; most of Texas; Vermont; Virginia; West Virginia and Wisconsin.

The new West region will include Alaska; Arizona; California; Colorado; Hawaii; Idaho; all of Iowa except the Rock Island Arsenal area; Kansas; Minnesota; all of Missouri except the St. Louis area; Montana; Nebraska; Nevada; New Mexico; North Dakota; Oregon; South Dakota; west Texas; Utah; Washington and Wyoming.

Beyond changing who processes military health care claims and payments for providers, it wasn't immediately clear how the shakeup will impact Tricare users, including those on Tricare for Life, if at all. A specific contract start date hasn't been released.

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

Show Full Article