Tricare to Change Upcoming Fees for Some Users

Lt. Allison Wessner, a pediatrician at Naval Hospital Jacksonville, conducts a check-up. (Photo: U.S. Navy/Jacob Sippel)
Lt. Allison Wessner, a pediatrician at Naval Hospital Jacksonville, conducts a check-up. (Photo: U.S. Navy/Jacob Sippel)

A set of previously announced new fees that families of current troops will pay for Tricare services starting Jan. 1 are being recalculated -- and could be lowered -- with 17 days remaining before they are scheduled to hit.

The series of major Tricare overhauls scheduled for Jan. 1 including a plan to combine Tricare Standard and Tricare Extra into a new program known as Tricare Select. All users of that program will pay flat fees for primary and specialty care instead of fees based on the percentage system used today.

Troops who join the military after Jan. 1, known as "Group B," will face one set of fees, while current troops, known as "Group A" will face another. The fees set by Tricare for the families of current troops in Group A, announced in late September, are higher than the fees mandated by Congress for Group B.

Currently the new fees for the families of current troops on Tricare Standard, which will become Tricare Select, are slated to be $27 for in-network primary care visits and $34 for in-network specialty visits. Tricare Select users whose service member joins Jan. 1 or thereafter will instead pay $15 for primary care or $25 for specialty care.

Now that could change, a Tricare spokesperson confirmed today.

"Group A copays are being recalculated and will be released as soon as they are approved," Kevin Dwyer, confirmed in an email to Military.com.

At issue is the method by which Tricare officials calculated fees for Group A, sources familiar with the subject told Military.com.

Unlike the Group B fees, which were mandated by Congress as part of the 2016 National Defense Authorization Act, the fees for Group A were chosen by Tricare based on a calculation of the average cost of care for all users.

Military family and veteran advocates, however, questioned that calculation process. Some argued that it factored in the wrong Tricare users, while others worried that it unfairly raised out of pocket costs for those who live in lower cost of living areas and, therefore, currently pay less for services.

The recalculated fees will likely reduce the upcoming out-of-pocket costs for the families of current troops in the Tricare Select program, sources told Military.com, although by how much is not yet known.

Officials with Tricare did not respond to requests for comment on a timeline for release of the new fees or whether or not the new calculations also affect military retirees.

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

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