Officials rolled out a parade of important Tricare changes in 2016 that have the ability to impact your military life in a big way. While we still don't know just what will pass out of the 2017 National Defense Authorization Act (NDAA) we do know how the changes that Tricare was able to put into policy on its own look.
Do you know what those changes are?
Tricare Changes 2016: What You Need to Know1. Tricare dental change. This year Tricare announced that they are shifting their dental coverage for active duty families and Tricare Reserve Select users away from Metlife and back United Concordia, which had been the provider until about 2012. While this Tricare benefit change doesn't go into effect until year, it's good to keep it in mind as you utilize your dental benefits. It could mean that you'll need to switch dentists next spring -- whether or not accept United Concordia's version is up to each individual provider. Thanks to the contract switch, your dental benefits will reset on Feb. 1, 2017 and again on May 1, 2017. That means you could, in theory, get a lot of dental work done over those three months without worrying about maxing out your benefit for the whole year. (Worth noting: the only benefit that won't reset is orthodontics, which is a lifetime cap, not an annual cap.)
2. Extended kid coverage. Starting next month well-child checks for kids over age 6 will be provided by Tricare -- and all well-child visits will have to meet certain standards. Currently, many providers find a way to bill for some of the work done in well-child checks for those older kids, but if you've been receiving check-ups for older kids until this point it's probably at your PCM's expense (unless you're seen at a Military Treatment Facility where things are a little different and the services decide what's provided -- not Tricare). Thanks to the rule change, your pediatrician will now actually get paid. And, even better, all well-child checks will have to meet a series of standards known as the "Bright Futures guidelines." This is winning.
3. Flu mist prohibition. Another one of the Tricare changes in 2016 impacted your flu shot. Tricare decided to follow the Centers for Disease Control's lead and mark the Flumist flu shot option a no-go. The CDC said it isn't effective against the strain of flu they are seeing this year. And Tricare has decided it won't be paying for it -- and the MTFs won't have it in stock, at least for the 2016-2017 flu season.
4. Pharmacy change. This one kicks-in really soon. Thanks to a contracting decision, Tricare benefits will no longer pay for drugs purchased at CVS (including locations in Target), but has added Walgreens back into the network. This change happens Dec. 1, so if you use CVS regularly it's time to brace yourself. Bonus information: CVS Minute Clinics are still good to go as an Urgent Care, but if you are prescribed drugs at one you'll need to take them somewhere else to be filled or pay out of pocket. Bummer.
5. Urgent care allowance. Each Tricare Prime user now gets two referral-free visits to network Urgent Cares per fiscal year. That means if you feel like death and you don't want to deal with the nurse advice line, you can take yourself to an urgent care and call it good. Tricare still wants you to try for a referral, though -- and save those urgent care visits for later if possible. Also: you might see unlimited referral-free visits come out of Congress soon. We'll just have to wait and see if we can add that to our Tricare changes 2016 list.