WEBINAR: Nov. 20, 2017, 1 p.m. EST Take Command The Future of TRICARE

Size: px

Start display at page:

Download "WEBINAR: Nov. 20, 2017, 1 p.m. EST Take Command The Future of TRICARE"

Lee Edwards
6 years ago
Views:

1 WEBINAR: Nov. 20, 2017, 1 p.m. EST Presenters: Mark Ellis, Senior Health Program Analyst for TRICARE, Defense Health Agency; Shane Pham, Health Program Analyst for TRICARE, Defense Health Agency

2 Disclaimer The appearance of hyperlinks does not constitute endorsement by the Department of Defense of this website or the information, products or services contained therein. For other than authorized activities such as military exchanges and Morale, Welfare and Recreation sites, the Department of Defense does not exercise any editorial control over the information you may find at these locations. Such links are provided consistent with the stated purpose of this Department of Defense-sponsored webinar. 2

3 Agenda TRICARE Is Changing Increasing access to care Consolidating TRICARE regions Moving to TRICARE Select Enrollment changes Health plan costs Prepare today Take Command Campaign: The Future of TRICARE #takecommand 3

4 Increasing Access to Care 4

two, which can streamline health care delivery.

5 TRICARE 2017 (T2017): Two Regions The TRICARE 2017 (T2017) contracts will consolidate three regions into two, which can streamline health care delivery. For more information about T2017, visit 5

6 Moving to TRICARE Select On Jan. 1, 2018, existing TRICARE Standard and TRICARE Extra beneficiaries will be converted to TRICARE Select. TRICARE Select is a preferred provider organization, or PPO, style plan. TRICARE Select replaces TRICARE Standard and TRICARE Extra. New active duty family members will be enrolled in TRICARE Select if they live outside of a Prime Service Area or overseas. Changing to TRICARE Select will not mean a decrease in coverage. 6

Enrollment Changes Administration of the TRICARE benefit will transition from a fiscal year

There will be a transition period from Oct. 1, 2017, to Dec. 31, 2017.

31, 2017) and billed accordingly for beneficiaries who pay on a monthly or quarterly basis.

7 Enrollment Changes Administration of the TRICARE benefit will transition from a fiscal year period (October September) to a calendar year period (January December). There will be a transition period from Oct. 1, 2017, to Dec. 31, Enrollment fees will be prorated for the three-month period (Oct. 1 Dec. 31, 2017) and billed accordingly for beneficiaries who pay on a monthly or quarterly basis. Beneficiaries who pay fees on an annual basis will be billed for the fees to cover the three-month period (Oct. 1 Dec. 31, 2017) and will receive a billing notice for the annual fee for calendar year TRICARE Prime beneficiaries will need to pay an additional quarter s premium to cover Oct. 1, 2017 Dec. 31, 2017, then actual renewal will be on Jan. 1,

8 Enrollment Freeze By Nov. 20, 2017, beneficiaries should complete any and all enrollment actions. Beginning Dec. 1, 2017, enrollments in TRICARE health plans will be delayed to transition to the new regional contractors that will begin delivering care in January. Regional contractors will accept enrollment applications during the enrollment freeze by phone or mail and will process these applications once the enrollment freeze is over. You will still be able to receive care during the enrollment freeze. 8

9 Enrollment During the Freeze Beginning Nov. 20, 2017, you will not be able to use the Beneficiary Web Enrollment, or BWE, website to enroll in or disenroll from TRICARE Prime options or to select or change primary care managers. While the BWE website is unavailable, you ll be able to enroll in a TRICARE health plan by phone or by mail. You don t have to enroll in TRICARE Select if you are a TRICARE Standard beneficiary as of Nov. 30, Eligible beneficiaries must be registered in the Defense Enrollment Eligibility Reporting System, or DEERS, to enroll in a TRICARE health plan. 9

Health Plan Costs (2018) Starting Jan. 1, 2018, costs for TRICARE benefits will be charged by calendar year (January December) instead of fiscal year (October September).

10 Health Plan Costs (2018) Starting Jan. 1, 2018, costs for TRICARE benefits will be charged by calendar year (January December) instead of fiscal year (October September). You will fall into one of two groups based on when you or your sponsor entered the military. Each group will have different enrollment fees and out-of-pocket costs: Group A: If you or your sponsor s initial enlistment or appointment occurred before Jan. 1, 2018, you are in Group A. Group B: If you or your sponsor s initial enlistment or appointment occurs on or after Jan. 1, 2018, you are in Group B. Note: Effective Jan. 1, 2018, enrollees in TRICARE Reserve Select, TRICARE Retired Reserve, TRICARE Young Adult, and Continued Health Care Benefit Program have Group B cost-shares, regardless of when the sponsor first joined the military. 10

11 Costs: Active Duty Family Members Costs for ADFMs Select Group A Select Group B Prime Group A Prime Group B Annual Enrollment $0 $0 $0 $0 Annual Deductible E1-E4: $50 for individual and $100 for family E1-E4: $50 for individual and $100 for family $0 $0 E5 and above: $150 for individual and $300 for family E5 and above: $150 for individual and $300 for family Catastrophic Cap Per Year $1,000 $1,000 $1,000 $1,000 Point-of-Service Option Deductible Point-of-Service Option Cost-Share After Deductible N/A N/A $300 for individual and $600 for family $300 for individual and $600 for family N/A N/A 50 percent 50 percent TRICARE costs are subject to change. Go to for the most up-to-date cost information. 11

12 Costs: Active Duty Family Members Costs for ADFMs Select Group A Select Group B Prime Group A Prime Group B Preventive Care Visit Network: $0 Network: $0 $0 $0 Primary Care Visit Network: $27 Network: $15 Network: $0 Network: $0 Specialty Care Visit Network: $34 Network $25 Network: $0 Network: $0 Urgent Care Center Visit Network: $27 Network: $20 Network: $0 Network: $0 Emergency Room Visit Network: $87 Network: $40 Network: $0 Network: $0 Inpatient Admission $18.60 per day or $25 per admission, whichever is more Network: $60 per day Out-of-Network: 20 percent of allowable charges Network: $0 Network: $0 Note: TRICARE Select out-of-network cost-shares for outpatient care are 20 percent of the allowed charges. TRICARE costs are subject to change. Go to for the most up-to-date cost information. 12

13 Costs: Retirees, Family and Other Users Costs for Retirees, Retiree Family and Other Plan Users (Excluding TFL) Select Group A Select Group B Prime Group A Prime Group B Annual Enrollment $0 $450 for individual and $900 for family Annual Deductible $150 for individual and $300 for family Network Provider: $150 for individual and $300 for family Out-of-Network: $300 for individual and $600 for family $ for individual and $ for family $0 $0 Catastrophic Cap Per Year $3,000 $3,500 $3,000 $3,500 Point-of-Service Option Deductible Point-of-Service Option Cost-Share After Deductible N/A N/A $300 for individual and $600 for family N/A N/A 50 percent 50 percent TRICARE costs are subject to change. Go to for the most up-to-date cost information. $350 for individual and $700 for family $300 for individual and $600 for family 13

14 Costs: Retirees, Family and Other Users Costs for Retirees, Retiree Family and Other Plan Users (Excluding TFL) Select Group A Select Group B Prime Group A Preventive Visit Network: $0 Network: $0 $0 $0 Primary Care Visit Network: $35 Network: $25 $20 $20 Specialty Care Visit Network: $45 Network: $40 $30 $30 Urgent Care Visit Network: $35 Network: $40 $30 $30 Emergency Room Visit Network: $116 Network: $80 $60 $60 Inpatient Admission Network: $250 per day or 25 percent of facility charges, whichever is less, plus 20 percent of separately billed services Out-of-Network: $901 per day or 25 percent of facility charges, whichever is less, plus 25 percent of separately billed services Network: $175 per day Out-of-Network: 25 percent of allowable charges $150 per admission Prime Group B $150 per admission Note: TRICARE Select out-of-network cost-shares for outpatient care are 25 percent of the allowed charges. TRICARE costs are subject to change. Go to for the most up-to-date cost information. 14

15 Prepare Today! Prepare for the changes now by: Updating your contact information for you and your family in the Defense Enrollment Eligibility Reporting System, or DEERS. Go to Call (TTY/TDD: ). Fax updates to Signing up for ecorrespondence in milconnect: Log in to and update your profile. Visiting the TRICARE website: Go to Sign up for alerts about changes to get an anytime this page is updated. #takecommand 15

16 Thank you for joining us today. For more information, log on to or call

CURRENT AS OF 26 SEPT 2017 MHS THE FUTURE OF TRICARE

CURRENT AS OF 26 SEPT 2017 MHS THE FUTURE OF TRICARE TRICARE is a registered trademark of the Department of Defense, Defense Health Agency. All rights reserved. TODAY S AGENDA TRICARE IS CHANGING Increasing