Health Care Happenings

The MOAA Healthcare Team attended a TRICARE Beneficiary Panel briefing earlier this morning.  We were reminded of an item of interest which actually took effect last Thursday the first of  October. 

This is the recent DoD policy which is aimed at cleaning up TRICARE Prime enrollment at military treatment facilities (MTF’s) and represent changes for what could be many TRICARE Prime enrollees.

TRICARE has long had established travel access standards to assist beneficiaries to recieve timely healthcare.  The standards require that enrollees shouldn’t be assigned a primary care manager (PCM) at a military hospital or clinic that is more than a 30 minute drive from the beneficiary’s home address.

As a practical matter, DoD never really enforced that policy.  But it will be enforced now.

If you as a beneficiary want to continue to be seen in the MTF, current Prime enrollees in the U.S. (except if you live in Alaska, you will be exempt from this policy) who live farther away than a 30-minute drive from the MTF will have to request a waiver of the drive-time standard from the MTF Commander or the TRICARE Regional Office.  Drive times will be determined by a computer program similar to MapQuest.  Approved waivers will have to be renewed annually from now on.  If you have not filled one of these out and you fit this category, you will be automatically assigned a civilian PCM closer to your residence. 

If you live over 40 miles from the MTF and have not submitted a waiver, you will automatically be disenrolled from Prime and will revert to TRICARE Standard.  We were informed that the TRICARE contractors have been mailing out letters to all affected beneficiaries providing detailed instructions on the waiver process.  To date 49% of those eligible have not submitted the required waiver request.

Many folks may not find out about this until they try to make their next appointment at the MTF!