Health Care Happenings

Having recently retired from active duty one of the biggest adjustments I faced (and pleasantly), was the choices that existed for my healthcare.  Retiring from my active duty career in the military offered a lot of choices that were not available while I was serving in uniform. 

While on active duty we were required to use TRICARE Prime or Prime Remote.  Retiree’s such as myself, who are not eligible for Medicare can and may be eligible to continue on in Prime or choose TRICARE Standard or Extra.  Each of these programs has advantages pertaining to cost, location and convenience.  But the great thing is you get to decide what is best for you!

If space is available, continuing care in a military treatment facility (MTF) with a primary care manager through TRICARE Prime requires re-enrolling and paying an annual fee of $230 for an individual and $460 for a family.  Retirees who choose to enroll in TRICARE Prime at an MTF, in my case NNMC Bethesda, will recieve care based upon the same access-to-care standards as all other Prime beneficiaries.  I choose this because of location convienence and continuity with my provider.

Retirees who move to a location that is not near an MTF, or where Prime is not offered, may find TRICARE Standard or Extra to be the best options.  TRICARE Standard is a flexible, affordable plan that gives beneficiaries and their eligible family members a greater choice of providers, no enrollment fees, waiver of cost shares for most preventive healthcare services and the same low catastrophic cap as TRICARE Prime.

TRICARE Extra offers even lower out of pocket expense if beneficiaries use network providers.   Although there is no enrollment fee for TRICARE Standard and Extra, a deductible of $150 for individuals and $300 for a family must be met before cost-sharing begins.  Under TRICARE Standard and Extra, most beneficiaries retain the same access to pharmacy benefits through a local MTF or the TRICARE Mail Order Pharmacy, as well as the option to use the TRICARE retail pharmacy network.

A couple of other things to keep in mind are that as a retiree you may also be eligible for certain medical and pharmacy benefits from the Department of Veterans Affairs in addition to your TRICARE benefit.  Also, you may want to start serious consideration of your healthcare choices well ahead of your actual transition as it will ensure a smooth transition post-retirement.  Believe me there is a lot to think about as you may find out in your Transition Assistance Program (TAP).