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Officials explain proposed health plan increase, costs (DOD - TRICARE)
American Forces Press Service ^ | 7 January 2011 | Donna Miles

Posted on 01/07/2011 1:46:58 PM PST by Racehorse

Defense Secretary Robert M. Gates is seeking modest premium increases for working-age military retirees who use the TRICARE Prime health plan.

Secretary Gates unveiled sweeping cost-cutting initiatives Jan. 6, including a recommendation to increase TRICARE Prime premiums for working-age retirees in fiscal 2012, the first increase in the plan's 15-year history.

"For some time, I've spoken about the department's unaffordable health costs, and in particular the benefits provided to working-age retirees under the TRICARE program," the secretary told reporters.

"Many of these beneficiaries are employed full-time while receiving their full pensions, and often forego their employers' health plan to remain with TRICARE," he said. "This should not come as a surprise, given that the current TRICARE enrollment fee was set in 1995 at $460 a year for the basic family plan, and has not been raised since."

Secretary Gates noted the dramatic increase in insurance premiums during that period for private-sector and other government employees. Federal workers pay roughly $5,000 a year for a comparable health insurance program, he said.

"Accordingly, with the fiscal year 2012 budget, we will propose reforms in the area of military health care to better manage medical cost growth and better align the department with the rest of the country," Secretary Gates said. "These will include initiatives to become more efficient, as well as modest increases to TRICARE fees for ... working-age retirees, with fees indexed to adjust for medical inflation."

These initiatives could save the department as much as $7 billion over the next five years, he said.

Military retirees automatically are enrolled in one of two TRICARE plans, program spokesman Austin Camacho explained. Retirees who join TRICARE Prime, the system's managed-care option that covers active-duty members, pay an annual enrollment fee of $230 per year for an individual or $460 for a family. Those in TRICARE Standard, a fee-for-service plan, pay no enrollment fee or premium. Instead, they pay a yearly deductible of $150 per person or $300 per family, as well as co-payments or cost shares for inpatient and outpatient care and medications, up to a $3,000 annual cap on out-of-pocket expenses.

TRICARE Prime, the managed-care option that covers all active-duty members and many retirees, costs the government $4,202 per beneficiary per year, said Mr. Camacho. TRICARE Standard, the program's fee-for-service plan, costs $3,584 per beneficiary per year. TRICARE for Life, for beneficiaries age 65 and older, costs the government $3,874 per patient per year.

Military retirees are not required to report whether they have jobs that offer insurance plans, Mr. Camacho said, noting that having other insurance does not take them off the TRICARE rolls. Rather, he explained, TRICARE becomes the "second payer" for health care, picking up co-payments and deductibles from the primary insurance plan.

Meanwhile, the senior TRICARE officer told American Forces Press Service the system is poised to support Secretary Gates' new efficiency measures and already is making progress as it strives to provide the best health care at the best cost.

"All of these things help us work together to help us achieve the secretary's goals, and we are already starting to make progress," Navy Rear Adm. (Dr.) Christine S. Hunter said.

Dr. Hunter cited several initiatives already bearing fruit. More beneficiaries are using the lower-cost mail-order pharmacy option to fill prescriptions. They are getting their immunizations and increasingly participating in a new concept called "patient-centered medical homes" that provide more comprehensive and personalized health care. They are making greater use of online appointment services and health care education materials. And they are increasingly using expensive emergency-room services only for actual emergencies.

"We need to be very aware that there is a pressure [to improve efficiency and control costs] and the resources are not infinite," said Dr. Hunter. "But we are all part of the solution."


TOPICS: Extended News; Government; News/Current Events
KEYWORDS: medicine; military; tricare

1 posted on 01/07/2011 1:47:01 PM PST by Racehorse
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To: Racehorse

Great. Meanwhile our emergency rooms are clogged with illegal immigrants and indigents. I could just puke.


2 posted on 01/07/2011 1:54:14 PM PST by tgusa (Investment plan: blued steel, brass, lead, copper)
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To: Racehorse

That bastard Gates is at it again. There will be a special place in Hell for him, once he moves on. Which can’t happen soon enough for me.


3 posted on 01/07/2011 1:54:54 PM PST by surely_you_jest
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To: Racehorse

Once again the military can be used to show the efficiency of our corrupt government. Chip away at the last potential defenders of our Constitution.


4 posted on 01/07/2011 1:56:00 PM PST by satan (Plumbing new depths of worthlessness on a daily basis.)
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To: Racehorse
Promise made will soon be broken...

Gates has to be the second worst Sec of Def of all time...


5 posted on 01/07/2011 1:58:38 PM PST by darkwing104 (Lets get dangerous)
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To: Racehorse
I pay more than $460 per year for my Prime. Second, Federal employees get paid more than military members, both in pay and benefits, so stop trying to lump them together.

Third, I do no get paid much right now and if I took the POS health benefit from my employer I would literally get about $175 per week after the deduction and still have to pay a huge deductible. At least my deductibles in Tricare Prime are manageable.

6 posted on 01/07/2011 2:05:11 PM PST by OldMissileer (Atlas, Titan, Minuteman, PK. Winners of the Cold War)
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To: Racehorse
Federal workers pay roughly $5,000 a year for a comparable health insurance program, he said. MY husband spent 22 years of his life serving this country with the promise of health care for life..These federal workers do not spent years at combat, months at a time separated from their families, and friends, miss their kids birth days, weddings, graduations and etc. there is no way Gates can compare the two..a military person signs a conract with the US Government, which includes giving his life for this country....Gates needs to go.... and fast "
7 posted on 01/07/2011 2:12:49 PM PST by JoanneSD
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To: tgusa
Does everyone named "Gates" need to drop off the end of the Earth? Is the surname a genetic marker of evil?


Frowning takes 68 muscles.
Smiling takes 6.
Pulling this trigger takes 2.
I'm lazy.

8 posted on 01/07/2011 2:23:28 PM PST by The Comedian (Puzzling puzzle pieces precisely proliferating panoramically.)
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To: Racehorse

As we give 6 billion a year to the UN. I prefer making huge cuts to not only the UN but to all foreign aid first.


9 posted on 01/07/2011 3:19:27 PM PST by katiedidit1
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To: Racehorse

When the average Federal Employee makes the same money as our troops then you can compare costs!

Plus, don’t even get me started on illegals and their costs regarding healthcare!!!!


10 posted on 01/07/2011 4:08:47 PM PST by panthermom
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To: OldMissileer

You are entitled to your healtcare, you wrote the check and sacrificed for all of us. I don’t have any problem with my taxes going to take care of you.

To compare what the average Federal employee pays vs our troops is insulting!!!


11 posted on 01/07/2011 4:12:45 PM PST by panthermom
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To: surely_you_jest
But Gates has millions to spend on new mandatory "sensitivity" training to force homosexuality on the military, He has millions to dole out to homosexual's "partners" in new housing, salary, insurance, dental, and health care costs. Plus, whatever other zillions are needed to implement this immoral social travesty on the US military.

I used to think Cohen and McNamara were the worst SecDefs of all time.

Obviously, I was wrong.

12 posted on 01/07/2011 4:26:47 PM PST by SkyPilot
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To: Racehorse

“working age” retirees to pay more for their “free healthcare for life” (just sign in the dotted line) because..well..they are “working age”

meanwhile the “working age” welfare classes in their teens and 20’s and 30’s pay nothing for their healthcare because..well...they aren’t working, are they


13 posted on 01/07/2011 7:10:19 PM PST by silverleaf (All that is necessary for evil to succeed, is that good men do nothing)
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To: Racehorse
“working age” retirees to pay more for their “free healthcare for life” (just sign in the dotted line) because..well..they are “working age” (get a job, ya bum, war’s over for you)

meanwhile the “working age” welfare classes in their teens and 20’s and 30’s pay nothing for their healthcare because..well...they aren't working, are they

14 posted on 01/07/2011 7:10:41 PM PST by silverleaf (All that is necessary for evil to succeed, is that good men do nothing)
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To: SkyPilot
the military officier groups especially the upper echelons are drunk on power....anything for power...sacrifce your troops?...no problem.....make deals with the devil?...go for it....

until we start producing REAL MEN military leaders again, we'll have to suffer these perfumed princes and their limosine liberal mamby pamby attitudes...

15 posted on 01/07/2011 10:00:24 PM PST by cherry
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To: Racehorse

Those over 65 will be next on his list.

DoD Budget 2012: Pay and TRICARE
http://militaryadvantage.military.com/2011/01/tricare-fee-outlook-for-2012/?wh=wh

he Sec­re­tary of Defense, Robert Gates, is mak­ing the rounds talk­ing about his pro­posed FY2012 bud­get. Although cur­rently light on details, the news seems good for mil­i­tary pay and ben­e­fits, but, not-so-good for mil­i­tary retirees who rely on TRICARE.

Mil­i­tary Pay and Ben­e­fits — Defense Sec­re­tary Gates plans to cut troops in order to cut costs. The troop level cuts are not to start until 2015, but this does reflect Gates’ ear­lier state­ments about look­ing at cut­ting troops before cut­ting pay and ben­e­fits.

TRICARE – On the other hand, Sec. Gates has stated that he is seek­ing changes to the military’s TRICARE med­ical pro­gram, not­ing that fees have not risen since the pro­gram replaced CHAMPUS in 1995. He said he is propos­ing mod­est increases to fees for working-age mil­i­tary retirees.


16 posted on 01/08/2011 7:30:57 AM PST by GailA (2012 rally cry DEMOCRATS and RINOS are BAD for the USA!)
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