A Handful of Improvements to Healthcare, Thanks to the NDAA
By now you have probably seen the headlines about the massive Military Health System Reform coming our way in the 2017 National Defense Authorization Act (NDAA). There are still so many questions about how it will all actually work, but the question we’re sure you might be wondering is,
“How will this impact my family’s healthcare?”
Let’s start with what we know for sure:
TRICARE Standard/Extra Becomes TRICARE Select
On the surface, this might seem like one of the biggest changes, but it’s mostly just a name change. TRICARE Standard/Extra will now be known as TRICARE Select.
With TRICARE Select, there will still be a network of providers you can choose from without a referral—including specialty care, and you will still have the option of being able to see those non-network providers for a higher out-of-pocket cost. That part hasn’t changed.
But future retirees who enter military service after January 1, 2018 can expect a change—higher fees. We appreciate Congress honoring their commitments to current retirees and all those currently serving. Those service members who entered the service prior to January 1, 2018 will be grandfathered into the old TRICARE fee structure. But under new changes, anyone entering service after January 1, 2018 will face higher out-of-pocket costs for their family if they have TRICARE Select. Our future force deserves better.
The good news, though, is that TRICARE Prime will remain free for ALL active duty families—no enrollment fees, deductibles, or out-of-pocket copays.
A Handful of Improvements to Access to Care
- No more Urgent Care referral requirements: Congress removed the requirement that families must have a referral for urgent care visits. This means, once the TRICARE policy is updated, you’ll be allowed to use urgent care for as many visits as needed, without referral. No more waiting for hours in the ER to be seen for an ear infection or strep throat! This is the most significant win for military family healthcare, and we could not have done it without the real stories you all shared with us!
- Vision coverage: That’s right! Military families will now be eligible for vision coverage through Federal Employee programs. Retirees and their dependents will be eligible for both Federal Employee dental and vision programs. Please note: We made a correction regarding eligibility for Federal Employee vision and dental programs. In reviewing the legislative language again, we noted that both military retirees and their dependents and active duty families will be eligible for Federal Employee vision insurance programs. However, only retirees and their dependents will be eligible for Federal Employee dental programs. Active duty families will continue to be eligible for the current TRICARE Dental Program for active duty family members.
- Appointment scheduling: Congress has listened to military family frustrations about the difficult process of scheduling appointments. The DoD is required to have a 24/7 system for appointment scheduling across all military treatment facilities (MTFs) that includes the ability to make appointments on the phone or online, and makes sure your needs are met on the very first call you make. MTF’s will also be required to open their appointment calendars out 6 months for both wellness and follow-up visits.
- Streamlined access to specialty care: You’ll still need a referral for specialty care, but you won’t need to wait for prior authorization before having the office visit or service.
You might be wondering how these changes could be considered a “massive reform.” We agree with you. These improvements are great, but they hardly scratch the surface on the problems families face with access, quality and the overall patient experience.
MHS Restructuring and TRICARE Reform
Part of the NDAA addresses the restructuring of military hospitals and clinics, and will change the way MTFs are managed. Which means there will also be changes to TRICARE contracts, in general. These changes aim to improve readiness with the military medical personnel while reducing costs, improve access & quality, and focus on the patient experience.
We aren’t entirely certain exactly how this restructuring and TRICARE reform will impact military families, like yours, in the long-term. However, we do know that we must make sure your health care needs are at the forefront of the discussion. The DoD was receptive to our Association’s request to be included throughout the process, and we will make sure your military family’s voice is heard.
We are committed to working with DoD, the Services, and TRICARE to ensure that you have access to the high quality health care and improved patient experience that you deserve.
Posted December 19, 2016