New Health Care Proposals for Military Families
The yearlong study into military benefits took a serious interest in health care. The Military Compensation and Retirement Modernization Commission (MCRMC) has proposed a new health care system that would offer a selection of commercial health care plans, similar to what’s offered to federal civilian employees. Those health plans are considered the gold standard for insurance.
TRICARE, as it exists today, would go away and would be replaced by a plan offering the following:
- A menu of high quality health plans modeled on the federal civilian plans but customized for the unique needs of military families
- An array of health plan options (e.g., PPO, HMO), covered benefits, and price
- Several choices in any geographic area
- Dental and vision coverage options (including current TRICARE Dental programs)
- Continued access to Military Treatment Facilities (MTFs). Insurance companies would include MTFs in their networks and reimburse MTFs for the care delivered as they do any other provider.
- The option for beneficiaries to change plans during the annual open season or at a life changing event such as a change in family size or PCS.
- Plans with catastrophic caps to alleviate large, unplanned health care bills
- Coverage for dependents until age 26 at no additional cost
- The pharmacy program as it currently exists
How Much Will the New Plan Cost?
The exact cost will depend on the type of plan the family selects. Active Duty Service Members (ADSMs) will receive a Basic Allowance for Health Care (BAHC), a non-taxable allowance to offset health care costs for their family members. The BAHC will be used by the active duty families to pay for premiums and out of pocket costs, such as office co-pays.
The health care allowance would:
- Vary based on location
- Completely cover the average family’s premiums and out of pocket costs
- Have a portion go directly to the insurance carrier to cover health plan premiums and what’s left go to the service member as a cash payment.
- Also be able to pay for health insurance outside of TRICARE Choice (e.g., a spouse’s employer based plan, an activated Reservist’s employer based plan, an ACA marketplace plan)
- Assist (the Active component) with out of pocket costs for chronic or catastrophic conditions until the plan’s catastrophic cap is reached. Active duty families would apply to this program for more money to cover co-payments that substantially exceed their BAHC.
- Let active duty families see providers at MTF, which would be considered in-network, but would have a cost associated with accessing care at an MTF. (No cost-share for ADSMs).
- Give families more responsibility for selecting a health insurance plan and managing the BAHC.
The health care proposals make no changes for:
- Active Duty Service Members. Service members will continue to receive health care through their unit or Military Treatment Facility (MTF). When referred to a private sector for specialist care, they would have access to network providers at no cost.
- Medicare Eligible Retirees. Currently use TRICARE for Life and would continue to do so.
Remember: No changes to the military health system can take place unless Congress passes legislation.
What do you think of these health care proposals? Is there information you’d like to know about MCRMC’s recommendations?
Posted February 17, 2015