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10 March 2012


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r whitman

The Army Times article is very confusing to readers who are not familiar or covered by Tricare. Can someone explain the controversy in plain English.

The Twisted Genius

r whitman,

With 25 years of service, I still don't understand Tricare. I glad I have a few years to figure it out. The controversy centers on the common and widespread belief by those of us who served that lifetime medical care was part of our agreement with the government. The courts have ruled that in accordance with the letter of the law and written contractual obligations this is not so. There was a time when honor carried much more weight than legalese.


As someone who neither served in the military nor followed this issue closely, I find these proposed cuts and recissions incomprehensible - ethically and politically. I, and I'm sure others, would be grateful if someone could explain briefly (or offer references that do so) the politics of this among both the uniformed and civilian leadership in the Pentagon, the big Congressional players, and of course the patriots in the White House. Do these people have no shame?



I am 71 and have 26 years active federal military service and a couple of years in the NG as enlisted (high school). I pay Medicare Part B premiums for me and SWMBO. Medicare is our first payer health insurance and Tricare for Life which I don't pay premiums for is the secondary payer. TFL has a pharmacy benefit for which there are co-pays.. They now want to have annual enrollment fees for Tricare for Life for both of us and co-fees for treatment. in Tricare for Life. My father served 34 years (1916-1953. He got out a couple of times.). He never paid any fee for any medical treatment. He had to seek treatment at armed forces medical facilities, but he did not pay. I could do that here in Washington but these hospitals are jammed with active duty patients and their dependents. pl

scott s.

Historically there was a presumption that military would be cared for in the military medical system. As the numbers of military and family members increased, it was impossible to serve this population entirely within the military system, so a civilian-style fee-for-service insurance plan was established, called Champus. Typical scenario was that you would first go to a military medical facility to be treated, and if they couldn't see you they would provide a "non-availability" statement allowing you to see a civilian provider. Over time the ability to be seen by the military facilities declined, so Champus became more important. Eligibility for Champus ended with eligibility for Medicare Part A/B (military members pay into part A like civilians).

During the Clinton admin, when "Hillary-care" was proposed the military was used as a case study, and the medical system changed into "Tricare". As in the admin's proposal, there were three options, HMO (prime), PPO (extra), and fee-for-service (standard). The HMO/prime option incorporated the military medical system augmented by whatever civilian medical services willing to contract with Tricare (reimbursement rates more or less the same as Medicare). I don't know if the PPO system ever got off the ground (never hear about it). Standard is more or less what Champus was. More recently, medical coverage was extended to Medicare-eligibles, in the form of "Tricare-for-life", a second payer to Medicare A/B.

At issue are the enrollment fees for HMO (prime) and Tricare for Life. I haven't heard about any changes in co-pays or benefit changes but I suppose there could be those as well.

Note that is possible for retired military members to also access the VA system, but due to VA priority system you pretty much need a 50% or greater disability rating to get access for most things.

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