Tricare to boot 170,000 off of Prime

[mickeyd]

This has been mentioned here before but this looks like it's really going to happen. Looks like if you are near a MTF (w/i 40 miles) it will not affect you. Says TFL will not be affected.

Chop, chop, chop...

January 11, 2013
Pentagon officials announced this week that, as of Oct. 1, TRICARE Prime no longer will be available for most retired and survivor military beneficiaries who live more than 40 miles from a military hospital, clinic, or base closure site.

Defense leaders say the change will affect about 170,000 beneficiaries across the country and most of those beneficiaries will need to switch to TRICARE Standard.

Almost 100,000 of the affected beneficiaries live in the TRICARE South region, where Prime is now almost universally available. About 37,000 beneficiaries in the North region and another 36,000 in the West region will be affected.

Retired and surviving beneficiaries using Medicare and TRICARE For Life won’t be affected by the change.

Big TRICARE Changes Coming : MOAA

 

[samclem]

Thanks for the update.
Keep an eye out for the next development: Retiree TRICARE becomes instead a voucher good for use at the health insurance exchanges. Employed military retirees or those with employed spouses: No voucher (all these folks should be covered under the PPACA's "individual mandate).

 

[friar1610]

There are a lot of people I know here in VT (mainly retired Guard) who will be affected by this as we have no bases with MTFs in the area. I was in a predecessor to Prime - the old USHFP - for a couple of years in a previous location. I didn't like the lack of choice and went to TRICARE Standard with a MOAA MEDIPLUS supplement. I may have paid a few more bucks over the years but to me it was worth it. I'm now on TFL and I expect that in the coming years there will be a premium charged for it.

 

[mickeyd]

I'm now on TFL and I expect that in the coming years there will be a premium charged for it.

I agree. Too bad they did not name it FTFL (free Tricare for life).

 

[infoseeker]

I've read that for some, you will be able to sign a waiver to keep tricare prime. It has to do with distance from your residence to your doctors clinic, hospital, etc. Still confused on qualifications for being offered the waiver........can anyone expand on what tricare is saying about this?
thanks

 

[mickeyd]

I've read that for some, you will be able to sign a waiver to keep tricare prime. It has to do with distance from your residence to your doctors clinic, hospital, etc. Still confused on qualifications for being offered the waiver........can anyone expand on what tricare is saying about this?
thanks

Yea I agree. That seemed overly complex to me when I read it also. It appears that the military still finds it difficult to state things clearly. I did not spend time trying to figure it out since I live w/i 40 miles of a MTF. So it won't affect us.

 

[packrat44]

While I am under Tricare for Life; DW is under Tricare Prime. During 6 months of the year (snowbird season) we are within 30/35 miles of a base with a clinic. During the other 6 months we are about 85 miles from a base with a clinic. We have been having to make the change in providers every 6 months whenever we went north (or south). With this new change in Tricare Prime to take place in Oct 2013, we will keep DW listed in our snowbird residence. All scheduled medical work will be done while south. If medical aid is needed when up north, she will call her PC and get authorization to go to urgent care or, if needed, go to an emergency room.

 

[av8er]

I did not spend time trying to figure it out since I live w/i 40 miles of a MTF. So it won't affect us.

I'm curious which facilities are considered a MTF for the purposes of determining which retirees get to keep Tricare Prime...does one have to live within 40 miles of an inpatient MTF catchment area (TRICARE Management Activity - Geographic Reference Information) or simply live within 40 miles of any post/base with a clinic? The tool found at the website listed above seems to indicate that catchment areas are only for inpatient facilities. Anybody know for sure?

 

[infoseeker]

223748, thanks for the TRICARE link. In their definition of catchment area, that 40 mile radius is described as being around an "inpatient MTF". Clinics, to the best of my knowledge, are not inpatient facilities, so makes me think the center of that 40 mile radius needs to be a hospital. I spoke with a tricare representative recently and she said the prime geographic areas will also be redefined. That raises more questions for my situation. I'm pretty good at researching things I dont understand, but this whole tricare system confuses me. I'm new to tricare and sometimes dont even know what questions I should be asking. Guess we just need to be patient until we are notified next month with possible change in our prime eligibility.

 

[packrat44]

I'm curious which facilities are considered a MTF for the purposes of determining which retirees get to keep Tricare Prime...does one have to live within 40 miles of an inpatient MTF catchment area (TRICARE Management Activity - Geographic Reference Information) or simply live within 40 miles of any post/base with a clinic? The tool found at the website listed above seems to indicate that catchment areas are only for inpatient facilities. Anybody know for sure?

I also found the information on this site to be confusing. Therefore, I called TriWest and was told the MTF did not have to have a hospital. I was also told written notification will be going out to those presently on Prime sometime between the middle of Feb and the end of Mar. Maybe the written notification will be more clear.

 

[braumeister]

FWIW, I thought it was interesting that the 40 mile rule is not from the facility to where you live, but to the center of your ZIP code. That could make a difference for some people.

 

[packrat44]

Military.com has an article with a very comprehensive explanation regarding Tricare Prime. However, the word "inpatient" did not arise in the article.