TRICARE After Retirement

TRICARE Program for Retirees

Soldiers who are retired have the option to continue with TRICARE if they wish.  Other options are healthcare through their new employer or using the options from the Affordable Care Act.  For the purposes of this post, I will only discuss TRICARE here.

TRICARE after retirement can be divided into TRICARE in the United States and Overseas.  This post will only discuss the TRICARE costs i the United States.  I will put the information for the TRICARE Overseas Program (TOP) in a future post.

TRICARE in the United States after Retirement

To enroll, you must contact the correct region: either TRICARE East or TRICARE West (or TRICARE Overseas, but that will be discussed in another post).

Then, you will have two choices for TRICARE when you retire in the United States, TRICARE Prime or TRICARE Select.

The payments are divided into Group A and Group B which are defined as:
Group A: if you or your uniformed services sponsor's initial enlistment or appointment began before 01Jan2018
Group B: if you or your uniformed services sponsor's initial enlistment or appointment began on or after 01Jan2018


TRICARE Prime for Retirees and their Families

Annual Enrollment Fees
Group A: $289.08 per individual/ $578.16 per family - per year
Group B: $350 per individual/ $700 per family - per year

Annual Deductible
None

Costs for Covered Services:                    Group A           Group B
Preventive Care Visit                              $0                     $0
Primary Care Outpatient Visit                $20                   $20
Specialty Care Outpatient Visit              $30                   $30
Urgent Care Center Visit                        $30                   $30
Emergency Room visit                           $60                   $60
Inpatient Admission (Hospitalization)   $150                 $150   per admission

When you see a TRICARE-authorized provider other than your primary care manager for any non-emergency services without a referral, you pay:

• A yearly deductible before TRICARE cost-sharing begins: $300 per individual/ $600 per family
• For services beyond this deductible, you pay 50% of the TRICARE-allowable charge
• These costs do not apply to the catastrophic cap

TRICARE Select for Retirees and their Families

Annual Enrollment Fees
Group A: $0 - per year
Group B: $450 per individual/ $900 per family - per year


Annual Deductible - must meet deductible before TRICARE cost-sharing begins:
Group A: $150 per individual/ $300 per Family per year
Group B in network: $150 per individual/ $300 per Family per year
Group B Out-of- network: $300 per individual/ $600 per Family per year
Network means a provider in the TRICARE network.  Out-of-network means a TRICARE-authorized provider not in the TRICARE network.

Costs for Covered Services:                    Group A In      A Out         Group B                B Out
Preventive Care Visit                              $0                     $0               $0                          $0
Primary Care Outpatient Visit                $28                   25%            $25                        25%
Specialty Care Outpatient Visit              $41                   25%            $40                        25%
Urgent Care Center Visit                        $28                   25%            $40                        25%
Emergency Room visit                           $109                 25%            $80                        25%
Inpatient Admission (Hospitalization)   $250/day          $901/day     $175/admission    25%
Hospitalization for Group A, daily rate is paid or 20% of hospital bill, whichever is less; plus 20% of separately billed services for in network and 25% of separately billed services for out-of-network.


TRICARE Prime and TRICARE Select Calendar Year 2018 Catastrophic Cap:
Group A: $3000 per family
Group B: $3500 per family

Pharmacy Program Costs

Pharmacy Types                                        Generic        Brand-Name       Non-formulary
Military Pharmacy                                    $0                $0                         Not Available
TRICARE Pharmacy Home Delivery      $7                $24                       $53
TRICARE Retail Network Pharmacy      $11              $28                       $53
Overseas                                                  25% cost-share after the yearly deductible is met; reimbursed

Summary

You will have up to 30 days to decide if you want to enroll in one of the TRICARE programs.  During that 30 days, you will be reimbursed by TRICARE once you sign up and send them the receipts.

Each family will have a unique situation to consider.  Whether they are located near a military facility or not.  Whether they will primarily live overseas or not.  The health care you ultimately select shouldn't be a decision you make at the last minute.  Take and estimate of your retirement living situation and make a plan.

TRICARE house open seasons available to enroll.  If you miss this open enrollment time period, you may apply to enroll if you have a life changing situation such as a move to another area of coverage or if you retire during a time when no open enrollment is taking place.  In that case, you will have to contact TRICARE and explain your situation.

I will discuss the TRICARE Overseas Program and the available Dental and Vision programs in future posts.

Good luck!!

RR


Resources
TRICARE Online
TRICARE-West
TRICARE-East/ Humana Military
Express Scripts - TRICARE Pharmacy Services
MILCONNECT - Update DEERS Information

Now What? Retiring after 31 years, what's the next step?

Thirty-one years of working for the Army.  Thirty-one years of doing what the Army told me to do, and letting the Army take care of my health care, take care of my family, give me direction, pay my salary, having my back.  And now what?

I have all these veterans benefits that I have to figure out: health insurance, life insurance, education benefits.  They aren't black and white, and there seem to be a lot of decisions to make.  Thousands of veterans have done it already, so I thought it would be clear and easy, but it sure doesn't seem like that.  So, one of the things I want to do in this blog is clarify these benefits and the steps I went through to retire and receive these benefits.

So this is my blog.  It’s about the things that affect my current life.

Retirement.  After 31 years in the Army, my retirement was a little scary.  There were a lot of unanswered questions that I ‘googled’ and ‘yahooed’ and asked and searched for and never got complete and accurate answers.  So, for this part of my blog, I’m trying to keep my fellow soldiers informed.  Trying to pass on the information that I wanted when I was getting ready to retire.  Things I could have used, such as my finances during the first 6 months of my retirement, using the VA health system, using education benefits, and a myriad of other things that I don’t even know now to list here.

Writing.  I acquired my MFA in Creative Writing about 6 months before I retired.  Instead of working, my goal was to make up the difference in my salary by writing after I retired.  So the other half of this blog will be how I worked through the ins and outs of writing a novel, starting a platform, and making money and learning about writing.  Hopefully, this will help some other wayward writer or retiree to have realistic goals and aspirations.  I don’t intend to destroy dreams, rather, share my experience so they are better prepared.

Job hunting.  I'll have to search for another job in the mean time, until the writing money comes in, so I'll also discuss the ups and downs of that process.

I hope that the information here is helpful, for ultimately I hope to write something useful and if one person uses this information, then I will have succeeded.

For those of you who may not know, a PACE plan is a contingency plan.  PACE stands for Primary, Alternate, Contingency, and Emergency.  It's usually attributed to ways to communicate, four methods in case one or two don't work.  Here, I want to discuss the plans I made for my retirement and how my plans worked, or didn't work.

Thanks for joining me here on the blog, I hope the information is useful to you.

RS