Military family advocates are worried that some beneficiaries dropped from the Defense Department's Tricare Select health program in January won't know they don't have health coverage until they go see a doctor.
These beneficiaries -- working-age military retirees and their family members who were enrolled in the Tricare Select health program last year -- failed to set up payment plans for enrollment fees introduced Jan. 1, leaving them without access to comprehensive health care coverage under Tricare.
Tricare's two main contractors, Humana Military and Health Net Federal Services, have been reaching out to individuals about their lapsed coverage and the new payment requirements; at least 400 have told the contractors they no longer want the coverage.
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But 14% of the 876,531 retirees and family members who were enrolled in Tricare Select in 2020 have not set up an allotment or payment plan, including at least 60,000 beneficiaries who haven't filed a medical claim in the past year. That leads advocates to worry that roughly 119,000 people have missed the news about the new fees.
"We had concerns that it was going to be difficult to reach some of these folks from the beginning," said Karen Ruedisueli, director of health affairs at the Military Officers Association of America. "You have people who are no longer connected to the military community, living in areas where there's not a military treatment facility and are 10 to 15 years into retirement."
According to data provided by Humana and Health Net, roughly 700,000 of those enrolled in Tricare Select last year have set up payment plans to cover the fees or have paid ahead for the year, including 54,000 who missed the Jan. 1 deadline.
The Defense Health Agency has extended what originally was a 90-day deadline for reinstating coverage to 180 days, or the end of June. During the grace period, those who failed to establish payment can pay any missed monthly fees and renew coverage.
If they miss the June deadline, however, they will have to wait until Tricare open enrollment season in November to re-enroll.
"I worry that there will be people out there who aren't going to find this out until after the reinstatement period is over, and they are pretty much out of luck until the next open enrollment period in November," said Eileen Huck, deputy director for health care at the National Military Family Association.
Sen. Steve Daines, R-Mont., and Sen. Joe Manchin, D-W.Va., introduced legislation last month that would extend the reinstatement period to the end of 2021. Huck said her organization has urged the Defense Health Agency to extend the deadline and would support legislation if that doesn't happen.
"I'm grateful [the senators] are following this issue and are concerned about it," Huck said. "I'm glad members of Congress are potentially aware that this is a big problem."
The enrollment fees were included in the fiscal 2017 National Defense Authorization Act at the request of the Defense Department, part of an overall reform effort of the military health system. The monthly fees, for retired beneficiaries who joined the military before 2018 or their dependents, are $12.50 for an individual or $25 for a family.
Last week, Sens. Jon Tester, D-Mont., and Lisa Murkowski, R-Alaska, introduced legislation that would eliminate the fees altogether, effectively overturning the 2017 provision that introduced them.
Tester said the bill would ensure that military retirees and their families aren't "burdened by costly enrollment fees [that] put their health care in jeopardy" during a pandemic.
"This legislation is a critical step in supporting more folks during these tough times," he said in a release Friday.
Murkowski said the fees affect most of Alaska's retired military population and should be eliminated.
"COVID-19 has had significant impacts on America's veterans and their families. We must guarantee their hard-earned medical benefits are protected throughout this public health crisis, and beyond," she said in a release.
Both senators voted in 2016 in favor of the bill that enacted the fees.
The enrollment fees are payable by allotment, credit card or direct debit from a bank account. They apply to "Group A" retirees and their dependents -- working-age retirees under age 65 who entered the military before Jan. 1, 2018, and their family members or survivors.
The fees do not apply to active-duty families who use Tricare Select or those who use Tricare for Life, are enrolled in Tricare Prime, or use any other premium-based plans through Tricare. The change also does not affect survivors of deceased active-duty members or medically retired retirees and their family members.
-- Patricia Kime can be reached at Patricia.Kime@Monster.com. Follow her on Twitter @patriciakime.
Related: Pentagon to Retirees: Plan Now for Tricare Select Enrollment Fees in 2021
