Military Officer - March 2008 - (Page 32) washingtonscene The chart below summarizes the task force plan. The yearly cost increase shows a fairly wide range because the task force recommended graduating fees based on the beneficiary’s level of military retired pay. Those with $19,999 or less in retired pay would pay one fee, with higher fees for those earning $20,000 to $39,000, and even larger amounts charged to people who earned $40,000 or more. And under the task force’s plan, more and more beneficiaries would be pushed into the higher-fee tiers every year, because fees would increase more than twice as fast as adjustments in the income thresholds. MOAA and TMC strongly object to this de facto means-testing of military health benefits, when no other federal health programs and less than 1 percent of civilian programs require different health fees for different salary levels. The secretary of Defense and the speaker of the House pay no more for health care than their lowest-paid clerks, nor will they in retirement. MOAA and TMC assert that all beneficiaries earn equal coverage by virtue of their service, and the fees required of them should be significantly lower than the lowest tier proposed by the task force. Proposed prescription fees would exceed those of many civilian plans. The task force would raise cost-shares by 100 percent to 400 percent for prescriptions dispensed through retail pharmacies. The copayment for generic drugs would increase from $3 to $15. For brand-name drugs, the beneficiary copayment would be $25 instead of $9. And for non-formulary drugs, it would increase from $22 to $45. For comparison, those pharmacy fees would exceed those of many plans currently offered to federal civilians, and they’re higher in all cases than the Blue Cross Blue Shield plan MOAA offers to its civilian employees (see chart on page 34). The proposal is all the more perplexing because many civilian plans have reduced copayments for generic drugs. Last year, Wal-Mart trumpeted its offer of $4 generic drugs to the general public. If DoD wants to make military people feel good about their health plan and encourage people with chronic diseases to take their medications (and thus reduce long-term TRICARE costs), we don’t see how jacking up fees to almost four times the Wal-Mart price is going to do that. What will happen next? The leadership of the House and Senate Armed Ser- Current Versus Proposed TRICARE Fees The DoD Task Force on the Future of Military Health Care recommended the fee structure below. The proposed deductibles include annual medical inflation adjustment. Some fees would vary based on retired pay amount. Current Proposed TRICARE Prime 1 — retiree under age 65, family of three $1,090-2,090 $460 Enrollment fee $125 Doctor visit copayments $60 $960 Prescription cost shares 2 $288 $2,175-3,175 $808 Yearly cost 1 TRICARE Standard — retiree under age 65, family of three $120 $0 Enrollment fee $600-1,150 $300 Deductible $960 Prescription cost shares 2 $288 $1,680-2,230 $588 Yearly cost TRICARE For Life — retiree over age 65 and spouse $2,314 $2,314 Medicare Part B $240 $0 Enrollment Fee 3 $1,260 Prescription cost share $396 $3,814 $2,710 Yearly Cost TRICARE Standard 1 — currently Enrollment fee Deductible Prescription cost shares5 Yearly cost 1 serving family of four $0 $300 $180 $480 $1204 $600-1,150 $660 $1,260-1,930 2 3 4 5 Fully phased-in proposal. Prime assumes five doctor visits a year. TRICARE For Life assumes lowest tier Medicare Part B premium for 2008. Assumes two generic and two brand-name prescriptions a month purchased at a retail pharmacy. Assumes two generic and three brand-name prescriptions a month purchased at a network retail pharmacy. Task force report does not clarify whether enrollment fees would apply to currently serving families who elect TRICARE Standard. Assumes two generic and one brand-name prescription a month purchased at a retail pharmacy. 32 MILITARY OFFICER MARCH 2008
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