Health care premiums for the adult children of military personnel and retirees will increase next year by 26 percent to 47 percent, depending on the type of coverage, Tricare officials announced Wednesday.

The monthly payment for beneficiaries using Tricare Young Adult Prime will rise from the current payment of $208 to $306 starting Jan. 1, while the monthly premium for those on Tricare Young Adult Standard will increase from $181 to $228.

Tricare officials say the increases are needed because the program must be "cost-neutral to the government," and after doing an analysis of the program's claims data from the past several years, Tricare officials found that the rates needed to be raised for the program to pay for itself.

"The reality is, by law, TYA is required to be cost-neutral, and we are following the law, to increase the premiums to reflect actual use of the program. There aren't other options on that," Tricare Health Plan Director Mary Kaye Justis said.

Tricare Young Adult offers coverage to unmarried dependents under age 26 of Tricare-eligible sponsors who don't have access to employee-offered health care or meet the age requirements to remain on regular Tricare — age 21, or 23 if the beneficiary is a full-time college student.

Young adults on TYA number 45,183 -- 26,910 using TYA Prime and 18,273 with TYA Standard.

Tricare Young Adult was established in 2011, providing military dependents the same extension of coverage required by the Affordable Care Act, which directed private health insurers to extend coverage for dependent children to age 26.

But some have criticized the program because, since it requires the Tricare sponsor to pay monthly premiums which are significantly higher than those required for enrollment in Tricare Prime, available for no enrollment fees for active-duty troops and families, and for $565.20 per year for military retirees with a family.

Beneficiaries who use Tricare Standard pay no enrollment fees but the program requires cost shares and co-payments.

Justis recommended that beneficiaries consider all their options when selecting a health plan, to include Tricare Young Adult Prime and Tricare Young Adult Standard.

Options include those on Tricare Young Adult Prime consider enrolling in Tricare Young Adult Standard, which is less expensive, determine whether they are eligible for coverage under another plan, for example, a different parent's employer coverage, or shop on the health care exchanges to determine whether there is a less expensive option or they are eligible for premium tax credits.

Justis acknowledged that beneficiaries are likely to be upset by the increases but added that the rate increases are not an effort to push beneficiaries off Tricare.

"From our standpoint, nothing could be further from the truth. There is an incredible commitment in Tricare to serve the active duty, the retirees and their families. We would absolutely love for young adults to stay on Tricare with us. But they may need to get an individual plan or perhaps they don't need the comprehensive plan that [Tricare Young Adult Prime] offers," Justis said.

About Patricia Kime

Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.

Share:
In Other News
Load More