TRICARE expansion for young adults will be retroactive

By Jared Serbu
Federal News Radio

A new program that will let TRICARE beneficiaries keep their dependent children insured on their own plans up to age 26 will not formally take effect for several months. But the government will pay the bill for any eligible health care costs incurred between now and then, a senior official said Tuesday.

Congress passed the eligibility expansion as part of the 2011 National Defense Authorization Act, which lawmakers intended to mirror a similar provision for private insurers in last year’s broader health care reform law. The new provision, however, will not take effect until President Obama signs the authorization bill, and then it will take the military health care program four to five months to design and launch the new benefit. But Michael O’Bar, TRICARE’s deputy chief for policy and operations, said in an interview with Federal News Radio that the agency intended to make the coverage retroactive to Jan. 1.

“As long as the parent is an eligible TRICARE beneficiary the child is eligible for the same versions of the health plan that the active duty member or retiree is eligible for,” O’Bar said. “We’ll be educating our beneficiary population that if they think they’re going to want to take advantage of this benefit when we finally have it implemented, they should begin now saving their medical and pharmacy receipts, because they can then retroactively file once we have the benefit up and running.”

O’Bar said TRICARE estimated that as many as 750,000 young adults might be eligible for coverage under the new Young Adult program. He said TRICARE assumes roughly 250,000 will actually sign up.

Separately, O’Bar said the TRICARE Management Activity had been working to expand the rolls of coverage to members of the National Guard, reserves and retired reservists via two programs either begun or expanded in 2010.

One program, known as TRICARE Reserve Select, added 11,500 new enrollees from January through November. It covers members of the Guard or reserves who currently are drilling.

“We think we’re working really hard, and successfully so, to cover reservists so that they can maintain their medical readiness status while they’re not on active duty,” O’Bar said. “That’s good for them, and it’s good for the nation when we activate them, because it means they’re ready to go.”

O’Bar said TRICARE had reshaped the plan in 2010 to make it more attractive to reservists and that it was now managing more than 66,000 Reserve Select plans.

A second plan aims to cover retired reservists who are in what had become known as the “gray area” — those who had retired from the Guard or reserve, but had not yet reached age 60–the point at which they would become eligible for TRICARE. The Retired Reserve program, launched in September, lets retirees buy into TRICARE for themselves and eligible family members prior to reaching 60 years old.

“We’re very proud of both of these efforts. We’ve spent a lot of time and effort making them attractive plans for reservists, National Guard and their families,” O’Bar said.

O’Bar said the Retired Reserve program is funded entirely by premium revenue, while participants in Reserve Select would pay 28 percent of the cost of the program – roughly in line with the share paid by enrollees in the Federal Employee Health Benefit Program.

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