On October 1, 2013, some Prime Service Areas (PSAs) for TRICARE were eliminated. This means to qualify for TRICARE Prime you now must live within 40 miles of an active or former military base. As a result of this change:
- About 3% of the current 5.25 million TRICARE Prime enrollees were affected and required to switch to TRICARE Standard. Check this ZIP Code Look-up Tool to see if you live in an area that has been affected by the PSA change.
- All beneficiaries remain eligible for TRICARE Standard. Watch this video to learn how to use TRICARE Standard.
- The PSA changes don’t affect other TRICARE benefits, such as pharmacy or dental coverage.
If you were among those affected, you were automatically switched from TRICARE Prime to TRICARE Standard effective September 30, 2013. Your regional contractor should have sent you a letter confirming this change.
So, what’s next?
Among the differences between TRICARE Prime and Standard is that beneficiaries accustomed to paying an annual enrollment fee for Prime and out-patient co-pays of $12 with no deductible will be seeing a dramatic difference. TRICARE Standard doesn’t have enrollment fees, but beneficiaries will have to pay cost shares of 25% and annual deductibles of $150 for individuals and $300 for families. This is a significant difference in cost.
To help cover these out-of-pocket costs, you may want consider USBA TRICARE Standard/Extra Supplement Plan. It’s an affordable way to help fill the gap between what TRICARE Standard pays and what you have to pay.
Important Note: If you’re eligible for TRICARE Standard, you’re guaranteed acceptance for the USBA TRICARE Standard/Extra Supplement Plan regardless of your health. There are no health questions to answer and no medical exam is required. When you apply, your coverage is guaranteed.
For more information and answers to your questions, take a look here or call and talk with a helpful USBA TRICARE Supplement specialist at 800-368-7021.
For more news of interest to military actives, retirees and transitioners, check out this new issue of Member Briefings.