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  • Tricare provider


    Some Tricare beneficiaries still have problems trying to get medical care, and officials have taken actions to try to improve the performance of contractors, said Navy Vice Adm. Raquel Bono, director of the Defense Health Agency.

    Officials are closely monitoring the performance of the two U.S. Tricare contractors, Humana Military in the East region, and Health Net Federal Services in the West region, said Bono, speaking at a family forum Monday at the 2018 AUSA annual meeting.

    She said she recently was impressing upon some senior spouses that “it’s extremely important to me that we get the type of performance we need” from the contractors.

    And, she told them, “While I may not look like it, I can be a bad ass.”

    Defense health officials have issued several corrective action plans to the contractors, among other things. Through August, the contractors were meeting contract requirements at a level of about 80 percent.

    She said there are still challenges with the accuracy of the contractors' provider directories. Defense health officials have issued corrective action plans to both contractors regarding these issues. Families have had trouble finding area doctors and other medical providers who are in the Tricare network.

    Officials also issued a corrective action plan to Health Net regarding its customer call centers. Humana has corrective action plans regarding claims processing, correspondence, autism care/Applied Behavior Analysis therapy.

    Tricare underwent massive changes in January, as three regions were reduced to two, and Tricare Select replaced Tricare Standard and Extra. There have also been increases in some co-pays and some pharmacy costs.

    Help spread the word

    Bono asked for the help of those in the audience – which included many military spouses – in getting the word out about important changes coming up.

    There are new requirements for those who are retiring. To keep Tricare with no break in coverage, the service member must re-enroll within 90 days of retirement.

    There are new open enrollment seasons affecting three benefits, all of which will be held Nov. 12 to Dec. 10:

    • Those in Tricare Prime or Select who like their plan don’t need to do anything. But anyone wishing to switch from Prime to Select, or vice versa, must do so during that open season. Until now, families could switch at any time. But once the open season is over, a switch can be made only for a qualifying life event. A few examples of those are moving, retiring, separating from active duty, getting married, having children, and getting divorced. (
    • The Tricare Retiree Dental Program ends Dec. 31. To have dental coverage for themselves and their family members through the government in 2019, retirees must enroll in the FEDVIP plan during that open enrollment season which starts Nov. 12. (
    • Retirees and their family members and active duty family members (not active duty) will also have access to new vision coverage under the FEDVIP, during that open enrollment season which starts Nov. 12. (


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  • 5 Things Tricare


    For the first time ever, Tricare will host an open enrollment period for military families and retirees who want to change their coverage plans.

    Currently, changing between Tricare Prime and Tricare Select, previously known as Tricare Standard, is easy and typically not time sensitive for active-duty families and retirees. If you want to change and your military status or location qualifies you to do so, you can simply call your Tricare regional contract and ask to be swapped. Sometimes, there is a waiting period before you can switch from Tricare Select to Tricare Prime, but it is often waived.

    Starting Jan. 1, however, the ability to switch back and forth at will is going away. Here's what you need to know:

    1. To change plans, you must have a "qualifying life event." Along with the change to Tricare Select from Tricare Standard, the Defense Health Agency did away with the ability to switch back and forth. Starting Jan. 1, you'll need to experience a "qualifying life event" (QLE). What does that mean? Tricare officials created a list based off industry standards. It includes things like a move, job loss and being recaptured from a civilian doctor into the Military Treatment Facility system. You can see a complete QLE list on Tricare's website.

    2. Tricare's QLE list does not include pregnancy. While giving birth is a qualifying event that would let you switch between plans, pregnancy is not. That means military spouses who think they might get pregnant and who do not want to be seen for their pregnancy within the military treatment facility system should register for Tricare Select during the annual open enrollment period.

    3. Open enrollment happens only one time each year. Once a year, all Tricare users will have the chance to switch plans without first having one of those QLEs. That window will run from mid-November to mid-December. Starting Jan. 1, 2019, if you missed that window, you will not be able to change plans.

    4. Other Tricare users can switch at any time. Tricare users on Tricare Reserve Select, Tricare Retired Reserve and Tricare Young Adult don't have to worry about QLEs. Instead, they can enroll or un-enroll at any time. That's because those programs, known as "purchased plans," are based on other eligibility factors such as age and Guard or Reserve status.

    5. The newly available vision plans also have enrollment rules. Looking to take advantage of the vision plan now available for military families through the Federal Employees Dental and Vision Insurance Program (FEDVIP)? That program has its own open enrollment rules. You will also need to enroll or make changes to your coverage during the annual open enrollment or during a qualifying life event.


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  • DVA Logo 009


    Do you have a family member who gets supplemental services through the TRICARE Extended Care Health Option (ECHO) program? If so, you need to know that beginning on Jan. 1, 2019, the ECHO benefit cap will apply to covered costs during a calendar year and not a fiscal year October 1 - September 30. The calendar year runs from Jan. 1 to Dec. 31. Due to the shift to calendar year, TRICARE adjusted the benefit cap by $9,000 to cover the remaining quarter of this year. The $36,000 limit for the costs of all ECHO benefits combined will reset on Jan. 1, 2019. For more information, visit the TRICARE ECHO webpage.


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  • Monitor Tricare


    Pentagon officials need to do more to make sure civilian health care providers are giving military families good care, according to a new report from the Government Accountability Office (GAO).

    The report, released Sept. 17, found that while military health care officials have created a way to monitor whether families and troops are getting quality care from military treatment facilities, those same benchmarks aren't applied to community-based providers.

    "As a result, DoD's senior leadership has limited information on the extent to which Military Health System (MHS) beneficiaries receive consistently high-quality care across the MHS," the report states.

    To keep track of health care performance, the Defense Department has two sets of measurements -- one for military treatment facilities and one for civilian care.

    But for community-based care, rather than the providers and hospitals themselves, the Pentagon instead reviews the performance of Tricare's two civilian health care contractors, Health Net and Humana, using what's known as the Purchased Care Dashboard. The Pentagon expects those contractors, in turn, to monitor individual doctors and hospitals.

    But the providers' performance isn't based off the metrics created by the Pentagon, and details on whether the contracted doctors are providing good care aren't shared with military officials, the report found.

    "According to MHS officials, the MHS does not require the contractors to ensure that each individual hospital, physician or other provider in these networks meets the performance standards related to the Purchased Care Dashboard measures," the report states.

    And while the contractors are expected to make sure military families are receiving quality care, they aren't required to push out providers who don't perform, it adds.

    "In practice, however, MHS officials said, and documents we reviewed show, that providers are rarely removed from the network," the report says. "For example, MHS officials reported that one contractor estimated that one provider was removed from its network over quality issues every one to two years."

    Pentagon officials told GAO investigators that they don't require performance reports from individual doctors because they don't want to increase provider workloads. Instead, they said they are creating a series of "value-based" pilot programs that give extra incentives and rewards to providers who have good outcomes.

    The GAO found fault with that plan, however, because even when completely in place in 2020, those incentive programs would affect only about 25 percent of care. That means the bulk of patient experiences would be left without DoD oversight.

    "Without consistent performance standards and corrective action requirements, DoD is limited in its ability to address variation in the quality of care delivered and help ensure that its beneficiaries receive consistent high-quality care across the MHS," the report states.

    Instead, the auditors recommend that the Pentagon fix the Tricare East and West contracts to require action against providers who don't meet the standards.

    Defense officials countered that when it comes to the contracts, their hands are tied -- at least for now.

    "The Defense Health Agency will hold the contractor to the contractual performance standards, but currently cannot take action against individual providers based solely on performance," Pentagon officials said in a response included with the report.


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  • TRICARE Logo

    By law, the TRICARE Retiree Dental Program (TRDP) will end on Dec. 31, 2018. New dental plan options for those enrolled in TRDP will be available through the Federal Employees Dental and Vision Insurance Program (FEDVIP). FEDVIP vision coverage will also be available for the first time.

    In case you missed the September webinar, join the TRICARE webinar on Oct. 11, from 2 to 3 p.m. ET, to learn about new dental and vision coverage under FEDVIP. The “New Dental and Vision Coverage Options for TRICARE Beneficiaries” webinar will discuss who is eligible for FEDVIP, as well as how and when to enroll.

    There’s no automatic enrollment into a new dental plan once TRDP ends. For 2019 dental coverage, retirees and their family members must take action to enroll in a FEDVIP plan. All beneficiaries eligible for TRDP are eligible for FEDVIP dental coverage. Visit the FEDVIP website for dental plan options.

    If you’re eligible, your first chance to enroll in FEDVIP is during the 2018 Federal Benefits Open Season. This runs from Nov. 12 through Dec. 10, 2018. Your coverage will then start Jan. 1, 2019.

    Retirees, retiree families, and active duty families are eligible for FEDVIP vision coverage. This year’s FEDVIP open season is also your first chance to enroll in a FEDVIP vision plan. If you enroll during open season, your coverage will start Jan. 1, 2019. Visit the FEDVIP website for vision plan options.

    Register to join us on Oct. 11 to learn more about the TRDP transition to FEDVIP and what the change means for you. A Q&A led by the presenters will follow the presentation.

    Keep updated on all of the TRICARE changes. For the latest on changes to TRICARE, visit TRICARE News and TRICARE Changes.


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  • Tricare Pmnt Glitch Snags


    More than 4,000 retired Tricare Prime users in the northern U.S. may not have paid their January enrollment fees due to a glitch caused during a contractor change this month.

  • TRICARE Logo


    If you’re eligible for TRICARE, you can choose from a variety of plans. This gives you options for where and how you seek medical care. But how do you decide which plan or plans are best for you and your family members? The TRICARE website can help you learn what health plans you may be eligible for and compare plan features and costs. This will help you choose the right TRICARE plan for you and your family.

    Find a TRICARE Plan

    If you aren’t sure what health plans you may be eligible for, start by using the TRICARE Plan Finder. Answer a few simple questions, and the tool will display the choices of plans you may be eligible for based on who you are and where you live. You can do this for yourself or for family members. Remember that different family members may be eligible for different plans.

    Compare Plans

    If you want to compare several health plans, you can compare their features side-by-side using the Compare Plans tool. Simply select the plans you’re interested in learning more about. The results will display in a table, allowing you to compare the main features and costs of each plan, including:

    • Cost for a primary or specialty care visit
    • Annual deductible
    • Maximum out-of-pocket costs
    • Enrollment requirements
    • Annual fee
    • Locations where the plan is available

    Take command of your health by making informed decisions about your TRICARE benefit. The TRICARE Plan Finder and Compare Plans are just two helpful tools that make it easier to determine the right health plan for you and your family.


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  • TRICARE Logo


    On July 13, 2018, the Food and Drug Administration (FDA) issued a voluntary recall of valsartan. Valsartan is used to treat high blood pressure and heart failure.

    The FDA announced the voluntary recall after finding an impurity linked to cancer in drug products containing valsartan.

    Not all valsartan-containing drugs are affected and have been recalled.

    Express Scripts identified 31,120 TRICARE beneficiaries who potentially received contaminated products through the mail order network or from retail pharmacies. The Department of Defense (DoD) sent notification letters to all beneficiaries who potentially received currently affected products.

    The FDA notes that because this is an ongoing investigation, more manufacturers may voluntarily recall their valsartan products. If additional valsartan products are added to the recall list, the DoD will continue to send letters to TRICARE beneficiaries who received contaminated products.

    Patients and prescribers are also encouraged to check the FDA website often for potential changes in the recall status of their valsartan medicine.

    If you take valsartan, the FDA recommends:

    • Continue taking your current medicine until your doctor or pharmacist gives you a replacement or a different treatment option.
    • If you are taking any medication containing valsartan, compare the information on your prescription bottle with the information in the recall list (company, National Drug Code, lot number) to determine if your current medicine has been recalled. If you are not certain, contact your pharmacist.
    • If you have medicine included in the recall, contact your pharmacist. The pharmacist may be able to provide you with valsartan made by another company. If not, contact your doctor immediately to discuss other treatment options.

    You can find the latest information about the recall and affected products on the FDA website.

    If you have more questions about the recall, contact the FDA or the Defense Health Agency (DHA) Pharmacy Operations:

    FDA: 855-543-3784 (toll-free) or This email address is being protected from spambots. You need JavaScript enabled to view it.">This email address is being protected from spambots. You need JavaScript enabled to view it.

    DHA: 866-275-4732, option 1 (toll-free) or This email address is being protected from spambots. You need JavaScript enabled to view it.">This email address is being protected from spambots. You need JavaScript enabled to view it.


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