TRICARE and You – Upcoming contract changes

This blog is the most recent in a series helping members of the Coast Guard family understand how to use their TRICARE benefits. The blog series will continue every Monday, right here on Coast Guard All Hands.

Written by Cmdr. Paul Fawcett, chief of Medical Administration for Coast Guard’s Office of Health, Safety and Work-Life

Changes are coming to the way TRICARE is managed, and it’s important that you stay informed so that you get the most out of your benefit. 2016 saw a major renegotiation of the TRICARE contract, affecting all Coast Guard, DOD, PHS and NOAA members, dependents and retirees. A transition period will be in effect until late 2017, when the new contract will begin.

1. What’s new?

The basic benefit remains the same. There won’t be any loss of services or programs that you currently use. In most cases you should be able to keep the doctor that you currently have. Most doctors should elect to participate in the new TRICARE contract, if for some reason yours doesn’t; TRICARE will provide you with a list of participating doctors in your area.

The new contract reduces the number of TRICARE regions from three to two. One of the benefits of the new contract is a push to reduce paperwork for referrals and improve coordination between military hospitals and civilian healthcare, particularly DOD healthcare facilities and the TRICARE network. The reduction of regions from three to two also allows the regional contractors to coordinate more easily.

2. What does it look like?

The below graphic shows the current three TRICARE regions, and the new two-region construct coming in late 2017. Healthnet will assume the new west region contract and Humana will assume the new east region.

tricare map change 2

Map of Tricare regions.

3. What should I do?

Right now you don’t need to do anything, your current regional contractor won’t change until late 2017. When it does change you should receive notice from TRICARE.

You can sign up for email updates from TRICARE so that you get the latest information available, or you visit the TRICARE new contracts page to stay current on new information.

4. Upcoming changes

The 2017 National Defense Authorization Act directs major improvements to the military health care system that we all use. These improvements include lower copays for certain high value drugs, eliminates preauthorization for specialty care referrals and expands the telehealth program.

* An upcoming blog will provide you with complete information on what this means to you.

For Coast Guard members with TRICARE questions or problems, contact the Health Benefits Assistance line at 1-800-9-HBA-HBA or CGHBA@uscg.mil.

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