FALLS CHURCH, Va. –
2023 was a big year for TRICARE. Digital tools, demonstrations, and a strong TRICARE Open Season were just a few of the major stories.
The Defense Health Agency delivers TRICARE, the military’s health benefit. It provides coverage to approximately 9.6 million uniformed service members, retirees, and their families.
There’s an App for That
The DHA has a strategic focus on a digital-first approach to health care access and information. And 2023 saw TRICARE offering new digital tools and apps.
In April, the TRICARE Overseas Program Office announced the launch of the MyCare Overseas app. International SOS, the TOP contractor, manages the app. MyCare Overseas makes it easy for you to manage your health care at home and on the go.
“MyCare Overseas lets you get help with health care services and manage your TRICARE benefit, all in one place,” said Michael Griffin, program analyst with the TRICARE Overseas Program Office at the Defense Health Agency. “It’s a handy tool for finding providers, getting real-time language help, tracking your referrals, and much more.”
TRICARE also has a pharmacy app to help fill prescriptions without talking to a doctor. The Express Scripts Pharmacy mobile app lets you securely manage your prescriptions. You can also order and track prescriptions from your phone.
“The mobile app is a great tool for learning about your medication and managing your TRICARE prescription benefits,” said Marcy Opstal, a senior program analyst with the DHA’s Pharmacy Operations Division. “And if you use TRICARE Pharmacy Home Delivery, the app makes it easy to order and track your prescriptions.”
Are you enrolled in the TRICARE Dental Program (TDP)? If so, TDP also has MyAccount. It’s an online tool for you to manage your dental benefits. Visit the TDP website to learn how to get started today.
But you don’t need an app to access immediate health care advice. The Military Health System Nurse Advice Line provides health advice from a registered nurse. This is available 24-hours a day, seven days a week. You can use the MHS Nurse Advice Line any time you have questions about an illness or injury.
No Copayments for Certain Contraceptive Care
In 2023, TRICARE eliminated copayments and cost-shares for TRICARE Prime and TRICARE Select beneficiaries who choose a permanent birth control method, such as tubal ligation.
TRICARE covers a full range of contraceptive methods, regardless of which health plan beneficiaries have. And these changes help make sure you’ll have easy, convenient, and timely access to contraceptive services.
“The waiving of cost-shares and copayments for certain contraceptive services is one way we’re making it easier for you to get the care you need. Remember to ask your primary care provider if you have questions,” according to Regina Julian, deputy assistant director for DHA’s Health Care Operations.
Under these changes, eligible beneficiaries no longer pay cost-shares or copayments for all TRICARE-covered reversible medical contraceptives. These include IUDs, hormonal shots, and slow-release hormonal rods, which go under the skin.
For details, check out TRICARE Offers Contraceptive Care To Support You, Your Family, and Your Readiness.
Pilots and Demonstrations
TRICARE offers pilots and demonstrations to achieve the goals of enhancing patient care and reducing costs. TRICARE pilots and demonstrations offer innovative health care services, treatments, and approaches.
“The use of these pilots and demonstrations allows TRICARE to develop and test innovative approaches and services with the broader TRICARE beneficiary population, as well as specific services to targeted groups,” said U.S. Air Force Lt. Col. Donald “Del” Lofton, chief, TRICARE Optimization. “The goal is always to provide the most effective, high-quality, value-based health care while seeking to improve the overall health care experience for both beneficiaries and those who provide them care.”
In the summer, TRICARE extended demonstrations for laboratory developed tests until July 18, 2028. Laboratory developed tests assess risk or help guide treatment of certain medical conditions or rare diseases. The laboratory developed tests demonstration project allows TRICARE to review tests that haven’t been evaluated by the Food and Drug Administration. It also gives members access to tests not usually covered by TRICARE.
Under the five-year TRICARE Childbirth and Breastfeeding Support Demonstration, TRICARE began covering three new types of TRICARE-authorized providers:
- Certified labor doulas
- Certified lactation consultants
- Certified lactation counselors
Read the review of ongoing pilots and demonstrations.
Health Plan and Pharmacy Costs
Updated health care costs made big news in November, in conjunction with the annual TRICARE Open Season. TRICARE announced new health plan costs and pharmacy costs to begin Jan. 1, 2024.
“TRICARE costs may change every year based on the law and the federal cost of living adjustment,” said Zelly Zim, a senior analyst with TRICARE Policy and Programs at the DHA. “Other factors, which include changes in the costs of health care services and prescription drugs, can also affect TRICARE costs.”
For pharmacy, “these new costs are part of the National Defense Authorization Act for Fiscal Year 2018,” said Melanie Richardson, a pharmacist in the Pharmacy Operations Division at the DHA. “Most beneficiaries will pay $1 to $8 more per copayment. These new costs help continue to maintain high-quality delivery of your TRICARE health benefit.”
Do you know the difference between copayments and cost-shares? You can learn more about cost terms by reading Copayments, Cost-Shares, and Other TRICARE Costs You Should Know or by going to TRICARE Copayments and Cost-Shares.
Coverage Added for New Insulin Delivery Device, Automatic Blood Pressure Monitors
On Feb. 15, TRICARE began covering the Omnipod 5 insulin delivery device under your pharmacy benefit. You must have pre-authorization from your doctor. To find the cost, coverage rules, and availability of this device, check the TRICARE Formulary Search Tool. You can find information on your other prescriptions and devices through the TRICARE Formulary Search Tool as well. You may find some products available at military pharmacies, through home delivery, or at TRICARE retail network pharmacies.
Keep in mind, if you use the US Family Health Plan, you must use a USFHP pharmacy provider. When you have USFHP, you can’t use the TRICARE Pharmacy Program.
In June, TRICARE started covering automatic blood pressure monitors when prescribed under certain circumstances.
New TRICARE Dental Program Contract Announced
In October, DHA announced that the new dental contract was awarded to United Concordia Companies. For current coverage, TRICARE offers a variety of information for beneficiaries to learn about the variety of dental coverage that TRICARE offers.
Prevention is Key
TRICARE publishes articles and other materials regarding preventive health services throughout the year. This is to remind you that taking care of yourself is vital to staying healthy. And that an emergency isn’t the only time to access health care.
A sampling of other TRICARE news in 2023 include:
Want to better understand your TRICARE benefit? Visit TRICARE.mil. You can also read informative articles, news, and tips in the TRICARE Newsroom.
Would you like the latest TRICARE news sent to you by email? Visit TRICARE Subscriptions, and create your personalized profile to get benefit updates, news, and more.