The U.S. Department of Defense plans to drastically reduce the areas where it offers the TRICARE Prime military health care system, a move that could impact some 2,500 military retirees and family members in Southern Oregon.
Effective Oct. 1, the action would eliminate TRICARE Prime beneficiaries along the Interstate 5 corridor in Oregon, according to U.S. Rep. Greg Walden, R-Ore. Moreover, it would eliminate service to a small number of military retirees within 100 miles of the interstate, including those in Klamath Falls, Bend and Hood River who choose to keep their primary care provider after moving, he said.
Those impacted would be taken out of TRICARE Prime, a health maintenance organization, and be placed in TRICARE Standard, a fee-for-service plan.
Many military retirees have told him they prefer their current plan and are concerned with the changes, said Walden.
TRICARE is the Department of Defense health care program, which provides coverage for medical services, medications and dental care for military families and military retirees and their survivors.
Nationwide, some 171,000 beneficiaries would be impacted by the move, which could cut costs by $56 million a year, according to the department. The move has been planned since 2007, it noted.
The change will not impact any active duty service members or their families. Nor will it affect those with TRICARE for Life, the program that covers military retirees older than 65.
However, the changes call for providing TRICARE Prime only to beneficiaries living within 40 miles of a military treatment facility, according to Walden. In Oregon, there are only two such treatment facilities, both U.S. Coast Guard medical clinics on the Oregon Coast, he said.
Concerned about the changes, Walden, along with fellow U.S. Reps. Suzanne Bonamici, D-Ore., and Mark Amodei, R-Nev., late last year sponsored legislation requiring the Pentagon to detail and address upcoming changes in TRICARE Prime in this year's defense authorization law.
The TRICARE Protection Act also requires the Defense Department to assess the increased cost and overall impact of the changes on military retirees and their families. It requires the department within 90 days to inform Congress of its plan to provide the beneficiaries with a smooth transition.
"Now that most TRICARE Prime patients will be switched to a different insurance plan, TRICARE Standard, patients aren't assured that their current primary care physician and health providers will be part of their network," Walden said in a prepared statement.
"It's up to the Pentagon to make sure that care is not interrupted for these patients," he continued. "Military retirees who served our nation in uniform deserve the very best care our nation has to offer."
Ashland resident Dave Dotterrer, 61, a retired Marine Corps colonel, has been in the TRICARE Prime system since he retired a dozen years ago after 27 years in uniform.
"I like TRICARE Prime," he said. "It's been a good program. There are some issues with it in terms of the numbers of doctors willing to take it, but we've always been able to find one.
"Now we will be forced into TRICARE Standard," he added. "That's going to be an issue. I'm concerned because of the reimbursement rate and whether our doctor will take it."
He also noted that it leaves only one option for him and his family.
"Now it will be unicare — they are taking away the options," he said.
The Defense Department had intended to implement the changes in April but announced last week that it would delay the move until Oct. 1 of this year. Last fall, the Oregon delegation had sent a letter to the department expressing concern about the planned changes.
In an information paper released Jan. 10, the Department of Defense said the move could save from $45 million to $56 million.
Military retirees impacted by the change may transfer their Prime enrollment to a more distant prime service area if one is available within 100 miles.
Anyone not enrolling in a more distant prime service area would automatically be covered by TRICARE Standard, it noted.
The department indicated it would be contacting beneficiaries months in advance of any changes.
It plans to post updates on www.tricare.mil.
Reach reporter Paul Fattig at 541-776-4496 or email@example.com.