04 Sep The Need for TRICARE
Not convinced whether TRICARE is the right option for you? Give this article a read to know why you should be signing up for a health care plan with TRICARE.
The Need for TRICARE Overview
The TRICARE health care system evolved from the CHAMPUS system. In the past, most men and women who were enlisted in the military and their families were catered to by military health care facilities.
In some cases, where military facilities were not available or there were not enough doctors or nurses to attend to people in military medical centers, these people were referred to civilian medical centers. There was a severe strain on military medical services in the aftermath of the Second World War as well as the Korean War. This highlighted a severe dearth of resources, both in terms of equipment as well as medical professionals.
The Congress addressed this issue by passing the Dependents Medical Care Act (1956) and Military Medical Benefits Amendments (1966). As a result of these acts, the Secretary of Defense could now form contracts with civilian medical care providers. This was then called CHAMPUS, which stands for Civilian Health and Medical Program of the Uniformed Services.
Over time, CHAMPUS went through various different reforms, until it was eventually decided to implement a program across the nation that would provide access to health care services to the armed services (and their families and dependents) in the United States. This was known as TRICARE and it was to be regionally managed; the country was split up into twelve different regions and each was to be headed by its own administrative organization. This program was first started in the month of May in 1997. Since the inception of the TRICARE program, this, too, has gone through various different levels of restructuring. For example, more benefits have been added (in accordance with the process that has been discussed in an earlier section) and there have been slight changes in the contracts that the organization has signed with other service providers.
What are the Advantages of TRICARE?
In general, the advantages that beneficiaries of the TRICARE plans can obtain are that they have access to many different health care providers and do not need to pay any fee for enrollment. Furthermore, services are available widely. All military health centers and clinics are a part of the TRICARE network and contracts have also been signed with other civilian providers, which makes for an extensive and sprawling network. Depending on the kind of plan that an individual is using, he or she may also be able to consult a physician of his or her own choice, regardless of whether that physician is working in a TRICARE network provider or not.
Beneficiaries have access to military health centers and where these lack in resources or personnel, contracts have also been made with civilian health care providers. The ultimate benefit of the TRICARE health care system is that it provides over 9.5 million people with access to affordable health care services at the time when they are most required. Because funding has been obtained for these services, they are partially subsidized by the program, which translates into cheaper and more affordable health care facilities for the beneficiaries.
The programs have been designed in such a way to allow access to health care facilities to a maximum number of potential beneficiaries, such as the old spouses of military personnel, their family members and/or any other dependents. It is a service that operates in a smooth and efficient manner. In addition to this, as has been discussed in earlier sections, the health care facilities are not just limited to physical health care facilities, but also include mental health care. This is of immense importance to certain people who are or were serving in the military forces, as they may have suffered from psychological issues such as depression and post-traumatic stress disorder. Therefore, the TRICARE health care plans are truly all encompassing, given the wide range of benefits that a person has access to.
Different plans offered by TRICARE come with their own advantages. The advantage of the TRICARE Prime plan is that each individual is assigned his or her own primary care manager, who will then be responsible for everything – from making appointments with the doctor on behalf of the individual to maintaining his or her health records. If a person is still an active service member, then the person himself and his or her family do not need to pay any enrollment fee. Furthermore, they can also consult any civilian provider and have to pay only a very small fee, while a person who is still in service does not have to pay any fee at all. Individuals who are covered by this plan can rest assured that they will always receive appointments with medical health care professionals whom they wish to consult. Furthermore, the plan also provides emergency cover.
Under the TRICARE Standard plan, an individual has the option to choose from many different providers; they may consult someone at an on-site, military health center, or they may visit a civilian provider if they wish to do so. There is wide and easy access to treatment facilities and individuals are not requirement to pay an enrollment fee.
If an individual opts for the TRICARE Extra plan, they can consult any medical health care facility or medical professional who is a part of the TRICARE network. Individuals are not required to pay any enrollment fee and there is no balance billing. In addition to this, they do not need to undertake the tedious task of filling out forms to claim reimbursements, as this is already taken care of by the provider. In addition to this, there is no deductible if an individual makes use of the retail pharmacy network.
TRICARE services are also extended to cover people who are eligible for TRICARE services but are residing overseas via the TRICARE Overseas program. This is particularly beneficial as a beneficiary living abroad can live in peace knowing that his or her health care is covered, should the need ever arise for him or her to receive medical attention.
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