Adult children of military members and retirees can extend federal health insurance coverage out through the age of 26.
That coverage, under the federal health insurance program for military members called Tricare, can be purchased retroactively to Jan. 1 this year.
The cost is steep, however, with the premium set at $186 a month, or $2,232 a year, for coverage under the fee-for-service Tricare Standard plan or the preferred provider network offered under Tricare Extra.
No other military members or retirees’ beneficiaries have to pay a premium. But in approving Tricare for young adults, Congress mandated that premium be set high enough to cover the entire cost. That includes both for medical services and internal administrative costs. So Tricare officials said they had no other choice than to set premiums at these levels.
Given the premiums, Tricare officials project only a modest “take rate” the first year of about 6 percent, or about 14,000 participants out of an eligible population of 233,000 young adult dependents.
For now, Tricare standard will be the only option for young adults. Tricare prime will become another option for enrollees effective Oct. 1. But to use the prime plan, young adults will have to live in areas where a Tricare managed-care network is available.
The monthly premium for the young adult prime plan will be $213 not counting co-pays. That is more than five times what a military family pays to enroll in Tricare Prime.
There will be no retroactive coverage back to January 2011 offered under the prime option when it begins next October.
Families with multiple children between age 21 and 26 won’t get a discount either. Each participant will have to pay the full monthly premium.
Retired Navy Chief Hospital Corpsman Henry Popell of Vista, Calif., had wanted the prime plan for his 20-year-old son, Colin, when he completes his studies in a few years. But Popell is reconsidering, given the premium rates, which would total more than $10,000 over four years of coverage eligibility.
“Wow!” said Popell, when he learned the rate. “That’s a hell of a jump” from what he now pays for covering Colin as a full-time student. “It puts me in a pickle.”
In better economic times, Popell said, he would count on his son landing a job with health benefits after graduate school. In this economy, that’s not at all certain.
“The burden’s going to be on me to provide him with health care because I won’t let him go without,” he added. “Tricare prime would be the best way to go. But if we’re talking about $2,500 a year, that’s a good hunk of money. There would have to be some very compelling reasons for me to continue that (coverage) after he got out of college.”
Congress imposed two other limitations unique to young adult Tricare users versus other American young adults:
•only unmarried dependents are eligible
and young adult dependents are disqualified if they are eligible for medical coverage through an employer-sponsored insurance program.
Youth applicants can find more information, including application forms, online at: www.Tricare.mil/tya.
The Department of Health and Human Services estimates that 1.2 million young adults have taken advantage of expanded dependent coverage for non-military families to age 26 under national health reform law. Spread across all plan participants, the new coverage likely bumped up insurance premiums for family coverage by $60 to $150 a year, according to HHS estimates.
That’s in sharp contrast to what military families will experience. Proponents on Capitol Hill argue that Tricare young adult insurance still will be more affordable than many commercial health insurance plans available for young adults, and that Tricare will provide more comprehensive coverage too.
To comment, e-mail milupdate@aol.com, write to Military Update, P.O. Box 231111, Centreville, VA, 20120-1111 or visit: www.militaryupdate.com.
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