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The 2001 National Defense Authorization Act expanded eligibility for coverage under TRICARE, the Department of Defense (DoD) health program, to Medicare-eligible military retirees age 65 and over. Medicare-eligible military retirees enrolled in Medicare Part B became entitled to both Medicare and TRICARE health care benefits — coverage referred to as TRICARE for Life (TFL). Under TFL, Medicare is the primary payer and TRICARE the secondary payer for Medicare-covered services. In addition, TRICARE covers all cost sharing by patients, including Medicare deductibles and coinsurance. This report examines the TFL benefit design and TFL’s potential benefits and costs for the DoD, Medicare, beneficiaries, and taxpayers. The authors summarize issues and policy options that were discussed in several briefings presented to the DoD for its consideration for improving TFL in the future. The authors offer policy options to rationalize benefits by considering changes in the TFL benefit structure, promote ease of operations by improving compatibility with Medicare benefits, improve efficiency by promoting optimal use of direct-care services, and improve the overall benefit package for Medicare-eligible military retirees. The 2001 National Defense Authorization Act expanded eligibility for coverage under TRICARE, the Department of Defense (DoD) health program, to Medicare-eligible military retirees age 65 and over. Medicare-eligible military retirees enrolled in Medicare Part B became entitled to both Medicare and TRICARE health care benefits — coverage referred to as TRICARE for Life (TFL). Under TFL, Medicare is the primary payer and TRICARE the secondary payer for Medicare-covered services. In addition, TRICARE covers all cost sharing by patients, including Medicare deductibles and coinsurance. This report examines the TFL benefit design and TFL’s potential benefits and costs for the DoD, Medicare, beneficiaries, and taxpayers. The authors summarize issues and policy options that were discussed in several briefings presented to the DoD for its consideration for improving TFL in the future. The authors offer policy options to rationalize benefits by considering changes in the TFL benefit structure, promote ease of operations by improving compatibility with Medicare benefits, improve efficiency by promoting optimal use of direct-care services, and improve the overall benefit package for Medicare-eligible military retirees.
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The research described in this report was sponsored by the Office of the Secretary of Defense (OSD) and was conducted jointly by RAND Health and the RAND National Defense Research Institute, a federally funded research and development center supported by the OSD, the Joint Staff, the unified commands, and the defense agencies.
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