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Cost Changes for 2019

The Defense Health Agency (DHA) recently released its schedule of TRICARE Prime enrollment fees for the 2019 Plan Year (January 1, 2019 through December 31, 2019). The DHA calculated the FY 2019 enrollment fee amounts based on current law. Because US Family Health Plan is a TRICARE Prime designated provider, the fees apply to our program.

2019 Plan Year Enrollment Fees

Effective January 1, 2019, the fee schedule for most retired beneficiaries currently enrolled and for newly enrolled beneficiaries in the 2019 Plan Year is:

 

Annual

Quarterly

Monthly

Individual

$ 297.00

$   74.25

$ 24.75

Family

$ 594.00

$ 148.50

$ 49.50

Two Exceptions

Two retired beneficiary categories are exempt from paying the 2019 Plan Year enrollment fee amounts:

  • Currently enrolled Survivors of Active Duty (AD) Deceased Sponsors, and
  • Uniformed Services Medically Retired Members and their Dependents.

The fees for currently enrolled beneficiaries in these two categories will remain frozen at their current fee amounts. Beneficiaries in these two categories who enroll during the 2019 Plan Year will pay the 2019 Plan Year amount. Fees for all beneficiaries in these two categories will remain frozen at the rate in effect when they were classified and enrolled, so long as the policy remains active.

Copay Changes

DHA also communicated changes to some medical copayments, effective January 1, 2019:

Service

2018 Copayment

2019 Copayment

Emergency Room Visit

$60

$61

Ambulatory Surgery

$60

$61

Ambulance Service (ground)

$40

$41

Inpatient Hospitalization

$150 per admission

$154 per admission

Questions?

If you have any questions about these changes, please call Member Services at 1.800.818.8589.