TRICARE costs remain mostly stable in 2027, but some premiums spike

Eric

Most military families will not see a major change in their healthcare costs next year, but some Tricare beneficiaries are facing some pretty steep premium increases. The Defense Department has released its 2027 rates, including a nearly 13% increase for young adults enrolled in one of Tricare's coverage options. Federal News Network's Rachel Cohen joins me to break down what's changing, who's going to pay more, and what military families should know as open enrollment gets underway.

Rachel Cohen

those aren't seeing major cost increases. There are some increases in deductibles and co-pays and annual out of pocket limits, particularly for families whose service member first joined the military in 2018 or later.

Rachel Cohen

But this year the monthly premium for Young Adult Prime is jumping to $893 per monththat's nearly $10,700 a year, and that's before you even factor in the cost of care.

Rachel Cohen

And it's not just young adultsfamilies enrolled in the retired reserve plan will pay nearly $1,700 a month for coverage next year, and that's an increase of almost 10%.

Rachel Cohen

The Defense Health Agency says the increase in Young Adult Prime is partially driven by higher healthcare use among a relatively small group of enrollees.

Rachel Cohen

There are only about 1300 people enrolled in Young Adult Prime compared with more than 27,000 in Young Adult Selectmore people going to the doctor, but because there's more people the cost is spread across them.

Rachel Cohen

the bigger issue is that these premium-based plans don't receive the same government subsidies as the main Tricare plans, right?

Rachel Cohen

Family advocates are pushing Congress to help subsidize these plans because they're concerned that young adults who can't afford the premiums might just decide to be uninsured altogether.

Rachel Cohen

So Prime is more of a managed care model. You generally have a PCP a primary doctor, who coordinates your care and you typically need referrals to go see specialistsif you follow the plan's rules, your out of pocket costs can be very low.

Rachel Cohen

Select gives you more freedom to choose providers and doesn't usually require referrals for specialists, but like I said, you do pay deductibles and co-pays, although they're very low, just a couple, couple dozen dollars, right? For co-pays, and those costs can add up depending on how much care your family actually needs.

Rachel Cohen

First, take a look at what you're paying right now and compare it with the 2027 rates.

Rachel Cohen

One important distinction is whether you're in group A or group B. Those groups depend on when a service member joined the military, so either before 2018 or in 2018 or later, those two groups have different sets of costs.

Rachel Cohen

And there's some good news for the pharmacy side. Prescription drug costs aren't changing next year.