Defense Bill May Enable Retirees to Get Back on TRICARE Prime

The House version of the 2014 National Defense Authorization Act has a provision to allow the military retirees who were kicked off TRICARE Prime last October, a one-time shot at re-enrolling.

As some of our readers have noted, Par. 3(B) limits re-enrollment eligibility to those living within 100 miles of a military treatment facility. The remainder of the 171K retirees that were kicked off TRICARE Prime (myself included) will have to remain on TRICARE Standard.

Sen. Klobuchar (D-MN) introduced Senate Bill S.1078, which would allow military retirees living outside of the 100-mile restricted TRICARE Prime Service Area to have a one-time opportunity to remain enrolled in TRICARE Prime as long as the beneficiary resides in the same zip code as he/she did at the time of election of benefits. Senators Hagan (D-NC), Hirono (D-HI), Schatz (D-HI), Casey (D-PA) and  Pryor (D-AR) have co-sponsored the bill.

Let your elected officials to know if you support Senate Bill s.1078.

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Here is a copy of the text from Sect. 701 of the House version of the National Defense Authorization Act:

ONE-TIME ELECTION —Subject to paragraph (3), the Secretary shall ensure that each affected eligible beneficiary who is enrolled in TRICARE Prime as of September 30, 2013, may make a one-time election to continue such enrollment in TRICARE Prime, notwithstanding that a contract described in subsection (a)(2)(A) does not allow for such enrollment based on the location in which such beneficiary resides. The beneficiary may continue such enrollment in TRICARE Prime so long as the beneficiary resides in the same ZIP code as the ZIP code in which the beneficiary resided at the time of such election.

“(2) ENROLLMENT IN TRICARE STANDARD —If an affected eligible beneficiary makes the one-time election under paragraph (1), the beneficiary may thereafter elect to enroll in TRICARE Standard at any time in accordance with a contract described in subsection (a)(2)(A).

“(3) RESIDENCE AT TIME OF ELECTION —An affected eligible beneficiary may not make the one-time election under paragraph (1) if, at the time of such election, the beneficiary does not reside—

“(A) in a ZIP code that is in a region described in subsection (c)(1)(B); and

“(B) within 100 miles of a military medical treatment facility.

“(4) NETWORK —In continuing enrollment in TRICARE Prime pursuant to paragraph (1), the Secretary may determine whether to maintain a TRICARE network of providers in an area that is between 40 and 100 miles of a military medical treatment facility.”

Read the 2014 National Defense Authorization Act. (PDF)

About the Author

Terry Howell
Before becoming the Managing Editor for Military.com, Terry served 20 years in the U.S. Coast Guard as an Aviation Electrician’s Mate and aircrewman. In his final role in the Coast Guard, Terry served as a Career Development Advisor, where he provided career, finance, education, and benefits counseling to servicemembers and their families. Since retiring from the Coast Guard, Terry has authored the book, The Military Advantage, managed the content for TurboTap, the DoD's online transition program and VAforVets, the VA's transition assistance website. Terry earned both his Bachelor's and MBA at Corban University using Military Tuition Assistance and his GI Bill benefits to help cover the cost.

60 Comments on "Defense Bill May Enable Retirees to Get Back on TRICARE Prime"

  1. I don't agree it's a one time only deal but it's at least a carrot. Maybe a rotting carrot but better than the other option.

  2. Timothy A Parker | December 13, 2013 at 10:43 pm |

    So does this mean that I can get my tricare prime back and the Dr we had before will be able to stay in the tricare network? This sure would make it easier for wife and I then having her to miss a days work and travel over 70 miles to hopeful see a Dr once there.

  3. if the NDAA law passes ,, it appears that you can

  4. Just in time for 2014 elections, how convenient.

  5. I'm confused as well with regard to the wording. The topic says 171K may be allowed to get TRICARE Prime back, but section 3.b says you must live within 100 miles of an MTF. That restriction will not allow all 171K to return to TRICARE Pime.

  6. I want to know WHY it's 100 miles? For that matter, why ANY MILES???

  7. Just so we understand what is at stake… I checked Healthcare.gov here in South Florida (I am lucky, still eligible given small military presence here), and you go straight to the "Platinum" plans to find anything comparable to Tricare Prime… average costs… $1,300 to $1,500 per month! I certainly understand the military lobby groups not wanting to allow any benefits to erode… but I'd sure be willing to pay a little more that $550/year to keep Tricare Prime to avoid losing it entirely. Although I m sure I would get something through my employer that is less costly than the Healthcare.gov "platinum" plans I looked at… suspect it would still be a lot more expensive than Tricare Prime.

  8. Somehow I just believe this more smoke up our ares. This administration and most Senators do not a flying F%*# about us.

  9. Yeah well, what if there is no doctor at the Military facility you have to go to? Because I live within 35 miles of a Navy facility, I have to go there for treatment, but there is no doctor there, I end up talking to a family practitioner, at my age, I feel a lot more comfortable talking to a doctor, they can at least tell me what is wrong with me. And if I get real sick, I am instructed to go to the emergency room. There are doctors not more than two blocks away from me, why can't I go there?, they accept Tri-Care.

  10. More smoke screens and mirrors fellow veterans. We really need to get our act together as a voting block and vote these people out of office. Sick of being on the chopping block everytime someone wants to lower spending. Time to look at all of the entitlement programs out there and foreign aid and start cutting these programs versus the veterans benefits.

  11. How does this affect folks with TriCare for Life?? I live in Pittsburgh too. No

  12. If you really want me to think that the current administration wants to reduce spending then cancel the health plan that they have and put them under Tri Care. The could also stop the multi million dollar vacations to Hawaii. Since this administration has been in office the cost of vacations and "date nights" could pay for health care for veterans for a couple of years. They act like neavou rich who had never had any money and now they are spending our money like a drunken sailor. Sorry Navy

  13. Why were they kicked off?

  14. Its a smoke screen just like Obama care. 22 years in the Army and Congress would rather give Money to Syrian Rebels.

  15. I retired 11 Sept 2012, my 60th birthday. I was already told that I would not be allowed to enroll. Thus I am in Standard. And the roll back to 30 Sept will not help me at all. 34 years active and reserve….and this is what you get.

  16. David Addison | December 16, 2013 at 4:42 pm |

    I was forced off tri-care prime and into standard because my wife lost her job and we had to relocate. Lucky for us or unlucky for us we found a great place to live 2 miles from the arkansas state line when I was instructede I could not use the doctors I use to because they are no longer in network based on my zip code. Had I of know when I enlisted many years ago I never would have.

  17. Tina Robinson | December 16, 2013 at 7:30 pm |

    i was fortunate to get tricare back this month when my dr had a practice in 2 counties over and i just had to sigh the drive waiver. I ll try 17 miles to see a verses paying 360.00 a month premiums. If you read the new bill pending it will allow those outside the 100 mile limit to re enroll if you still live in the same zip code that you lived in when you originally emrolled. Lets just see if it passes.

  18. “ONE-TIME ELECTION —Subject to paragraph (3), the Secretary shall ensure that affected eligible beneficiary who is enrolled in TRICARE Prime as of September 30, 2013, may make a one-time election to continue such enrollment in TRICARE Prime, notwithstanding that a contract described in subsection (a)(2)(A) does not allow for such enrollment based on the location in which such beneficiary resides. The beneficiary may continue such enrollment in TRICARE Prime so long as the beneficiary resides in the same ZIP code as the ZIP code in which the beneficiary resided at the time of such election.” Can anybody explain what exactly this is saying? I had Prime when I was taken away, but I live more than 100 miles from an MTF. I still live at the same place as when I lost my Prime but is that the same as “at the time of election” is confusing?

  19. Every time the DOD is asked to curb it's budget, the Retiree and Veteran benefits are the first to get cut. I say with this crop of weak Generals it is time to take ALL Military Retiree Benefits OUT of the DOD budget and put them in an agency that cares for it's citizens and will get the proper funding. Also, it is time we vote as a block and start voting against those in Congress that continually vote against Retiree and Veteran benefits. Enough is enough.

  20. Frustrated Retiree | December 16, 2013 at 8:18 pm |

    Why is the Military Retiree the first group of people that is looked at when cuts are ordered within DOD? We make up about .03 of 1% of the total budget yet we are asked to cut about 17%. Enough already. TRICARE Prime should be restored immediately to all those that lost the coverage. It is time we vote ONLY for those that have served in the military and make it clear that we as a group will not support any member of Congress regardless of party affiliation that votes to cut Military Retiree Benefits. We are not their punching bag.

  21. I'm 66 and enrolled in TriCare For Life and 100% VA and Social (in)Security. My wife turns 65 March 1. I hope nothing happens between that time as we lost TriCare Prime for her on 1 Oct too. The House just voted retirees from 42-62 a 1% reduction in COLA allowances. For an E7 that is over $72K of lost income. No government employees or congress jerks received these cuts, no welfare or illegal alien benefits have been cut and no cost restrictions on POTUS vacations were addressed. I did four combat tours in 38 years EM/Off and I feel the soldier and retiree have been violated by this congress and that slime POTUS. The above blogger is correct, we need to vote as a block, vet the candidates, call them out as liars if they are. Go to the Townhall meetings until they no longer will hold them out of fear of their constituents!

  22. I was told that the zip code my long time physician is in is in the network still, but not for Prime. I have also been told that my zip code (on a ranch – 30 miles from town) is eligible for Prime and that I am still in Prime. What am I supposed to do when the surrounding zip codes, IOWs, those in town, where the physicians are at is Standard only?

  23. What, you could already get a waiver if you lived within a 100 miles, what a bunch of crap this is nothing!!!!!!!!!

  24. Guys this has been going on decades with every president and congress with the exception of Ronald Regan. Every one that I can remember couldn’t wait to Butt F@#k the G.I. what’s new now is the current group wants to quit providing the Vaseline!
    I don’t think the majority of the American people are for it but the public doesn't hear about it from the scum buckets in the press.
    I’m dying of lung disease from military service. I have had to fight the VA and TRICARE to just get health care that is just below what the veteran gives my dog; so they won’t be able to do me much longer.
    You guys still left keep up the fight NEVER ACCEPT DEFEAT!!!!

  25. I am a retired RVN Vet I think it is time for every vet to come together and go to washington . Also where is our High ranking military leaders? We are all still Brothers, Its time for all those in Washington to go.

  26. Master Chief Gunz | December 17, 2013 at 9:22 am |

    To My Elected Servants,
    Just as you are obviously dedicated to protecting your current and future pay and benefits, I am also interested in mine. I faithfully served my country in uniform for twenty-two plus years. Like many of my fellow retired warriors, I was shocked and dismayed that I was callously stripped of my TRICARE Prime health insurance based on simply living too far from a Military Treatment Facility. Those of us who voluntarily served in uniform have paid our dues and have unquestionably earned the right to benefits such as TRICARE Prime in return for being asked (by you and your predecessors) to serve in harms way. It’s no different than dishonoring us by spitting in our faces, particularly when you choose to cut our benefits over so many other goverment funded recipients who have in many cases never contributed at all to our country’s economic, social, or moral well being. Do the right thing and restore TRICARE Prime benefits to those of us military retirees who have unquestionably earned that benefit. Show us who have served, who are currently serving, and who may consider serving in the future that our uniformed service is genuinely appreciated by you and your peers, and that you will ensure that those who sacrifice and answer the call to duty will be taken care of in return.

  27. It is sad that yet again our elected officials are tearing away at the
    active and retired military benefits. The "bipartisan" budget deal struck
    by Rep. Paul Ryan (R-Wis.) and Sen. Patty Murray (D-Wash.), is another
    example of this. Our military have earned their benefits. These are not
    "entitlements" given to secure votes of those given hand outs. In the two
    years since my retirement, I have had to wait for veteran's benefits,
    battle to find employment, lost Tricare due to my "geographically-remote"
    location, and now look forward to another cut in retirement benefits. We
    are simply an easy target to secure budget cuts instead of looking at
    wasteful programs. Military, their families, and our veterans are looked
    upon to sacrifice for years of service, then are the first to be singled
    out when cuts are needed. It is even more shameful that some of our
    elected representatives that served are leading this effort. I really
    don't expect someone that hasn't worn the uniform to understand, but do
    not stand up and proclaim that you support us, then not only abandon us on
    the battlefield but when we return as well.

  28. LOOKS LIKE ITS TIME FOR AN ALL BRANCH MILITARY UNION. LETS GET THESE BASTARDS OUT OF CONGRESS AND THE SENATE.

  29. More broken promises. How bout you just give us our youth back to when we enlisted and we can spend that 20 or 30 years of having no permanent home doing something else> We may even be able to recover the marriages we lost because we were never home, watch our children grow up in person instead of pictures and letters, spend all those holidays with family, and maybe even have a mortgage payed of before age 80 since we wouldnt have moved every couple years for decades. Thanks America for the opportunity to serve you.

  30. I believe it is time for a REAL march on Washington D.C.

  31. I JUST WANT TO SAY THAT EACH AND EVERYONE OF YOU VETERANS, WHO NOT ONLY GAVE THERE LIVES FOR US AND THOSE WHO HAVE SCARIFIED, THERE HOMES AND THERE FAMILY FOR US, TO HAVE TO COME HOME AND HAVE THE MAIN THING TAKING AWAY FROM YOU, IS VERY HARSH, I CAN NOT SEE WHY WE HAD TO GIVE UP OUR TRICARE PRIME SERVES, BECAUSE TO ME THE RETIREES HAS EARN TO BE IN THAT TYPE OF PROGRAM. JUST A MAGICIAN YOU TAKE ILL AND THE CLOSEST HOSPITAL OR DOCTOR YOU CAN GET TO IS NOT IN THE 100 / MILES NET-WORTH, SO YOU KNOW WHAT WILL HAPPEN IN THAT SITUATION. SO I BEG OF YOU TO LET THE RETIREES AND THERE FAMILY'S GET BACK IN WITH TIRCARE PRIME.

  32. I do believe that along with term limits on our elected royalty that there should be a requirement that you cannot hold an office of this country until you have served at least 4 years in the military. Just sayin'!

  33. Term limits. No lifetime Congress people. If elected officials know what it's like to work for a living first hand, decisions made will change for the better for the people.

  34. If congress wants to reduce our COLA, then congress if receiving a retirement COLA should abide by the exact same stipulations as Military retiree's. I think it is very close for the Military active and retired, to begin a Class Action Suit to limit congress's ability to change laws that are changes to our original contract terms.

  35. MASTERCHIEFMO | December 17, 2013 at 3:12 pm |

    I have to admin Bleu – Your Points are very well taken.

  36. It is so ridiculous to say that a person needs to still be living n the same zip code to be eligible for Tricare Prime. Many of us have moved several times. This is just another way to screw the Veterans. What does zip code have to do with it. The government should just grandfather all of the vets that are on Tricare prime as Oct. 13th 2013. Then institute the new program for those who registered after the 13th of Oct.

  37. When is it enough? Elected Representives that have never served in our military making decisions for our benefit, really! We as veterns who have no real voice much alone real representation and you ask me to sacrifice for whom, people on welfare or workmans comp who never served with the excuse that they could not pass the test. Shame on the whole lot and thanks for nothing heck our votes don't even count!!

  38. I'm one of those who was kicked off of tricare prime but this article is confusing. I live within 100 miles of a military facility. I'm still living at the same address but the one difference is that this is December 17, 2013. I would love to get back on prime but according to this article I'm ineligible. In order to stay on prime I would have to changed doctors people in my health condition just really like to find one doctor and stick with them. I really don't see where this bill is helping those who were disenfranchised.

  39. Tricare prime… yeah, they even raised the annual price to secure access to care in an MTF. Now they want to get your money by re-enrolling you back after being disenfranchised without the opportunity to fight for promised benefits if you made a career in the military. As much as VFW and the Legion pound on their chest defending what was promised to us… they showed no resolve and allowed increase and now we are looking at reduced pay raises approved by our sweet congress. I for one dis-enrolled myself from Tricare Prime to Tricare Standard and will haunt the MTF until space availability is given to me. Soon I will be Medicare obligated to pay for part B and that will increase substantially what I was paying for Prime. What the hell, they will take it out of Social Security. But this Zip Code crap is what it is and unfair to those that serve the nation. Then again, this is what redistribution is about as they sway us to feel sorry for those healthy young folks who don't need or want to pay for health care and those that just live smooching off the taxpayers purse. Did you know they want you to believe that your retired pay and benefits are part of the nations welfare system and thus you also are as much a leech as those who never lift a finger to do for themselves. Time to march in DC!!!

  40. sonja Silipino | December 18, 2013 at 1:42 am |

    What is the difference between "Tricare for Life" for retirees and "Tricare Prime" ?

  41. Bottom line is we literally signed a legal binding contract that put our life on the line. Agreed to go ANYWHERE (certainly not just a 100 mile radius) and for many of us, we signed based on the package benefits stated IN THAT CONTRACT. If at any time we would have broke our end of that"legal" contract you can bet your ass we would have been court martialed. Congress has just redefined the legality of ALL "legal contracts right? What good is my mortgage contract? So what if I signed the bank papers. I mean really!!! It's all downright illegal!! Nice to see the benefits keep rolling for those welfare folks who spend the day on the sofa, and occasionally put their life on the line for a daring refrigerator run.

  42. Mr. Howell, I saw the article saying that the Senate has sent the Defense Bill to the White House. Any update on what the final verbiage is for the Tricare issue in regards to the one time re-enroll in Tricare Prime and all of that jazz? Thank you!!!!

  43. David Rivera | December 21, 2013 at 1:25 pm |

    I agree that they should have grandfather all vets that were on Tricare prime as Oct 2013. We got the short end of the stick again.

  44. I agree with ALMOST everything you say here, Sam. I had called and written to my Senators and Congressmen here in MN because I was so PO'd that one guy who fought in a foxhole gets to keep Prime, and the guy that fought next to him, in that SAME foxhole, but unlucky enough to have lived in a NOW arbitrarily ineligible zip code (BS!!!), LOSES Prime! I was that "second guy"! I got no response from my politicians, which made me even madder!

    But much later, I saw the blurb about TriCare Prime reinstatement in Military.com this week. I was surprised and VERY happy to see (in the article above) that the S. 1078 bill removing the zip code requirement for pre-Oct. 1 Prime enrollees who wish to get their TriCare Prime coverage back, was actually introduced by one of MY Senators…Amy Klobuchar! Since a separate bill already cleared the House, and since Sen. Klobuchar's bill is co-sponsored by 5 other Democrat Senators, it "appears" that this bill has an excellent chance of passing! Then, of course, we have to worry about the President signing it into law.

    Okay, Sam…now the part that I disagree with you on. It was your entire last sentence, actually. I don't understand why ANYONE who wore the uniform, and served our country honorably, shouldn't have full rights to Prime coverage! NO EXCEPTIONS!!! Screw that damn zip code and date BS! That would be doing to them exactly the same thing that happened to us…some get it, and some don't…and that is grossly unfair and unacceptable!!!

    Thanks to all of you for serving so honorably and proudly. I'm proud to be numbered among you!

  45. MN1 A.R.B. RET.NAVY | December 22, 2013 at 10:56 am |

    Question: What difference does it make how far away from a MTF that a RETIRED PERSON live? WE had doctors and medical offices that were seeing us before this all came about without any problems. NOW, am I supposed to sell my house an move closer to an MTF ?? THIS MAKES NO SENSE, THE PEOPLE THAT REALLY NEED TRICARE PRIME ARE THE ONE'S THAT LIVE AWAY FROM THE M.T.F.s because when we get ill we can't drive 200 miles to get to one..

  46. Are we ever going to get an update on this?

  47. The President just signed the 2014 NDAA an hour ago..now if we can get the real info on which retirees get Tricare prime back..so confusing I live more then a 100 miles away from a MTF and still don't know if I qualify..i called Tricare south and they don't want to say anything

  48. My husband and I are some of those kicked off Prime also. Both are retired E-7's. Have you seen the fees they are going to hike them to? I have purchased a supplement that together we pay 100 a month. I gotta say, I am staying on standard even if given the options. The new future fees are outrageous.

  49. I was promised V.A. Health benefits for life when I enlisted in 1973. Got screwed out of that.

  50. come on folks POTUS needs to pay for his ACA some how!!!! Just take a deep breath and vote every son of a bitch out and keep voting them out until they get the message.

  51. recreatorll | January 5, 2014 at 9:07 pm |

    I just got kicked off and my wife didn't. We're both retired. i was in the middle of getting surgery when they kicked me now it will cost me three times as much

  52. Does anyone have an update on the tricare prime reinstatement fo those that were kicked off in 2013?

  53. I am totally confused, I was kicked off Tricare prime but I live within 10 miles of a MTF. So, should I have been able to stay on Tricare prime? My doctor is the same.

  54. I live outside the 100-mile radius and am still on Tri-Care Standard. My question is–am I supposed to be on Tri-Care prime and if so why haven't I been reinstated yet? Anybody have anything that would help I surely would appreciate it if they could send me an E-Mail explaining what–if anything–I need to do. Thanks.

  55. Oh yeah, we had prime and all of a sudden we have to visit military facilities for care and have to change doctors? We have been using these same doctors for years and I don't care what anyone says, being familiar with your medical history and being comfortable with your doctors means a lot. Why should we have to change? Why are we the "target" one more time? Why do our sacrifices all of a sudden mean so little? My husband was constantly in a war zone it seems and constantly gone and we did what we needed to do as a family to adjust with every change, every move, every deployment… Now we are getting older (60's) and we all of a sudden aren't valuable enough and start losing our "privileged benefits" as these idiots in office seem to think of them. We signed a waiver for mileage and we've used the express scripts to save money for prescriptions and we've gone by all the "rules" and now we're being punished. We would do it over. We are proud to be a retired military family. But at what cost now?

  56. The problem is that we (retirees and veterans) don't have anything remotely as powerful as the defense contractors when it comes to influencing Congress. Money talks and corporations like Boeing or McDonnell-Douglas can throw billions of dollars while our lobbies (American Legion, VFW, etc.) can only threaten them by our votes which are typically split along party lines. Not only that but far too often there is confusion about which politician is actually "pro-military" versus which politician is "pro-military defense contractor". My Congressman for example (Mac Thornberry, R-Tx) could care less about veterans but he always manages to wrap himself in the American flag and appeal to the patriotism of his constituents. As a result when issues like Tri-Care Prime come up he could care less. He has his health care and pension paid for by the government and that's all he cares about.

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