A memo from the Department of Defense was released earlier this month outlining 38 different Military Treatment Facilities, or MTF’s, that they are suggesting close or limit services to military dependents and retirees. The directive must be reviewed and approved by Congress before being implemented, but what do we, as military families, really need to consider with some of the MTF’s closing?
The original memo released earlier this month and was first reported by military.com. On Wednesday, February 19th, 2020, the DoD sent a full list of suggested closures and facility changes of 38 different MTFs around the country. You can read the full directive here.
Why is the DoD Considering Closing Some of the MTFs?
The DoD announced that some of the MTFs closing at different bases will only be ceasing services to military dependents and retirees. They will be serving active duty service members only, but pharmacy services will more than likely be available to any military family member and retirees. In the February 3rd memo released by the DoD, Pentagon officials state that the reason for the MTFs closing is the increase the readiness of the active duty forces. Closing the services to families and retirees allows the MTFs to focus more on the health of the active duty forces.
But cost plays a factor, too. In a press conference, Pentagon officials noted that it is more cost-effective in many areas for families and retirees to receive treatment out in the civilian community than it is to do it within the MTFs. It is reported that the changes could save the government $36 million by 2021.
Here is the breakdown of the MTFs closing:
- All of the closures to military dependents and retirees are all outpatient clinics. None of the MTFs closing are hospitals or offer emergency services.
- Some of the MTFs closing to military dependents and retirees are off-shoot sub-clinics. Some of the locations still have other clinics and facilities on base that will still provide services to military families and retirees.
- Some of the facilities will not close to military dependents and retirees completely, but some of the clinics will be downgraded to no longer include some services.
- Some of the MTFs will not be closing or downgraded- they will actually get an upgrade like the trauma center at Camp Lejeune.
- Three of the MTFs will close completely, to all military dependents, retirees, and active duty service members. These clinics include MacDill Air Force Base’s Sabal Park clinic, Fort Benning’s North Columbus-Benning clinic, and Fort Irwin’s Department of Behavioral Health.
To see a full list of all MTFs closing to military families and retirees, click here.
When Will the MTFs Start Closing Services to Military Families?
The DoD recently sent the directive to Congress which will need to be reviewed and approved. It will be a few years before families see any real changes as the changes will only be implemented, and families will only be pushed to facilities out in town, once they are sure that they will have continuing care in the civilian community. Military.com states that “Officials told reporters Wednesday that no clinics identified for transition will do so until care is secured within the civilian community for each patient, a process that they said could take as long as five years.” The transition will be overlooked by Defense Health Services who manages TRICARE and the private contract.
What Military Families (and the Government) Needs to Consider if an MTF By Them is Ceasing Services to Military Families
TRICARE’s Current Policies
TRICARE currently has two main different plans for military families to choose from. TRICARE Prime and TRICARE Select. TRICARE Prime members are usually assigned to a Primary Care Manager (PCM) at an MTF, and do not pay co-pays nor do they pay for many specialty services. TRICARE Select members opt to see a civilian provider and are designated to pay co-pays for routine and specialty services, and have a capped deductible of $600 (i.e., the do not pay more than $600 in one year for services for the entire family).
There is also TRICARE Remote, where military service members do not have the option of being seen at an MTF and are designated to civilian in-network providers. It is similar to TRICARE Prime in terms of coverage. TRICARE for Life is the insurance plan for retirees.
Read here to find out more about the differences between TRICARE’s plans.
Will You Have to Pay a Co-Pay Now?
The short answer is that if you are TRICARE Prime, you will not see a co-pay or pay for any services that you otherwise would not pay when seen by an MTF or when seeing a civilian PCM if forced to do so by TRICARE because of lack of services at your duty station. If you are TRICARE Standard, the same co-pay and deductibles will be applicable as they were with your previous plan.
The biggest changes will come for retirees. TRICARE for Life currently states that if a retiree is seen by a civilian provider they are required to pay a $20 co-pay for routine services and $31 for specialty services. Now retirees will be forced to pay these co-pays as they are transitioned out to town whereas before they may have had the option to be seen on base and not pay the co-pay.
How Will the Transition Work?
As the MTFs begin the transition, they will have to identify in-network providers available in the civilian community that will accept additional patients. TRICARE Prime families will be given a choice of providers that currently have available space to take them for care. Specialty clinics will go through the same referral process that is currently held by TRICARE where you will receive a referral from your PCM and TRICARE will provide an appointment with an in-network provider for those specialty services.
Will the Surrounding Communities be Able to Support the Influx of Military Families as Patients?
The biggest concern for many military families is whether or not the civilian community will be able to support the influx of military families as patients. Many military families who are currently on TRICARE Standard will tell you that finding providers who are accepting new patients can be difficult at many duty stations. Add in the over 120,000 military family members who are expected to be affected by this change, it may be even more difficult to find a provider in the civilian community, much less one that you like for your family. And even if you are able to find a provider, getting an appointment within a reasonable time frame is something that may become difficult to do in some areas as more and more people will need to be seen.
What Happens if You PCS to an Area Where an MTF is Transitioning to Active Duty Only?
But what about new families PCSing to these areas? At this point, it is assumed that they will be automatically be given a Primary Care Manager (PCM) out in town when they PCS to a duty station where the MTF is closing to military families and retirees.
What about EFMP Families?
Nothing in the directive states anything about changes in care for EFMP families, but it is assumed that any services no longer provided by the MTF will need to be sought out in the civilian community. Your current TRICARE plan will reflect any costs you may or may not incur. The directive does note that no services will be ceased until a patient has comparable services available in the civilian community, so EMFP families should have continuity of care until they can secure services out in town. If no services are available in the civilian community that were previously available at your MTF or you are concerned with continuity of care, you can contact your patient advocate at your local MTF.
Could This Be a Good Thing?
For years military families have complained about military medicine and how it is not up to par with the civilian community. There are thousands of stories, Facebook rants, and dependents fed up with the lack of care for their families at MTFs all around the country. However, despite this stigma of poor medical care provided by MTFs, many families still opt to stay on TRICARE Prime because it provides more financial support than TRICARE Standard. With this change, families who would normally be on TRICARE Prime and seen at an MTF can now be seen by a civilian provider without incurring the co-pays or deductibles that those on TRICARE Standard currently pay in order to be seen out in town.
The overarching purpose of this change is to create better care for the active duty service members. Eliminating MTF resources that are normally used to care for families and retirees will allow these resources to be used for our active duty service members, which may result in better physical and mental health care that is so desperately needed. Physical and mental readiness is one of the most important parts of the military, and allowing providers to focus their efforts and resources on our nation’s active duty members will help to increase this readiness.
This transition for the 38 different MTFs around the country may take up to five years, and many active duty military families will not see an increase in their out-of-pocket costs. The biggest change will most likely be for retirees who will be forced to pay the current TRICARE for Life’s co-pays as outlined in their plans, but all military families will likely see more difficulty in finding providers and making appointments as the civilian community begins to navigate the large influx of new patients.
WANT TO READ MORE?
Check out What’s the Diffrence Between TRICARE Plans?