servicemembers, active duty family members, surviving children, and surviving spouses (the last for the first 3 years) pay no costs. Military retirees and their family members, qualifying former spouses, and surviving spouses (the last after 3 years) pay a modest annual enrollment fee ($260 for individuals, $520 for families in fiscal year 2012).

May Use an MTF on a Space-Available Basis. DoD beneficiaries not enrolled in TRICARE Prime may receive care at an MTF on a space-available basis. TRICARE Standard beneficiaries usually choose TRICARE Standard so they may use providers of their choice, but they must pay annual deductibles and copayments. However, they are not required to cost share if they receive services at an MTF. Retirees who become eligible for Medicare fall under the TRICARE for Life (TFL) option. TFL beneficiaries are not subject to deductibles or copayments but must take Medicare Part B, whereupon TRICARE becomes the secondary payer. If a Department of Veterans Affairs (VA) medical center treats a TFL beneficiary, it cannot be reimbursed because the VA is not authorized to bill Medicare.

Priority for Care at an MTF

  1. Active duty servicemembers
  2. Active duty family members enrolled in TRICARE Prime
  3. Retirees, their family members, and survivors enrolled in TRICARE Prime
  4. Active duty family members not enrolled in TRICARE Prime
  5. All other eligible persons (CRS, 2009)


* SOURCE: See (accessed September 14, 2012).

their providers (if they are able to use an MTF on a space-available basis, they are not charged for a copayment) (see Box 2-1 for an explanation of TRICARE program options).

Although the number of MHS enrollees has been increasing in recent years, enrollment at MTFs, although required for active duty servicemembers, has been trending down, from about 4.2 million in 2004 to about 4.0 million in 2010. Meanwhile, enrollment in TRICARE Standard has increased from about 1.0 million in 2004 to 1.7 million in 2010.

Rising health care costs are a major concern. The budget has increased from $32 billion in FY 2004 to more than $49 billion in FY 2011, mostly due to the increase in average per capita costs ($3,500 a year in 2010, compared with $2,000 a year in 2002). While the use of inpatient and outpatient services at MTFs has changed little, the use of care purchased from network providers has been increasing substantially. The per capita costs of direct care are less on average than the costs of purchased care, which

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