Demand for Health Insurance by Military Retirees
Abstract
About three million military retirees and their dependents less than 65 years of age ( Retirees ) are eligible for group health insurance from the Department of Defense (DoD) under the TRICARE program. TRICARE offers three health plans: Prime, a health maintenance organization (HMO); Standard, a fee-for-service plan (FFS); and Extra, a preferred provider organization (PPO). (Standard and Extra, similar plans, are combined in the empirical analysis as S/E. ) Under TRICARE, Retirees obtain direct care at military facilities (usually from military providers) and purchased care at civilian facilities from civilian providers. TRICARE is relatively inexpensive compared to other health insurance (OHI) that can be obtained from civilian employers. However, according to surveys of beneficiaries, some Retirees are dissatisfied with the access and/or quality of care that they receive from military providers, and some using civilian providers are dissatisfied with purchased care claims processing. As a result, many have obtained other health insurance (OHI), and this reduces DoD health care costs. The Office of the Director, Cost Assessment and Program Evaluation asked the Institute for Defense Analyses (IDA) to assist with out-year budgeting by analyzing past military health care utilization as a basis for forecasting future utilization and costs. In reviewing data from a thirteen-year period, IDA s research team found that in Fiscal Year (FY) 2000, 46 percent of retiree families had OHI, but by FY 2012, that number had dropped to 20 percent, with a corresponding rise in TRICARE usage. The return of previously non-reliant beneficiaries sharply increased TRICARE costs, leading to the questions of what caused the return of ghost beneficiaries to TRICARE and whether the trend will continue.
Document Details
- Document Type
- Technical Report
- Publication Date
- May 01, 2015
- Accession Number
- ADA620060
Entities
People
- Dennis D. Kimko
- Lawrence Goldberg
- Maggie Li
- Philip M. Lurie
Organizations
- Institute for Defense Analyses