Priced Out of TRICARE

November 6, 2015

TRICARE Young Adult (TYA) beneficiaries will see a steep rise in their premiums next year.

TRICARE provides coverage for dependents of active duty servicemembers and retirees up to age 21 (or 23 for full-time students). After that, TYA allows qualified adult children to purchase TRICARE coverage until age 26, consistent with other civilian health plans. 

Beginning Jan. 1, premiums are increasing to $306 monthly for TYA Prime and $228 monthly for TYA Standard.


Why are costs spiking 26 to 47 percent?

The TYA program is required to charge its young adult beneficiaries premiums that cover the full government cost of coverage. 

DoD originally had to rely on estimates when establishing premium costs. Now that the program has been up and running, it has several years of actual costs to set premiums based on real health care usage. 

The cost of the TYA program is spread over a small beneficiary group of approximately 45,000 enrollees. 

This is the big difference between the military TYA program and other civilian insurance programs that cover young adults. Most civilian plans spread their young adult costs over their entire enrolled population, so every insured person, regardless of age, pays a small amount more.

MOAA questions the affordability of this benefit for military families, especially those with more than one child in this age range, and is looking into possible solutions to lower this cost.