Tricare youth coverage could prove costly - Marine Corps Health Issues | Marine Corps Times

Tricare youth coverage could prove costly

Anthony Abruzcato, a college student in north Texas, grew up under the umbrella of Tricare health coverage.

The son of a Vietnam vet and 23-year Army reservist, Abruzcato is a Type I diabetic who requires care that would cost more than $1,000 a month without Tricare.

So his family heaved a sigh of relief a few weeks ago, when Congress passed a law allowing dependent children to keep Tricare coverage until age 26, an increase from the previous cap of 23 for full-time college students and 21 for all others.

“We have no choice. We have to buy this coverage,” said Sue Abruzcato, Anthony’s mother, who chokes up at the thought of any gap in his coverage that could disrupt his daily — and costly — insulin injections.

Anthony Abruzcato is among more than 200,000 young adults who will be eligible for the new coverage, enacted to bring Tricare in line with last year’s national health care reform law. A key provision in that law requires private-sector insurers to allow children to remain on family health care plans up to age 26.

Tricare will announce the fees for the new policy this spring — and many experts say it will be pricey. Congress prohibited the Pentagon from subsidizing the coverage in any way, so the fees are likely to match those in the private sector, which typically run $100 to $200 per month.

Officials estimate that about 6 percent — or about 14,000 young adults — will actually sign up for the program in 2011, said Tricare spokesman Kevin Dwyer.

Nevertheless, the option will fill a critical gap for some families, said Mike Saunders, deputy legislative director for The Retired Enlisted Association.

“The unemployment rate is through the roof, a lot of these kids aren’t working, and they need coverage at any price because one accident can wipe them out or wipe their parents out,” Saunders said.

But the cost will likely deter many families. For example, retired Air Force Col. Victor Hnatiuk has two children who are about to age out of the family’s Tricare plan. Hnatiuk doesn’t expect to keep them on that coverage, since he’ll probably be able to find similar options in the private sector.

“In other words, there is no benefit in being a vet or retiree in this instance,” Hnatiuk said.

In practice, military families likely will pay more than many civilian workers who get benefits through their employer, some health care lawyers said. Many traditional family plans offered by private insurance companies are subsidized by employers.

“In this case, the government is the employer and the government is saying, essentially, ‘We’ll cover you, but we’re not going to subsidize you.’ You’re going to pay the full cost,” said Greg Piche, a health care lawyer in Denver.

The new Tricare Young Adult Program is the second time in recent years that Congress has ordered an expansion of coverage with the requirement that military pass along the entire cost to the beneficiaries.

In October, retired reservists under age 65 were offered Tricare benefits, but the cost — more than $400 a month for a family — discouraged many people, and only a few hundred initially signed up.

The high cost for the expanded coverage for dependent children is a disappointment to some military families but does not come as a shock.

“Realistically, I was never promised health care for my children to age 26 as part of my military service,” Hnatiuk said.