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Organization Behavior In Management Essay

3235 words - 13 pages

The History and Future of TRICARE and HIPP

In this term paper I will discuss the history and future of Tricare and HIPAA. Tricare is the program that the military provides for active duty and retired service personnel, their eligible family members and survivors' healthcare. I will be discussing the history and the future of Tricare. I will also discuss the types of Tricare. HIPAA stands for Health Insurance Portability and Accountability Act. It was enacted by the U.S. Congress and signed by President Bill Clinton in 1996. Title I of HIPAA protects health insurance coverage for workers and their families when they change or lose their jobs. Title II of HIPAA, known as the ...view middle of the document...

After CHAMPUS was official in 1966, it served the uniformed services for over thirty years as a cost sharing program that was used to provide civilian in- and outpatient care, including ambulatory and psychiatric care, for active duty family members when a military facility was unable to do so. CHAMPUS was changed in January 1967 to bring retirees, their family members, and certain surviving family members of deceased uniformed services sponsors into the program. CHAMPUS needed some improvement.
Thus, during the 1980s, there was the launch of CHAMPUS “demonstration” projects such as the CHAMPUS Reform Initiative (CRI) in 1988. The CRI tested the program in California and Hawaii and offered family members a choice of ways in which they could use their military health care benefits. During the five years of the demonstration, it was very satisfactory. In 1993, Department of Defense officials saw the current benefits and decided to extend - and improved - the CRI. The new and improved program was renamed TRICARE.
Types of TRICARE
There are several types of TRICARE options. The first option I will discuss is called TRICARE Standard. TRICARE Standard provides a similar benefit to the original CHAMPUS program and is available to active duty personnel, retirees from the Active Component, retirees from the Reserve Component age 60 or older, and their eligible family members. Under TRICARE Standard, beneficiaries can use any civilian health care provider that is payable under TRICARE regulations. The beneficiary is responsible for payment of an annual deductible and coinsurance, and may be responsible for certain other out-of-pocket expenses. There is no enrollment fee for TRICARE Standard.
TRICARE Standard beneficiaries can elect to use the TRICARE Extra option by using a civilian health care provider from within the regional contractor's provider network. In this way, TRICARE Extra represents a preferred provider organization (PPO). When using TRICARE Extra, the beneficiary's coinsurance amount is reduced by at least five percentage points. There is no fee for use of the TRICARE Extra benefit other than the coinsurance.
TRICARE Prime is a health maintenance organization (HMO) style plan available to active duty personnel, retirees from the Active Component, retirees from the Reserve Component age 60 or older, and their eligible family members. Under TRICARE Prime, beneficiaries must choose a primary care physician and obtain referrals and authorizations for specialty care. In return for these restrictions, beneficiaries are responsible only for small copayments for each visit. There is an annual enrollment fee for TRICARE Prime for military retirees and their family members. There is no enrollment fee for active duty military and their family members.
TRICARE Reserve Select [TRS]
TRICARE Reserve Select is a premium-based health plan that active status qualified National Guard and Reserve members may purchase....

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