TRICARE; Calendar Year (CY) 2019 TRICARE Prime and TRICARE Select Out of Pocket Expenses, 14353-14354 [2019-07067]
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14353
Federal Register / Vol. 84, No. 69 / Wednesday, April 10, 2019 / Notices
The CY19 rates contained in this
notice are effective for services on or
after January 1, 2019, unless otherwise
indicated.
ADDRESSES: Defense Health Agency
(DHA), TRICARE Health Plan, 7700
Arlington Boulevard, Suite 5101, Falls
Church, Virginia 22042–5101.
FOR FURTHER INFORMATION CONTACT:
Mark A. Ellis, telephone (703) 275–
6234.
DATES:
DEPARTMENT OF DEFENSE
Office of the Secretary
TRICARE; Calendar Year (CY) 2019
TRICARE Prime and TRICARE Select
Out of Pocket Expenses
Office of the Secretary,
Department of Defense.
ACTION: Notice of Calendar Year (CY)
2019 TRICARE Prime and TRICARE
Select Out of Pocket Expenses.
AGENCY:
This notice provides the
Calendar Year (CY) 2019 TRICARE
Prime and TRICARE Select Out of
Pocket Expenses.
SUMMARY:
The
National Defense Authorization Acts
(NDAAs) for Fiscal Year (FY) 2012 and
2017 established rates for TRICARE
beneficiary out of pocket expenses and
SUPPLEMENTARY INFORMATION:
how they may be increased by either the
annual cost of living adjustment (COLA)
percentage used to increase military
retired pay or via budget neutrality
rules. The FY 2019 retiree COLA
increase is 2.8%. The ‘‘TRICARE Select
and Other TRICARE Reforms’’ final rule
(published February 15, 2019 at 84 FR
4326–4333) allows for adjustments to
beneficiary out of pocket expenses for
Group A beneficiaries (sponsor enlisted
or was commissioned in a Uniformed
Service before January 1, 2018) to
maintain budget neutrality compared to
the previous year.
The DHA has updated the CY19 fees
as shown below:
TABLE 1—TRICARE PRIME AND TRICARE SELECT OUT OF POCKET EXPENSES FOR CY19—RETIREES AND RETIREE
FAMILY MEMBERS
Annual enrollment fee:
Individual ...........................
Family ................................
Annual Deductible:
Individual ...........................
Family ................................
Annual catastrophic cap ...........
Preventive visit .........................
Primary care .............................
Specialty care ...........................
ER visit .....................................
Urgent care center visit ............
Ambulatory surgery ..................
Ambulance, outpatient ground
Ambulance, outpatient air .........
Durable medical equipment ......
Inpatient admission:
In-network ..........................
Out of network ...................
Inpatient SNF/rehab facility ......
Select Group A retirees CY19
Select Group B retirees CY19
Prime** Group A
retirees CY19
Prime** Group B
retirees CY19
$0 ..............................................
$0 ..............................................
$462 ..........................................
$924 ..........................................
$297 .......................
$594 .......................
$360.
$720.
$150 ..........................................
$300 ..........................................
$3,000 .......................................
$0 ..............................................
$29 (IN) .....................................
25% (OON) ...............................
$41 (IN) .....................................
25% (OON) ...............................
$111 (IN) ...................................
25% (OON) ...............................
$29 (IN) .....................................
25% (OON) ...............................
20% (IN) ...................................
25% (OON) ...............................
$102 (IN) ...................................
25% (OON) ...............................
25% (IN or OON) ......................
20% (IN) ...................................
25% (OON) ...............................
$154 (IN); $308 (OON) .............
$308 (IN); $616 (OON) .............
$3,598 .......................................
$0 ..............................................
$25 (IN) .....................................
25% (OON) ...............................
$41 (IN) .....................................
25% (OON) ...............................
$82 (IN) .....................................
25% (OON) ...............................
$41 (IN) .....................................
25% (OON) ...............................
$97 (IN) .....................................
25% (OON) ...............................
$61 (IN) .....................................
25% (OON) ...............................
25% (IN or OON) ......................
20% (ON) ..................................
25% (OON) ...............................
$0 ...........................
$0 ...........................
$3,000 ....................
$0 ...........................
$20 .........................
$0.
$0.
$3,598.
$0.
$20.
$30 .........................
$30.
$61 .........................
$61.
$30 .........................
$30.
$61 .........................
$61.
$41 .........................
$41.
$20 .........................
20% ........................
$20.
20%.
$250/day up to 25% of hospital
charges, plus 20% of sep.
billed services.
* $953/day up to 25% of hosp.
charges, plus 25% of sep.
billed services.
$250/day up to 25% of hospital
charges, plus 20% of sep.
billed services (IN); 25%
(OON).
$179 per adm ...........................
$154 per adm ........
$154 per adm.
25% ...........................................
$154 per adm ........
$154 per adm.
$51 per day (IN); lesser of
$308 per day or 20% (OON).
$30 per day ...........
$30 per day.
jbell on DSK30RV082PROD with NOTICES
IN: In Network.
OON: Out of Network.
* Per day rate change effective October 1, 2018.
** When TRICARE Prime enrollees other than active duty service members self-refer to specialty or non-emergent inpatient care without a referral from a network provider and/or authorization from the regional contractor, the TRICARE Point of Service deductible and copayment applies
in lieu of TRICARE Prime copayments.
TABLE 2—TRICARE PRIME AND TRICARE SELECT OUT OF POCKET EXPENSES FOR CY19—ACTIVE DUTY FAMILY
MEMBERS
Annual enrollment fee:
Individual ............................
VerDate Sep<11>2014
20:36 Apr 09, 2019
Select Group A ADFM CY19
Select Group B ADFM CY19
$0 ..............................................
$0 ..............................................
Jkt 247001
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Prime ** Group A
ADFM CY19
$0
10APN1
Prime ** Group B
ADFM CY19
$0
14354
Federal Register / Vol. 84, No. 69 / Wednesday, April 10, 2019 / Notices
TABLE 2—TRICARE PRIME AND TRICARE SELECT OUT OF POCKET EXPENSES FOR CY19—ACTIVE DUTY FAMILY
MEMBERS—Continued
Family .................................
Annual Deductible:
E1–E4, individual ...............
E1–E4, family .....................
E5 & above, individual .......
E5 & above, family .............
Annual catastrophic cap ............
Preventive visit ..........................
Primary care ..............................
Specialty care ............................
ER visit ......................................
Urgent care center visit .............
Ambulatory surgery ...................
Ambulance, outpatient ground ..
Ambulance, outpatient air .........
Durable medical equipment ......
Inpatient admission ...................
Inpatient SNF/rehab facility .......
Prime ** Group A
ADFM CY19
Prime ** Group B
ADFM CY19
Select Group A ADFM CY19
Select Group B ADFM CY19
$0 ..............................................
$0 ..............................................
0
0
$50 ............................................
$100 ..........................................
$150 ..........................................
$300 ..........................................
$1,000 .......................................
$0 ..............................................
$21 (IN) .....................................
20% (OON) ...............................
$31 (IN) .....................................
20% (OON) ...............................
$83 (IN) .....................................
20% (OON) ...............................
$21 (IN) .....................................
20% (OON) ...............................
$25 (IN) .....................................
20% (OON) ...............................
$76 (IN) .....................................
20% (OON) ...............................
20% (IN or OON) ......................
15% (IN) ...................................
20% (OON) ...............................
* $19.05 per day; $25 min. per
admission.
*$19.05 per day; $25 min. per
admission.
$51 ............................................
$102 ..........................................
$154 ..........................................
$308 ..........................................
$1,028 .......................................
$0 ..............................................
$15 (IN) .....................................
20% (OON) ...............................
$25 (IN) .....................................
20% (OON) ...............................
$41 (IN) .....................................
20% (OON) ...............................
$20 (IN) .....................................
20% (OON) ...............................
$25 (IN) .....................................
20% (OON) ...............................
$15 (IN) .....................................
20% (OON) ...............................
20% (IN or OON) ......................
10% (ON) ..................................
20% (OON) ...............................
$61 per adm. (IN); 20% (OON)
0
0
0
0
1,000
0
0
0
0
0
0
1,028
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$25 per day (IN); $51 per day
(OON).
0
0
IN: In Network.
OON: Out of Network.
* Per day rate change effective October 1, 2018.
** When TRICARE Prime enrollees other than active duty service members self-refer to specialty or non-emergent inpatient care without a referral from a network provider and/or authorization from the regional contractor, the TRICARE Point of Service deductible and copayment applies
in lieu of TRICARE Prime copayments.
The above rates are effective for
services rendered on or after January 1,
2019 unless otherwise indicated.
Dated: April 5, 2019.
Aaron T. Siegel,
Alternate OSD Federal Register Liaison
Officer, Department of Defense.
[FR Doc. 2019–07067 Filed 4–9–19; 8:45 am]
BILLING CODE 5001–06–P
DEPARTMENT OF DEFENSE
Office of the Secretary
[Docket ID: DOD–2019–OS–0037]
Privacy Act of 1974; System of
Records
Defense Finance and
Accounting Service, DoD.
ACTION: Rescindment of a system of
records notice.
jbell on DSK30RV082PROD with NOTICES
AGENCY:
The Defense Finance and
Accounting Service is rescinding a
system of records, T7901b, Consolidated
Returned Items Stop Payment System.
This system of records assisted in the
processing and tracking of military pay
returned checks for the active U.S.
SUMMARY:
VerDate Sep<11>2014
20:36 Apr 09, 2019
Jkt 247001
Army and Reserve military members.
The Consolidated Returned Items Stop
Payment System (CRISPS) is no longer
in use and is considered deactivated.
DATES: This action will be effective
April 10, 2019. The specific date for
when this system ceased to be a Privacy
Act System of Records is February 22,
2017.
FOR FURTHER INFORMATION CONTACT: Mr.
Gregory L. Outlaw, DFAS Privacy
Officer, Defense Finance and
Accounting Service, Corporate
Communications Office, FOIA/PA
Adherence Division, 8899 East 56th St.,
Indianapolis, IN 46249–3300, (317) 212–
4591.
SUPPLEMENTARY INFORMATION: The
Consolidated Returned Items Stop
Payment System (CRISPS) is no longer
in use and is considered deactivated.
All CRISPS customers successfully
migrated to the system of records,
T7320a, Deployable Disbursing System.
The system of records notice for the
Deployable Disbursing System is at 78
FR 14286 (March 5, 2013) and 72 FR
30785 (June 4, 2007). Department of
Defense system of records notices
subject to the Privacy Act of 1974 (5
PO 00000
Frm 00016
Fmt 4703
Sfmt 4703
U.S.C. 552a), as amended, have been
published in the Federal Register and
are available from the address in FOR
FURTHER INFORMATION CONTACT or at the
Defense Privacy, Civil Liberties and
Transparency Division website at https://
dpcld.defense.gov/. The proposed
systems reports, as required by the
Privacy Act of 1974, as amended, were
submitted on January 15, 2019, to the
House Committee on Oversight and
Government Reform, the Senate
Committee on Homeland Security and
Governmental Affairs, and on February
13, 2019, to the Office of Management
and Budget (OMB) pursuant to Section
6 to OMB Circular No. A–108, ‘‘Federal
Agency Responsibilities for Review,
Reporting, and Publication under the
Privacy Act,’’ revised December 23,
2016 (December 23, 2016, 81 FR 94424).
System Name and Number
Consolidated Returned Items Stop
Payment System (CRISPS), T7901b
HISTORY
May 28, 2013, 78 FR 31905.
E:\FR\FM\10APN1.SGM
10APN1
]]>Agencies
[Federal Register Volume 84, Number 69 (Wednesday, April 10, 2019)]
[Notices]
[Pages 14353-14354]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-07067]
[[Page 14353]]
-----------------------------------------------------------------------
DEPARTMENT OF DEFENSE
Office of the Secretary
TRICARE; Calendar Year (CY) 2019 TRICARE Prime and TRICARE Select
Out of Pocket Expenses
AGENCY: Office of the Secretary, Department of Defense.
ACTION: Notice of Calendar Year (CY) 2019 TRICARE Prime and TRICARE
Select Out of Pocket Expenses.
-----------------------------------------------------------------------
SUMMARY: This notice provides the Calendar Year (CY) 2019 TRICARE Prime
and TRICARE Select Out of Pocket Expenses.
DATES: The CY19 rates contained in this notice are effective for
services on or after January 1, 2019, unless otherwise indicated.
ADDRESSES: Defense Health Agency (DHA), TRICARE Health Plan, 7700
Arlington Boulevard, Suite 5101, Falls Church, Virginia 22042-5101.
FOR FURTHER INFORMATION CONTACT: Mark A. Ellis, telephone (703) 275-
6234.
SUPPLEMENTARY INFORMATION: The National Defense Authorization Acts
(NDAAs) for Fiscal Year (FY) 2012 and 2017 established rates for
TRICARE beneficiary out of pocket expenses and how they may be
increased by either the annual cost of living adjustment (COLA)
percentage used to increase military retired pay or via budget
neutrality rules. The FY 2019 retiree COLA increase is 2.8%. The
``TRICARE Select and Other TRICARE Reforms'' final rule (published
February 15, 2019 at 84 FR 4326-4333) allows for adjustments to
beneficiary out of pocket expenses for Group A beneficiaries (sponsor
enlisted or was commissioned in a Uniformed Service before January 1,
2018) to maintain budget neutrality compared to the previous year.
The DHA has updated the CY19 fees as shown below:
Table 1--TRICARE Prime and TRICARE Select Out of Pocket Expenses for CY19--Retirees and Retiree Family Members
--------------------------------------------------------------------------------------------------------------------------------------------------------
Select Group A retirees Select Group B retirees
CY19 CY19 Prime** Group A retirees CY19 Prime** Group B retirees CY19
--------------------------------------------------------------------------------------------------------------------------------------------------------
Annual enrollment fee:
Individual...................... $0..................... $462................... $297........................... $360.
Family.......................... $0..................... $924................... $594........................... $720.
Annual Deductible:
Individual...................... $150................... $154 (IN); $308 (OON).. $0............................. $0.
Family.......................... $300................... $308 (IN); $616 (OON).. $0............................. $0.
Annual catastrophic cap............. $3,000................. $3,598................. $3,000......................... $3,598.
Preventive visit.................... $0..................... $0..................... $0............................. $0.
Primary care........................ $29 (IN)............... $25 (IN)............... $20............................ $20.
25% (OON).............. 25% (OON)..............
Specialty care...................... $41 (IN)............... $41 (IN)............... $30............................ $30.
25% (OON).............. 25% (OON)..............
ER visit............................ $111 (IN).............. $82 (IN)............... $61............................ $61.
25% (OON).............. 25% (OON)..............
Urgent care center visit............ $29 (IN)............... $41 (IN)............... $30............................ $30.
25% (OON).............. 25% (OON)..............
Ambulatory surgery.................. 20% (IN)............... $97 (IN)............... $61............................ $61.
25% (OON).............. 25% (OON)..............
Ambulance, outpatient ground........ $102 (IN).............. $61 (IN)............... $41............................ $41.
25% (OON).............. 25% (OON)..............
Ambulance, outpatient air........... 25% (IN or OON)........ 25% (IN or OON)........ $20............................ $20.
Durable medical equipment........... 20% (IN)............... 20% (ON)............... 20%............................ 20%.
25% (OON).............. 25% (OON)..............
Inpatient admission:
In-network...................... $250/day up to 25% of $179 per adm........... $154 per adm................... $154 per adm.
hospital charges, plus
20% of sep. billed
services.
Out of network.................. * $953/day up to 25% of 25%.................... $154 per adm................... $154 per adm.
hosp. charges, plus
25% of sep. billed
services.
Inpatient SNF/rehab facility........ $250/day up to 25% of $51 per day (IN); $30 per day.................... $30 per day.
hospital charges, plus lesser of $308 per day
20% of sep. billed or 20% (OON).
services (IN); 25%
(OON).
--------------------------------------------------------------------------------------------------------------------------------------------------------
IN: In Network.
OON: Out of Network.
* Per day rate change effective October 1, 2018.
** When TRICARE Prime enrollees other than active duty service members self-refer to specialty or non-emergent inpatient care without a referral from a
network provider and/or authorization from the regional contractor, the TRICARE Point of Service deductible and copayment applies in lieu of TRICARE
Prime copayments.
Table 2--TRICARE Prime and TRICARE Select Out of Pocket Expenses for CY19--Active Duty Family Members
----------------------------------------------------------------------------------------------------------------
Select Group A Select Group B Prime ** Group A Prime ** Group B
ADFM CY19 ADFM CY19 ADFM CY19 ADFM CY19
----------------------------------------------------------------------------------------------------------------
Annual enrollment fee:
Individual.................. $0................ $0................ $0 $0
[[Page 14354]]
Family...................... $0................ $0................ 0 0
Annual Deductible:
E1-E4, individual........... $50............... $51............... 0 0
E1-E4, family............... $100.............. $102.............. 0 0
E5 & above, individual...... $150.............. $154.............. 0 0
E5 & above, family.......... $300.............. $308.............. 0 0
Annual catastrophic cap......... $1,000............ $1,028............ 1,000 1,028
Preventive visit................ $0................ $0................ 0 0
Primary care.................... $21 (IN).......... $15 (IN).......... 0 0
20% (OON)......... 20% (OON).........
Specialty care.................. $31 (IN).......... $25 (IN).......... 0 0
20% (OON)......... 20% (OON).........
ER visit........................ $83 (IN).......... $41 (IN).......... 0 0
20% (OON)......... 20% (OON).........
Urgent care center visit........ $21 (IN).......... $20 (IN).......... 0 0
20% (OON)......... 20% (OON).........
Ambulatory surgery.............. $25 (IN).......... $25 (IN).......... 0 0
20% (OON)......... 20% (OON).........
Ambulance, outpatient ground.... $76 (IN).......... $15 (IN).......... 0 0
20% (OON)......... 20% (OON).........
Ambulance, outpatient air....... 20% (IN or OON)... 20% (IN or OON)... 0 0
Durable medical equipment....... 15% (IN).......... 10% (ON).......... 0 0
20% (OON)......... 20% (OON).........
Inpatient admission............. * $19.05 per day; $61 per adm. (IN); 0 0
$25 min. per 20% (OON).
admission.
Inpatient SNF/rehab facility.... *$19.05 per day; $25 per day (IN); 0 0
$25 min. per $51 per day (OON).
admission.
----------------------------------------------------------------------------------------------------------------
IN: In Network.
OON: Out of Network.
* Per day rate change effective October 1, 2018.
** When TRICARE Prime enrollees other than active duty service members self-refer to specialty or non-emergent
inpatient care without a referral from a network provider and/or authorization from the regional contractor,
the TRICARE Point of Service deductible and copayment applies in lieu of TRICARE Prime copayments.
The above rates are effective for services rendered on or after
January 1, 2019 unless otherwise indicated.
Dated: April 5, 2019.
Aaron T. Siegel,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2019-07067 Filed 4-9-19; 8:45 am]
BILLING CODE 5001-06-P
