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Cost for Inpatient Services Increase Slightly (Article 4)
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New Rates Effective Oct. 1, 2007, through Sept. 30, 2008 |
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Each fiscal year, some of the costs for TRICARE-covered inpatient services may increase slightly. The following tables highlight the new rates for inpatient services for fiscal year 2008 (Oct. 1, 2007–Sept. 30, 2008).*
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For additional information about copayments and cost-shares for TRICARE-covered services, visit the TRICARE Web Site. You can also browse our site or call 1-800-444-5445 for more information.
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* While the inpatient rate increases are technically effective Oct. 1, 2007, there may be some delay between then and the time Humana Militaryreceives direction from the TRICARE Management Activity and is able to implement the change.
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| Beneficiary Costs for Inpatient Services for Civilian Hospital Admissions |
| Program |
Active Duty Family Members |
Retirees, Their Families and Other Eligible Beneficiaries |
| TRICARE Prime |
(no change)
$0 per admission |
(no change)
$11 per day or $25 per admission, whichever is greater. No charge for seperately billed professional services. |
| TRICARE Standard |
Increases from $14.80 to $15.15 per day or $25 per admission, whichever is greater. No charge for separately billed professional services. |
(no change)
$535 per day, or 25% of the total charge, whichever is less. Plus, 25% of of the TRICARE- allowable charge for separately billed professional services. |
| TRICARE Extra |
Increases from $14.80 to $15.15 per day or $25 per admission, whichever is greater. No charge for separately billed professional service. |
(no change)
$250 per day or 25% of total charge, whichever is less. Plus, 20% of the allowable charge for separately billed professional services. |
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| Beneficiary Costs for Inpatient Behavioral Health Services at Civilian Facilities |
| Program |
Active Duty Family Members |
Retirees, Their Families and Other Eligible Beneficiaries |
| TRICARE Prime |
(no change)
$0 per admission |
(no change)
$40 per day. No charge for separately billed professional charges. |
| TRICARE Standard |
(no change)
$20 per day or $25 per admission, whichever is greater. |
High Volume Hospitals—(no change): 25% of hospital-specific charges.
Low Volume Hospital —increases from $181 to $187 per day or 25% of the billed charges, whichever is lower.
Residential Treatment Center (no change): 25% of the allowed amount.
Partial hospitalization (no change): 25% of the allowed amount, plus 25% of the allowable charge for separately billed professional services.
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| TRICARE Extra |
(no change)
$20 per day or $25 per admission, whichever is greater. |
(no change)
20% of total charge. Plus, 20% of the allowable charge for separately billed professional services. |
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Military Treatment Facility Inpatient Admission Cost Increase
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The cost for inpatient care provided at a military treatment facility increasesfrom $14.80 to $15.15 per day for active duty family members and retireefamily members using TRICARE Standard or TRICARE Extra and forretiree family members enrolled in TRICARE Prime.
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Created: October 15, 2007
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