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Inpatient Cost-Shares Increase Slightly for Fiscal Year 2006 (Article 10) |
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New Rates Effective Oct. 1, 2005, through Sept. 30, 2006 |
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Each fiscal year (Oct. 1–Sept. 30), some TRICARE inpatient cost-share rates increase slightly. The following tables highlight the new inpatient rates for Fiscal Year 2006.*
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For additional information about cost-shares for TRICARE-covered services, visit the TRICARE Web site. You can also contact Humana Military at 1-800-444-5445 for more information. |
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| Inpatient Cost-Shares for Civilian Hospital Admissions |
| Program |
Active Duty Family Members |
Retirees, Their Families and Other Eligible Beneficiaries |
| TRICARE Prime |
No increase
$0 per admission
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No increase
$11 per day or $25 per admission, whichever is greater. No charge for separately billed professional services. |
| TRICARE Extra |
Increases from $13.90 to $14.35
per day or $25 per admission, whichever is greater. No charge for separately billed professional
services. |
No increase
$250 per day or 25% of total charge, whichever is less. Plus, 20% of the allowable charge for separately billed professional services. |
| TRICARE Standard |
Increases from $13.90 to $14.35
per day or $25 per admission, whichever is greater. No charge for separately billed professional
services. |
Increases from $512 to $535 per day or 25% of the total charge, whichever is less. Plus, 25% of the allowable charge for separately billed professional services. |
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| Inpatient Cost-Shares for Behavioral Health |
| Program |
Active Duty Family Members |
Retirees, Their Families and Other Eligible Beneficiaries |
| TRICARE Prime |
No increase
$0 per admission
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No increase
$40 per day. No charge for separately billed professional services. |
| TRICARE Extra |
No increase
$20 per day or $25 per admission, whichever is greater. |
No increase
20% of total charge. Plus, 20% of the allowable charge for separately billed professional services. |
| TRICARE Standard |
No increase
$20 per day or $25 per admission, whichever is greater. |
High Volume Hospitals: No increase
Low Volume Hospitals: Increases from $169 to $175 per day or 25% of the billed charges, whichever is less. Plus, 25% of the allowable charge for separately billed professional services. |
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*While the inpatient cost-share increases are technically effective Oct. 1, 2005, there may be some delay between the effective date and the time Humana Military receives direction from TRICARE Management Activity (TMA) and is able to implement the change. |
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