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1 1 (December 14, 2020)

handle is hein.crs/govdcxf0001 and id is 1 raw text is: * ~ ~ tiE>sct~rch $3c ~ Updated December 14, 2020 Defense Primer: Military Health The Department of Defense (DOD) administers a statutory health entitlement (under Chapter 55 of Title 10, U.S. Code) through the Military Health System (MHS). The MHS offers health care benefits and services through its TRICARE program to approximately 9.5 million beneficiaries composed of servicemembers, military retirees, and family members. Health care services are available through DOD-operated hospitals and clinics, referred to collectively as military treatment facilities (MTFs), or through civilian health care providers participating in the TRICARE program. The fundamental reason for an MHS is to support medical readiness. The medical readiness mission involves promoting a healthy and fit fighting force that is medically prepared to provide the Military Departments with the maximum ability to accomplish their deployment missions throughout the spectrum of military operations. The MHS also serves to create and maintain high morale in the uniformed services by providing an improved and uniform program of medical and dental care for members and certain former members of those services, and for their dependents (10 U.S.C. §1071). In addition, the resources of the MHS may be used to provide humanitarian assistance (10 U.S.C. §401) and to perform medical research (10 U.S.C. §2358). The Under Secretary of Defense for Personnel and Readiness (USD[P&R]) is the principal staff assistant and advisor to the Secretary and to the Deputy Secretary of Defense, for Total Force Management as it relates to readiness issues, including health affairs (see 10 U.S.C. §136). Key MHS Organizations * Office of the Assistant Secretary of Defense for Health Affairs (OASD[HA]) * Defense Health Agency (DHA) * Surgeons General of the Army, Navy, and Air Force The Assistant Secretary of Defense for Health Affairs (ASD[HA]) reports to the USD(P&R). The ASD(HA) is the principal advisor to the Secretary of Defense on all DOD health policies, programs and activities and has primary responsibility for the MHS (see DOD Directive 5136.01). Reporting to the USD(P&R) through the ASD(HA), the Defense Health Agency (DHA) is a joint combat support agency whose purpose is to enable the Army, Navy, and Air Force medical services to provide a medically ready force and a ready medical force to combatant commands in both peacetime and wartime. System In FY2019, there were 9.57 million total MHS beneficiaries (see Figure 1). Figure I. MHS Beneficiaries, FY20 19 N eomen Crpet Total enefiiries =9 57millon Source: Defense Health Agency, Evaluation of the TRICARE Program: Fiscal Year 2020 Report to Congress, Washington, DC, 2020, p. 23. Note: Numbers may not add up to total because of rounding. On October 1, 2018, administration and management of the MTFs began to transfer from each Military Department to the DHA. The DHA administers all MTFs in the United States, while each respective Service Surgeon General administers the overseas MTFs. These facilities provide a wide range of clinical services depending on size, mission, and level of capabilities. MTFs provide inpatient and outpatient medical care and dental services. There are 721 MTFs, with 109 located overseas. The facilities are generally on or near a U.S. military base and are typically staffed by military, civil service, and contract personnel. TR&CARE Optins With the exception of active duty servicemembers (who are assigned to the TRICARE Prime option and pay no out-of- pocket costs for TRICARE coverage), MHS beneficiaries may have a choice of TRICARE plan options depending upon their status (e.g., active duty family member, retiree, reservist, child under age 26 ineligible for family coverage, Medicare-eligible) and geographic location. Each plan option has different beneficiary cost-sharing features. Cost sharing may include an annual enrollment fee, annual deductible, monthly premiums, copayments, and an annual catastrophic cap. Pharmacy copayments are established separately and are the same for all beneficiaries under each option. The current major plan options are listed below. Mip-------------------.-,'*g-v

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