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Delivering Readiness: The Evolution of TRICARE

A picture of a laptop TRICARE benefits have continued to evolve, but the mission of ‘delivering exceptional medical and dental care to eligible beneficiaries and their families’ remains (Courtesy photo).

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Ever wonder about the people behind the curtain at TRICARE? Maybe you imagine policy gurus or bureaucrats with little connection to military service. If so, you may be surprised to learn that’s not true. The halls of the Defense Health Agency Headquarters are filled with men and women in uniform, military retirees, dedicated civil servants, and contractors. They understand and care about the mission and the people they serve.

While the TRICARE benefit is always evolving, the mission never does. From day one, the mission is to deliver exceptional medical and dental care to eligible beneficiaries and their families.

Mark Ellis, chief of the Policy and Programs section of the TRICARE Health Plan at the Defense Health Agency, understands this contrast between evolving while staying true to an unwavering mission. In fact, he lives it.

In 1976, Ellis enlisted in the Air Force Medical Service. Throughout his military career, he served in a variety of roles. He worked in hospitals as a medical support person and on aircrafts as an aerial refueling specialist during the Cold War. He rose through the ranks, earning a commission in the Air Force Medical Service Corps. TRICARE came into existence during his time in the medical service.

After almost 23 years of active military service, he retired in August 2001, days before 9/11. As a contractor working for TRICARE on that day, he stood at his office window. He watched the smoke billowing from the Pentagon with renewed resolve. Years later, Ellis became a civil servant, culminating with his current role as chief of the Policy and Programs section.

"My military service informs what I bring to policymaking at TRICARE," said Ellis. "We still do what we've always done - support the Medically Ready Force, Ready Medical Force. We deliver a high-quality medical and dental benefit to eligible beneficiaries and their family members."

During his long career with the Military Health System (MHS), Ellis witnessed the evolution of the military medical benefit from the basic CHAMPUS program to the TRICARE triple option (Prime, Standard, and Extra). He also served throughout the creation of new TRICARE programs, like TRICARE Reserve Select TRICARE Retired Reserve. These two health plans provide TRICARE coverage for Reserve Component members and their families. He led the MHS's efforts to implement the TRICARE Young Adult plan. And he led the recent transition from TRICARE Standard and TRICARE Extra to TRICARE SelectTRICARE Select is a self-managed, preferred provider network plan. TRICARE Select is a fee-for-service option in the United States that allows you to get care from any TRICARE-authorized provider.  Enrollment is required to participate.TRICARE Select coverage.

But Ellis regards the creation of TRICARE For Life (TFL) in 2001, TRICARE's Medicare wraparound coverage, as the key TRICARE transformation during his career.

"Before TFL, military retirees lost all TRICARE coverage when they became entitled to Medicare due to age or disability," said Ellis. "Under TFL, you pay your Medicare Part B premiums, as most Americans must do. Then TFL provides the full TRICARE plan and pharmacy coverage as your free Medicare-wraparound coverage, without premiums or enrollment fees. Personally, my wife and I are more than happy to pay our Medicare Part B premium as TFL provides such a rich benefit."

Ellis also worked to develop TRICARE Open Season. Open season is the annual period each fall when you can change or enroll in a health plan. During the enrollment period, you can adjust your health coverage for the upcoming year.

For example, you may decide you value having a choice of provider. You understand your out-of-pocket costs and decide TRICARE Select will serve you best. If you want a primary care manager to oversee your care, TRICARE Prime may be the option for you.

"These options help you take command of your health by choosing the TRICARE plan that best meets your family's health care needs," said Ellis.

Choices help you take charge of your own health benefit. Beyond plan options, TRICARE also offers unparalleled savings.

"Compared to the Affordable Care Act and the average out-of-pocket costs for commercial health plans, TRICARE offers incredible value," said Ellis. "There's no comparison to civilian plans, even when you adjust for the sacrifices that military families make. Congress provides - and the Military Health System delivers - an attractive health care benefit under the TRICARE program."

Highly regulated, ever-changing, and overseen by people who understand they serve those who serve. Those people understand the value of the benefit. They believe in its evolution.

"What a transformation that I've seen since the 70s," said Ellis, who retires from civil service next month. "From 1976 to today, I've seen nothing but change. And I know for sure that TRICARE will continue to evolve to support readiness and deliver an unparalleled health care benefit for those who serve and have served, and their family members."

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