TRICARE Equality Act: Bill Seeks Parity for Puerto Rico Beneficiaries with Prime Expansion and Travel Aid

The TRICARE Equality Act aims to put healthcare access for military families and personnel in Puerto Rico on par with those living in the mainland United States. This legislation directs specific improvements to how the TRICARE program operates on the island, focusing on expanding coverage options and facilitating better access to care.

Leveling the Playing Field: TRICARE Prime Comes to PR

A key provision mandates making TRICARE Prime available in Puerto Rico similar to how it's offered stateside. TRICARE Prime is a managed care option, often with lower out-of-pocket costs compared to the TRICARE Select plan, but typically requiring enrollment and using network providers. Expanding Prime could mean more affordable, consistent healthcare choices for the thousands of TRICARE beneficiaries—active duty personnel, retirees, and their families—residing in Puerto Rico.

Getting Care When Needed: Travel and Data Flow

The bill also addresses the practical challenges of accessing specialized care. It extends travel benefits, as defined under section 1074i of title 10, U.S. Code, to eligible individuals in Puerto Rico. This could help cover costs when beneficiaries need to travel for necessary medical services unavailable locally, a significant hurdle for island residents. Furthermore, the act pushes for better health information sharing. It directs federal health record systems to coordinate with Puerto Rico's Department of Health through the Joint Health Information Exchange, aiming for smoother care transitions and potentially reducing redundant tests when patients see different providers within federal and local systems.

Keeping Tabs: Reporting Back

To ensure these changes are implemented effectively, the legislation requires the Secretary of Defense to report back to Congress within 180 days on the progress made. This reporting requirement acts as an accountability measure, tracking the rollout of these enhanced benefits and system integrations for beneficiaries in Puerto Rico.