TRICARE trying for those overseas

In decades past, the U.S. military discouraged family members from joining loved ones on “unaccompanied” year-long tours to places like South Korea, Okinawa, Guam and more remote tours in “Cold War” Europe.

“Non-command sponsored” dependents who traveled to these assignments often were seen as a distraction and strain on support services. Some got the cold shoulder from commands and saw only limited access to medical care, base shopping or other amenities.

The signals sent today to non-command sponsored dependents are more positive though still mixed. The warmest change perhaps is in South Korea where Army Gen. B. B. Bell runs three major commands including the 30,000-member U.S. Forces Korea. Force strength will fall to 25,000 as American bases are consolidated in a few southern locations.

Like his predecessor, retired Gen. Leon J. LaPorte, Bell is doing what he can to make both command and non-command sponsored families feel welcomed, said Col. (Dr.) James Gregory Jolissaint, commander of the 18th Medical Command and the 121st General Hospital in Yongsan, Korea.

The inventory of Army housing dictates how many families receive command sponsored status, Jolissaint said in a phone interview. The number today is about 1,500, he said. Yet several thousand more “non-command-sponsored” families are also are living in Korea.

They paid their own travel costs and live on the economy without benefit of “with-dependents” housing or cost-of-living allowances. Some feel they can cope financially because of an extra $300 a month in Assignment Incentive Pay paid in Korea to members who extend their tours another year. After Iraq or Afghanistan, any more time away from family is a harder sell.

“In olden days, if you weren’t command sponsored, you couldn’t get a ration card,” said Jolissaint. “You couldn’t access other services on post. Now we are treating these folks as if they are command sponsored. They get their ID cards. They can come on post. They can use the PX (post exchange). They can use the commissary. They have access to all services. They just can’t get housing on post, and there’s the TRICARE Prime issue.”

In April last year, William Winkenwerder Jr., assistant secretary of Defense for health affairs, clarified in a memo to the services that department policy bans enrollment of non-command sponsored dependents in TRICARE Prime programs overseas.

Citing “differing interpretations’’ that exist across overseas regions, Winkenwerder wrote that, except in few select circumstances, only active duty family members who are “command sponsored,” as defined by travel orders, “shall be eligible” for TRICARE Overseas Program (TOP) Prime or the TRICARE Global Remote Overseas (TGRO) program.

Some commands overseas howled in protest. The policy would disrupt medical benefits to many families, they said, though Winkenwerder noted that these families would remain eligible for TRICARE Standard, the military’s fee-for-service insurance; for TRICARE Plus, which offers discounts for using network physicians; and for space available care on base.

Two months later, Winkenwerder agreed to delay the policy crackdown until Oct. 1, 2005 and to allow a “grandfather” clause. Non-command sponsored families who enrolled in TOP or TGRO before Oct. 1 can stay enrolled until members complete current overseas assignments.

TRICARE officials said the toughened policy isn’t meant to punish or to discourage non-command sponsored families. It’s to emphasize that families should have their medical needs screened, and matched to available services overseas, before they consider a non-command move.

Tom Philpott can be contacted at Military Update, P.O. Box 231111, Centreville, Va. 20120-1111, or by e-mail at:

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