A healthy choice

The Defense Department has proposed a rule that would enable veterans covered by two federal health insurance plans more freedom to switch between the

The proposed rule would lift a restriction requiring veterans eligible for care from the Veterans Affairs Department and Tricare, the Pentagon's managed care program, to stick with just one of the plans while being treated for a single injury or illness, commonly referred to as an "episode of care."

It is unclear, however, when an episode of care ends, Defense notes in the proposed rule. This is especially true under Tricare, which has never defined the term. For instance, if a beneficiary goes to a VA hospital for back pain, but then doesn't receive treatment until several weeks later, has the episode ended?

The 2003 Defense Authorization Act required the Defense Department to better define an episode of care. Instead, the department chose to eliminate the ban on switching health plans in mid-treatment.

Under the proposed regulation, a beneficiary of both programs could begin treatment for an ailment at a VA health facility and then switch to a Tricare provider at will. However, the rule does not cover mid-treatment switches from a Tricare provider to a VA hospital. To make the benefits completely interchangeable, the Veterans Affairs Department would have to initiate a companion rule.

-Amelia Gruber