Defense Department officials have drafted plans to raise TRICARE enrollment fees and deductibles sharply over the next three years for military retirees under age 65 and their families, about 3 million beneficiaries of the health insurance program.

If the changes are adopted, annual enrollment fees for TRICARE Prime, the military's managed-care option, would triple by October 2008 for working-age retired officers and double for enlisted retirees.

Yearly deductibles for retirees using TRICARE Standard, the fee-for-service health insurance option, would double for officers and rise by a third for enlisted. Also, for the first time, retirees who use TRICARE Standard would pay an enrollment fee in addition to their deductible.

Pharmacy co-payments also would be raised.

The aim of these initiatives is to slow the projected rise in military healthcare costs by as much as $12 billion over five years and $32 billion through fiscal 2015. This would occur, proponents argue, by having working-age retirees pay a greater share of TRICARE costs and by encouraging others to switch to their employer-provided health insurance.

Bryan Whitman, deputy assistant secretary of defense for public affairs, said defense healthcare spending, if left unchecked, could reach $64 billion by 2015, or 12 percent of total defense spending. In fiscal 1995, he said, healthcare was only 5 percent of the defense budget.

TRICARE Prime enrollment fees of $230 a year for individual coverage and $460 for family coverage, and the TRICARE Standard deductible of $150 (single) and $300 (family), haven't been raised for more than a decade.

Prime enrollment fees would be raised for retired officers to $400/$800 (individual/family) in October, to $600/$1,200 a year later and to $750/$1,500 by October 2008, the start of fiscal 2009.

Enlisted retirees under 65 would see Prime enrollment fees climb to $300/$600 in October, to $375/$750 a year later and to $450/$900 in October 2008.

First-ever enrollment fees for TRICARE Standard would start for officers at $150/$300 (individual/family) and rise to $225/$450 by October 2007 and to $300/$600 in 2008.

Enlisted retirees would pay $100/$200 next October, rising to $150/$300 the next year and to $200/$400 in 2008.

Annual deductibles under TRICARE Standard and Extra, now $150/$300, would climb for retired officers to $200/$400 next fall, to $250/$500 in October 2007 and to $300/$600 in 2008.

Enlisted retirees would see their Standard deductible rise to $175/$350 next October, remain there for two years and rise to $200/400 in October 2008.

Co-payments under the TRICARE pharmacy program would be reshaped to discourage purchase of maintenance medicines in the more expensive retail network. The $3 co-payment for generic drugs would rise to $5 in the retail network but would be zero if ordered by mail. The current $9 co-pay for brand drugs would rise to $15 in retail network and $10 by mail.