By Katie Lange
Department of Defense
As with private-sector health care, there’s now a yearly open enrollment “season” for TRICARE Prime and TRICARE Select planholders. TRICARE open season runs from Nov. 12 to Dec. 10. The changes you make will take effect Jan. 1, 2019.
TRICARE is establishing an open enrollment season. Watch this video to learn more about what this means for your TRICARE benefit.
Posted by TRICARE on Tuesday, September 18, 2018
During open season, beneficiaries can:
- Enroll in a plan. Beneficiaries eligible for TRICARE Prime or TRICARE Select can enroll in either plan for 2019 coverage.
- Change plans. Beneficiaries already enrolled in TRICARE Prime or TRICARE Select can switch plans for 2019 coverage. In other words, if you are in TRICARE Prime and want to switch to TRICARE Select, open season is the time to make this change. Beneficiaries may also change their type of enrollment from individual to family coverage.
- Do nothing. Beneficiaries will keep the same coverage through 2019 or as long as they remain eligible.
For more on TRICARE open season, visit www.tricare.mil/openseason.
Outside of TRICARE open season, you can only make enrollment changes when you or your family experience a Qualifying Life Event. QLEs are certain life events like getting married, having a baby or retiring from active duty. When a QLE happens to you or family, you have 90 days from the QLE to make any enrollment changes. Your coverage is effective on the day of that life event.
How do I enroll during open season?
Enrollment is the same process as previous enrollment actions. The easiest way to do so is online at the Beneficiary Web Enrollment website (stateside only). But you can also call your regional contractor or snail mail them your enrollment form.
I’m a new active-duty service member. How does this work for me?
If you joined the military this year, you were automatically enrolled in TRICARE Prime. If you live in remote areas of the U.S., you’ve been enrolled in TRICARE Prime Remote.
When it comes to your eligible family members:
- If they live stateside, they’ll automatically be enrolled in TRICARE Prime if they live in a Prime Service Area. If they live outside of a PSA, they’ll be enrolled in TRICARE Select. Family members have up to 90 days to change their plans if they want to.
- If your family is in the TRICARE Overseas Program, they’ll be enrolled in TRICARE Select. They also have 90 days to change their plans, if they’re command-sponsored.
If you have one of the other premium-based plans:
TRICARE open season doesn’t apply to you. Tricare Retired Reserve, Reserve Select, Young Adult and the Continued Health Care Benefit Program offer continuous open enrollment all year long. Tricare For Life doesn’t require enrollment.
Enrollment fees are based on whether you choose TRICARE Prime or TRICARE Select, and whether you fall into Group A or Group B. Group A refers to active-duty members and their families who have been in before Jan. 1, 2018. Group B includes those who joined the military (and their families) after Jan. 1, 2018.
When it comes to TRICARE Select, there are also slightly different copays for Group A and B.
“Instead of paying cost-shares, we’re now going to [fixed] copays,” said Vice Adm. Raquel Bono, director of the Defense Health Agency. However, those copays only apply to network providers. Non-network providers in TRICARE Select will still have cost-shares.
With TRICARE Select Group A, the fixed copay will be based on the type of care you need and where you live. “For the Group B people, those copays actually came directly from Congress,” Bono said.
Currently, active-duty military, their family members, and retirees and their families in TRICARE Select Group A do not have to pay enrollment fees, but that’s expected to change in a few years.
We’re sure you have more questions. The best way to get answers is to click on the links above or visit TRICARE.mil. We’ll also be putting out more blogs to help you through the change, so keep checking back for those!
Editor’s note: This blog was originally published Oct. 9, 2018, on DoD Live.