As this year’s Tricare open season draws near, some military families may need to act before the end of the year to avoid losing coverage, as new Tricare contracts and regions take effect Jan. 1.
Enrolled beneficiaries living in one of the 26 states in the new Tricare West Region, including the six states moving from the East to the West Region, must provide their payment information to the new West Region contractor, TriWest Healthcare Alliance, before Jan. 1.
If you don’t provide your payment information to TriWest by then, you may be involuntarily disenrolled from Tricare, according to Tricare officials. This applies only to those who currently pay by electronic funds transfer, debit card or credit card. If you pay by military allotment, that allotment will automatically transfer, officials said.
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You can provide your payment information now through Tricare.mil/west or by downloading the Tricare automatic payment authorization form and mailing it to TriWest. Beneficiaries don’t have to wait until open season to do this.
Effective Jan. 1, Arkansas, Illinois, Louisiana, Oklahoma, Texas and Wisconsin will join the new West Region. About 1.1 million beneficiaries live in those six states.
Enrolled beneficiaries living in either the East or West Region who don’t want to change their current Tricare plan don’t need to re-enroll during open season, which runs from Nov. 11 through Dec. 10.
During open season, enrolled beneficiaries have the ability to change their plan if, for example, they decide to move from Tricare Select to Tricare Prime. This year, because of Tricare’s current online limitations, you will have to make those changes by contacting your Tricare regional contractor by phone at their call center. Any changes made during open season take effect Jan. 1.
Open season is the only time you can change your plan, except for a qualifying life event such as the birth or adoption of a child, marriage, divorce or retirement from active duty. Eligible beneficiaries can also enroll in Tricare during this time.
If you need to know whether your health care provider is staying in the network before making a decision about open season, you can check the contractors’ provider directories. Humana Military will continue as the East Region Tricare contractor; Humana and TriWest will publish their online provider directories by Nov. 2, according to the Defense Health Agency.
Tricare officials will publish information about Tricare rate changes in the coming weeks.
For those eligible for the Federal Employees Dental and Vision Insurance Program, or FEDVIP, open season is one day shorter, running from Nov. 11 through Dec. 9. That time frame also applies to service members who want to enroll in the dependent care flexible spending accounts and the new health care flexible spending accounts, which are administered by the Federal Flexible Spending Account Program, or FSAFEDS.
Tricare open season applies to those enrolled in or eligible for the following plans:
- Tricare Prime
- U.S. Family Health Plan
- Tricare Prime Remote
- Tricare Prime Overseas
- Tricare Prime Remote Overseas
- Tricare Select
- Tricare Select Overseas
Open season doesn’t apply to active duty service members or those with Tricare for Life coverage, which is automatic for those with Medicare Part A and Part B.
It also doesn’t apply to those enrolled in Tricare premium-based plans — Tricare Reserve Select, Tricare Retired Reserve and Tricare Young Adult — which can be purchased any time of the year. Still, those enrolled in those plans and who are living in a state moving to the West Region contract may still need to provide their payment information to TriWest at Tricare.mil/west by Jan. 1.
Tricare Prime is a health maintenance organization-style plan in which you get most of your care from a primary care manager, with referrals required for specialty care. There are no deductibles. Active duty service members, their family members and transitional survivors don’t pay enrollment fees or out-of-pocket costs for covered services. Retirees, their families and all others pay enrollment fees and out-of-pocket costs for covered services except for preventive care.
Tricare Select is a preferred provider organization-style plan in which you choose your Tricare-authorized provider and don’t have to get referrals for most services. There are deductibles, copayments and cost-shares.
Karen has covered military families, quality of life and consumer issues for Military Times for more than 30 years, and is co-author of a chapter on media coverage of military families in the book “A Battle Plan for Supporting Military Families.” She previously worked for newspapers in Guam, Norfolk, Jacksonville, Fla., and Athens, Ga.
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