Tricare Open Enrollment – Overview
The annual Tricare Open Season is when eligible beneficiaries can enroll in or change their health coverage for the upcoming year. Open Season applies to those already enrolled in or eligible for Tricare Prime, Tricare Select, or the US Family Health Plan (USFHP). Open season is applicable for people who are already registered or eligible for Tricare Prime, Tricare Select, or the US Family Health Plan (USFHP).
What is Tricare Open Enrollment?
Tricare Open Enrollment is when individuals can enroll in a new Tricare plan or change their existing coverage plan for the following year.
Tricare allows its members to switch healthcare plans annually during the Open Season. This is a standard feature of Tricare’s benefits, allowing for adjustments in coverage according to the beneficiaries’ current needs.
Can you make Enrollment Changes Outside of the Open Season?
Active duty service members, retirees, and their families can change their Tricare plans outside the annual Open Season only if they experience a Qualifying Life Event (QLE). These events trigger a 90-day period when beneficiaries can change their healthcare coverage.
A QLE is a significant change that can affect your life, including marriage, the birth of a child, relocation, changing primary care providers, or retirement from active duty.
You can apply to modify your TRICARE health insurance during a QLE.
A TRICARE QLE offers a 90-day window to modify or change your eligible enrollment. A QLE for one person provides all of their eligible family members with the chance to change their enrollment.
You can only sign up for a new FEDVIP and modify your existing one outside of the Federal Benefits Open Season if you encounter a FEDVIP QLE. However, you must remember that FEDVIP QLEs are different from TRICARE QLEs.
Tricare Open Season Enrollment Options
If you are eligible for Tricare Open Season enrollment, you can choose any of the three available options –
1. Stay in your existing plan
You may already have a Tricare Prime or Tricare Select plan. If you want to continue your existing coverage plan, you do not have to do anything during the Open Season.
You can continue with it as long as you are eligible. However, you can always change your plan during the next annual Tricare Opening Season.
2. Change your existing plan
If you are unsatisfied with your existing Tricare health plan, you can always switch it during the open enrollment period. The procedure is quite simple.
To change your healthcare coverage plan, you can call your nearby Tricare office, change the plan online, or send an enrollment form.
3. Enroll in a plan
Once qualified, the active duty members are automatically registered in a suitable Tricare plan.
However, if you are a retiree or a family member of a retiree and do not have any active Tricare plans, you can enroll during the Open Season.
Who is eligible to enroll in Tricare Open Season?
Individuals who can meet the eligibility criteria for Tricare Select, Tricare Prime, Tricare Prime Remote, Tricare Overseas Program Prime, Tricare Overseas Program Select, or U.S. Family Health Plan can enroll in Tricare Open Season.
Active duty members or retirees under a Tricare coverage plan can modify or change their plan during the period.
However, Tricare Open Season primarily targets beneficiaries under Tricare Prime, Tricare Select, and similar plans. Active duty service members with automatic coverage and retirees with Tricare for Life are not required to make changes during the Open Season, as their coverage does not necessitate annual enrollment.
Additionally, Platinum-Based Plans are not covered by Tricare Open Season. If qualified, you can buy specific Tricare plans, including Tricare Young Adult, Tricare Reserve Select, and Tricare Retired Reserve, any time of the year.
You do not have to wait for the annual Tricare Open Season to apply for these coverage plans.
Enrollment Fees and Annual deductibles
Active duty service members and their families do not pay annual enrollment fees for their Tricare coverage, and retirees enrolled in Tricare for Life do not have enrollment fees for that specific coverage. Still, it is important to note that Tricare for Life acts as a Medicare wraparound coverage and thus has different cost structures from other Tricare plans.
A working-age retiree with a Tricare Prime plan may need to pay $323 for the annual enrollment fee. It can increase by $20 per year.
The annual enrollment fee for a family with the Tricare Prime plan is around $647, and it may increase by $41 every year.
A working-age retiree may need to pay an annual registration fee of $158 per person and $317 per family for the Tricare Select coverage plan. It can increase by $8 and $17 per year, respectively.
FAQs
What is Tricare Prime Overseas?
TRICARE Prime Overseas is a managed care alternative. It is available in foreign countries near military clinics and hospitals. This program is not available for retirees and their family members.
There are no copayments or annual fees if you receive care from your PCM or Primary Care Manager.
Can I enroll in Tricare If I do not have a plan?
If you are a retiree or a family member of a retiree and do not have a Tricare coverage plan, you can apply during the Open Season. However, you must fulfill all the eligibility requirements to apply for Tricare.
Does Tricare offer Dental Coverage?
Tricare offers broad medical and dental coverage to eligible members and their families. The Tricare program is a part of the DOD’s Defense Military Health System.
They offer three different types of dental programs, including the Tricare Active Duty Dental Program (ADDP), Tricare Dental Program (TDP), and Tricare Retiree Dental Program (TRDP).
Conclusion
Tricare Open Enrollment allows you to sign up for a health coverage plan. However, you must fulfill all the eligibility requirements to apply for a Tricare health program.
Existing Tricare members can also modify or change their healthcare coverage plan during the annual Open Enrollment Season.
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