Q&A: What To Know as TRICARE Open Season Begins Nov. 11
“TRICARE Open Season is your chance to review your options and make any changes to your health plan for 2025,” said Zelly Zim, senior policy analyst, TRICARE Health Plan Policy and Programs, at the Defense Health Agency. “It’s important to understand what’s different this year, compared to past open seasons, to ensure your coverage continues without interruption.”
Keep reading for answers to commonly asked questions about TRICARE Open Season—including new actions you may need to take this year.
Q: Does TRICARE Open Season apply to me?
A: TRICARE Open Season applies to you if you’re enrolled in or eligible for the following TRICARE health plans:
- TRICARE Prime
- US Family Health Plan
- TRICARE Prime Remote
- TRICARE Prime Overseas
- TRICARE Prime Remote Overseas
- TRICARE Select
- TRICARE Select Overseas
Even if open season doesn’t apply to you, you may still need to take certain actions this year. If you live in the West Region, or in a state that’s moving to the West Region on Jan. 1, you may need to provide your payment information to TriWest Healthcare Alliance, the incoming West Region contractor, by Jan. 1. You must do this if you pay by bank electronic funds transfer or debit or credit card, but not if you pay by military pay system allotment—allotment payments will transfer automatically. You can find out more at tricare.mil/west.
Q: How do I know if TRICARE Open Season doesn’t apply to me?
A: TRICARE Open season doesn’t apply to you if:
-
You’re an active duty service member.
- You have TRICARE For Life coverage. TFL coverage is automatic if you have Medicare Part A and Part B.
- You have a premium-based plan (TRICARE Reserve Select, TRICARE Retired Reserve, or TRICARE Young Adult). You can buy these plans any time in the year. But if you live in a state that’s moving to the West Region, you may still need to provide your payment information to TriWest at tricare.mil/west.
Q: What are my options during TRICARE Open Season?
A: If you’re eligible, you have three options:
- Stay in the same plan: Don’t want to change your current plan? You don’t have to re-enroll. (Note: You may still need to provide your payment information if you live in the West Region or a state that’s moving to the West Region.)
- Enroll in a plan: If you’re not currently enrolled in a TRICARE health plan, you can enroll during open season if you’re eligible for TRICARE.
- Change your plan: Before you make changes, make sure your family’s information is up to date in the Defense Enrollment Eligibility Reporting System. If you have questions about eligibility, ask your service’s personnel office.
Q: If I want to stay in my current plan, do I need to take any action?
A: Maybe. If you live in the West Region, or in a state that’s moving to the West Region on Jan. 1, you may need to provide your payment information to TriWest, the incoming West Region contractor. You must do this if you pay by bank electronic funds transfer or debit or credit card, but not if you pay by military pay system allotment—allotment payments will transfer automatically.
If you don’t provide your payment information to TriWest before Jan. 1, you may be involuntarily disenrolled from TRICARE.
The good news? You don’t need to wait until open season to provide your payment information. You can do this now at tricare.mil/west through a secure portal, or by downloading the TRICARE Automatic Payment Authorization Form and mailing it to TriWest.
If you have recurring payments scheduled with Health Net Federal Services, LLC or Humana Military for the rest of 2024, don’t cancel them. Your payment method will automatically stop being charged after you’ve paid all your 2024 costs.
If you don’t live in the West Region or a state that’s moving to the West Region, you don’t need to take any action to stay in your current plan.
Q: How do I make changes to my plan during open season?
A: It depends on where you live. If you live in the U.S., you cannot change your plan online in milConnect through Beneficiary Web Enrollment. You must call your regional contractor to do that. (Note: You can use milConnect to enroll in a plan if you’re not currently enrolled in TRICARE.)
Here’s a guide of who to call based on your region:
- East Region: Call Humana Military at 800-444-5445.
- West Region (including states moving to the West Region: Arkansas, Illinois, Louisiana, Oklahoma, Texas, and Wisconsin): TriWest’s call center will open Nov. 11. Starting Nov. 11, you can call TriWest at 888-TRIWEST (888-874-9378).
- Overseas: Update your plan online in milConnect or call International SOS.
You can also complete and mail an enrollment form to your regional contractor.
Q: I want to know if my providers are staying in the network before I decide to keep or change my plan. How can I check?
A: Humana Military and TriWest provider directories are now published. You are able to search the provider directories and see if your providers are still in the network. Your providers may also contact you directly to let you know their status.
After checking, you have until the end of open season (Dec. 10) to decide if you want to change your plan.
Q: What about dental and vision coverage?
A: You may be eligible for dental or vision coverage through the Federal Employees Dental and Vision Insurance Program. Your eligibility depends on your beneficiary category. FEDVIP dental and vision plans are separate from TRICARE. Keep in mind that you must be enrolled in a TRICARE health plan to get FEDVIP vision coverage.
If you’re eligible for FEDVIP, you can enroll in or change your coverage during Federal Benefits Open Season. Federal Benefits Open Season also began Nov. 11. But note that it ends Dec. 9—one day before TRICARE Open Season ends.
Q: What else should I know or do now, before open season starts?
A: Remember: Changes you make during TRICARE Open Season will take effect Jan. 1, 2025. If you don’t make a change now, you’ll need to wait until:
- You have a special enrollment period due to a Qualifying Life Event, as described in the TRICARE Qualifying Life Events Fact Sheet, or
- Next year’s open season.
Here are some actions you can take now:
- Keep an eye on tricare.mil/changes and the TRICARE Newsroom for the latest updates on the new TRICARE contracts.
- Stay in the know by signing up for email alerts from TRICARE.
TRICARE Open Season is your chance to choose the health plan that makes sense for your family’s needs. Don’t wait—start thinking about your options today.
Article Source: https://newsroom.tricare.mil/News/TRICARE-News/Article/3944525/qa-what-to-know-as-tricare-open-season-begins-nov-11