Retirees: Don’t forget that your dental is changing, too. How To Pick A New Retiree Dental Plan
Starting in 2019, you won’t be able to change your Tricare plans whenever you want. As you know, there were a lot of changes to Tricare this year. One of those changes actually had a delayed implementation date, meaning that it is happening now.
What Is The Change?
In the past, you could switch between Tricare programs whenever you wanted. You could be on Tricare Prime for a while, then switch to Select, and even to a US Family Health Plan, without any reason. You can’t switch between Tricare Prime and Tricare Select randomly anymore. (But you can still switch between Tricare Prime and USFHP, because they are both considered a Tricare Prime plan. Go figure.)
Under the new rules, you will only be permitted to change plans during an annual open season, or if you have a qualifying life event. The open season happens in November and December of each year, during which time you will select your plan for the following year. The open season for 2019 Tricare coverage will be from 12 November 2018 to 10 December 2018.
If you are currently enrolled in a Tricare plan, and do not switch during the open season, then you’ll remain enrolled in your previous plan for the following year.
This includes maternity care, and becoming pregnant is not a qualifying life event. If you become pregnant, you’re stuck with the Tricare plan you have until the open season or until you have a separate qualifying life event. No more staying on Prime until you become pregnant, then switching to Standard for maternity care. When the baby is actually born, that is a qualifying life event, and then you can change plans.
Who Does This Change Impact?
This change applies to most people who use Tricare, including folks currently using US Family Health Plan through Tricare.
It does not apply to Tricare for Life, or premium-based plans such as Tricare Reserve Select, Tricare Retired Reserve, Tricare Young Adult, or the Continued Health Care Benefit Program.
Qualifying Life Events
If you have one of the following qualifying life events (QLE), you can change your Tricare coverage outside of the open season. You must make the change within 90 days of the QLE, but the change is effective the date of the QLE regardless of when you actually make the change.
A QLE makes everyone in the family eligible to change their coverage, even if the QLE only affects one person.
- Getting Married
- Getting Divorced
- Having a Baby or Adopting (the date of birth or date of adoption)
- Children go to College
- Children Become Adults
- Becoming Medicare-Eligible
- Moving
- Death in Family
- Loss or Gain of Other Health Insurance
- Activating
- Deactivating
- Deploying
- Injured on Active Duty
- Moving
- Separating from Active Duty
- Retiring
You can also read about Qualifying Life Events at this Tricare webpage: Life Events.
How Do You Change Your Plan?
If you have a QLE, or you want to change your plan during the open season, you can make the change three ways. Personally, I’d try to do it online so that you can print out a copy of what you’ve done. Regardless of how you make the change, log in and ensure that the change occurs before you seek any care – problems do happen.
- Online: Go to the Beneficiary Web Enrollment website (stateside only)
- By phone: Call your regional contractor
- By mail: Mail your enrollment form to your regional contractor
Which Plan Should You Choose?
Unfortunately, this is the hardest question and the answer is very personal. I can’t tell you what’s best for you, but I can give you some questions to ask yourself.
Do you want the flexibility to choose your own providers without referrals?
- Can you afford the deductible and cost-shares on Tricare Select, understanding that you’ll never pay more than your catastrophic cap ($1,000 for active duty families, $3,000 for retiree families for service members who entered the military prior to 01/01/2018, $3,500 if you have a family member on Tricare Young Adult) as long as you see in-network providers?
- Are you committed to certain doctors? Are they in-network or out-of-network?
Just For Retirees
Don’t forget that your dental plan is changing, too, and has the same open season. You can read more about it in Understanding Changes to Military Dental and Vision Coverage and How To Pick A New Retiree Dental Plan. This is important stuff, folks!
I’m trying to keep this short and sweet while still including all the information you need to know. If you think there’s something important that needs to be added, please let me know in the comments and I’ll add more to the article!And please, please share this will your people. So far, I’m seeing that very few people know that this is happening, and it is important. Spread the word!
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In areas that there are USFHP and Tricare Prime plans, a person can switch back and forth between those two as they are both Tricare Prime. I work for USFHP, and the manual states that in areas that they overlap a person can switch freely. It’s only going to effect people going from Prime to select and vice versa.
Thanks for sharing this, Ginni! Based upon your comment, I’ve done some research and it seems that is true. I’ve amended the article to explain that, because it is not at all clear anywhere else.
Does the whole family have to change plans . My daughter is in college out of state, so can she change to standard but I stay on prime?
Yes, your family members can be on different plans. The only downside is that the catastrophic cap doesn’t change, so you’ll still be liable for the full amount of your catastrophic cap even though it is only one person.
Thank you, this clears it up.