It’s that time of year again: OPEN SEASON. This year’s Tricare Open Season runs from Monday, 9 November 2020 (that’s Monday!) through Monday, 14 December 2020. Be sure to select what Tricare plan you want to use for 2021 during the open season, or you’re stuck with what you had in 2020 unless you have a Qualifying Life Event that lets you change. This open season applies to Tricare plans (Prime vs. Select) and FEDVIP vision and dental coverage. Open season DOES not apply to Tricare Dental for Active Duty families.
What Is An Open Season?
Open season, also called open enrollment or annual enrollment, is a designated time of year where employees can select from their different benefit options. For military families, that means picking your Tricare plan for the next year, and deciding whether you want to enroll in FEDVIP vision insurance for the next year. For retirees, it is also the time where you pick your dental coverage for the next year if you are using the FEDVIP program
But I Used To Switch Tricare Whenever I Wanted!
Yup, that’s true. You used to be able to switch Tricare throughout the year. Starting in 2019, that’s no longer true. Switching Tricare plans has to happen during the open season or after a Qualifying Life Event.
Qualifying Life Events, often called QLEs) include:
- separating from the military
- birth or adoption of a child
- placement of a child in the home
- child leaving for college
- child leaving Tricare for other coverage
- change in command sponsorship
- losing or gaining other health insurance
- losing eligiblity for Tricare upon Medicare eligibility
- death in the family
What About USFHPs?
Uniformed Services Family Health Plans are a special type of Tricare Prime. They seem like they are a third Tricare choice, but they’re really a Primary Care Manager under Tricare Prime. What this means for you is that you can switch from Prime to USFHP to Prime whenever you want, because you’re not switching plans, you’re just doing a PCM change. Crazy, right? But true.
You may want to consider adding a Tricare Supplement to your overall coverage. A Tricare supplement can cover some of your out-of-pocket costs for whichever Tricare you choose, but you have to factor the cost of the supplement to decide if that’s a good plan for you. You can learn more at this article: Tricare Supplements: Do You Want One? Where Would You Get It?
How Do I Pick Which Tricare I Want?
First, get to know the plans. I’ve broken down the Active Duty and Retiree options:
Then, consider your family’s situation. Questions to ask include:
Is there an MTF convenient to you, and are they accepting patients in your category (AD family members, pediatrics, retirees)?
Do you see a lot of specialists? Where do you have to go to see those specialists? Would you like more flexibility?
Do you want to be able to fill prescriptions on base? Are you happy being limited on which pharmacy you use in town?
Do you typically hit your catastrophic cap, or not?
Are you more interested in convenience or cost?
Our family has been on USFHP, Tricare Prime, and Tricare Select. They all have pros and cons. For us, Tricare Select has provided the simplest coverage, including no PCM appointments to get referrals to my daughter’s many specialists. And since we hit our catastrophic cap every year, the co-pays don’t really matter. It’s just a matter of whether we pay more at the beginning of the year or if we stretch those expenses over the full year. Plus, we generally get to pick specialists who are either really, really good at what they do OR very convenient to our house. Much better than schlepping an hour away to the MTF that has the specialty you need, or finding the perfect doctor only to discover that they aren’t in the USFHP system.
If you have less complex medical needs, Tricare Prime or USFHP may be a good option for you. You may save money, either a little bit or more, depending on your details.
What Do I Need To Do?
There are three possible actions here:
Do Nothing: If you are happy with your current Tricare plan, you do not have to do anything. You will remain enrolled in that plan.
Change Plans: If you are currently enrolled in Tricare, and want to switch plans, you need to do it no later than 14 December 2020. I recommend going ahead and doing it as soon as you make your decision, because you know how life can get in the way of remembering things. Or internet goes out. Or people get sick. We’ve all been there.
Select A Plan: If you are not currently enrolled in a Tricare plan, this is the time to enroll. Again, do it no later than 14 December 2020, but earlier is better. You know how something always happens when you wait until the last minute.
How To Do It: To the best of my knowledge, there are two readily available ways to enroll or change your Tricare enrollment: by telephone or online. There is a mail option, but that would make me nervous, and there may be a Tricare office available to you, but they have become very rare.
By telephone, call your Tricare contractor. You can see how the regions are divided and find the most up-to-date phone numbers at this webpage.
Online, you have to have a DS Login or CAC card and log into the Beneficiary Web Enrollment Website at MilConnect. Once you are logged in, you should see a screen that looks like this:
Click on the button that says Manage Health Benefits. This will take you to a page where you can click on each beneficiary.
Arrange To Pay The Premiums
If you are a retiree family member, you will have enrollment fees for either Tricare Prime or Tricare Select in 2021. You can pay your Tricare enrollment fees by allotment out of the retirement paycheck, an electronic funds transfer from a U.S. bank account, credit card, or debit card.
If you make arrangements to set up an allotment or other payment arrangements by 20 November, you will be set up when the new Tricare Select enrollment fees go into effect on 1 January 2021. If you do not get your payment arrangements established until after 20 November 2020, you may need to pre-pay a month or two of premiums.
How you can set up your enrollment fee payments depends on your Tricare region:
Don’t Forget Vision and Dental
It is also open season for vision coverage and retiree dental coverage through the FEDVIP program. Active duty family members covered under the Tricare Dental Plan do not have an open season and do not need to take any action.
See why I choose a vision plan outside of FEDVIP – cheaper, better coverage, and no open seasons!
All Tricare coverage is outstanding, especially for the price. The important thing is that you make a thoughtful, educated decision so that you don’t feel like you are stuck in a plan that isn’t what you wanted.
Do you want to know more about your military pay and benefits?
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