The 2020 TRICARE Open Season begins Nov. 9 and continues through Dec. 14. This year, there is an important change to the “Select” plan that requires proactivity to ensure the continuation of health insurance coverage.
Those enrolled in TRICARE Select – an enrollment option that’s different than Prime – will be placed into one of two categories as of Jan. 1. Group A is those individuals (family members, retirees, qualified survivors, etc.) whose became affiliated with the uniformed services through enlistment or appointment before Jan. 1, 2018. All other Select enrollees fall into Group B.
Group A beneficiaries will be required to pay a new enrollment fee starting in January. They are being asked to contact their regional contractor (Fort Lee falls under the Humana East Region, 1-800-444-5445) before the end of TRICARE Open Season to set up a monthly allotment, if feasible. Beneficiaries will be dis-enrolled for failure to pay the new enrollment fee.
TRICARE Select Group A out-of-pocket costs and resulting coverage are as follows:
- Individual monthly enrollment fee, $12.50, or annual, $150
- Family monthly enrollment fee, $25, or annual, $300
- Deductibles: $150 individual or $300 family
- Catastrophic cap: $3,500, an increase from $3,000
The point that bears repeating is that sponsors of Select Group A plans who don’t act by the end of Open Season will be dis-enrolled from TRICARE Select due to non-payment. If nothing is done as of the Dec. 14 deadline, a letter will be sent to MilConnect, resulting in dis-enrollment.
A sponsor will have 90 days from the dis-enrollment date to request reinstatement. If no action is taken, those under that plan will only be able to receive care at a military hospital or clinic if space is available. The sponsor would be responsible for all civilian health care costs off-post.
While the new enrollment fees do not apply to those enrolled in TRICARE Prime, TRICARE Prime retiree or TRICARE Select on active duty, Open Season is always a good time to review health care plans to learn what’s covered and what’s not. Look at percentages of coverage for different types of care, i.e. emergency, routine and ambulatory assistance.
All sponsors have the option of doing nothing and continuing with their current plan or transitioning to a different category of TRICARE coverage. Everything covered in this article and more is detailed in an overview available at www.tricare.mil/CoveredServices/BenefitUpdates/Archives/10_08_2020_TRICARE_Open_Season_Just_a_Month_Away.
It’s important to note also that changes to TRICARE coverage cannot be made outside of the Open Season period unless it meets the criteria of a “qualifying life event” – such as marriage, birth of a child, or retirement from active duty. A TRICARE QLE opens a 90-day period for individuals to make enrollment changes. A QLE for one family member means all under the same plan may make enrollment changes. To learn more, visit www.tricare.mil/lifeevents.
Open Season also is the time when military retirees, family members and others who are part of TRICARE can enroll in or make changes to their FEDVIP Dental and Vision Coverage Plans. Learn more about those coverage options at www.benefeds.com.