TRICARE Changes: What you need to know

There are two big changes coming to TRICARE on Jan. 1, 2018. Here’s a quick breakdown of what you need to know and what you need to do.

What you need to know: Regardless of whether you are overseas or stateside, TRICARE Standard and TRICARE Extra will be replaced by TRICARE Select. According to TRICARE.mil, TRICARE Select will be a self-managed program, so you won’t need a primary care manager. You also won’t need a referral for services within the authorized provider network. If you’re overseas, you will have access to network and non-network providers (when medically necessary).

What you need to do:

• If you are currently enrolled in TRICARE Standard or TRICARE Extra, and you don’t wish to switch to TRICARE Prime, you don’t have to do anything. You will automatically be enrolled in TRICARE Select on Jan. 1, 2018.
• If you are currently enrolled in TRICARE Standard or TRICARE Extra, and you do wish to switch to TRICARE Prime, you will need to do so during the open enrollment period in November and December 2018.
• If you are currently enrolled in TRICARE Prime, you will automatically be re-enrolled — unless you choose to switch to TRICARE Select, which you can do in November and December 2018.

It’s important to note that the process for switching between TRICARE Select and TRICARE Prime has changed. As of now, families can switch between TRICARE Standard (which will become Select) and TRICARE Prime at any point — the only catch being that they are locked into that plan for a full year. With the new system, families can enroll only during open enrollment in November and December.

This could create challenges for families who are used to changing their coverage when needed, depending on where they are stationed and what is going on in their life at that time. To make this transition easier for military families, TRICARE has extended the catastrophic cap (which usually resets on Oct. 1) to Jan. 1, 2018 — so any enrollment fees you pay during this transition period will count toward that cap. This means that if you reach your fiscal 2017 catastrophic cap, you won’t be charged additional out-of-pocket expenses for authorized TRICARE-covered services for the last three months of 2017.

There are, of course, exceptions known as qualifying life events that will allow families to enroll or switch outside of the open enrollment period. Go to the Office of Personnel Management website to get a general idea of what constitutes as a qualifying life event.

What you need to know: TRICARE regions are changing. On Jan. 1, 2018, TRICARE’s North and South regions will combine to become TRICARE East. (TRICARE West will stay more or less the same.) With this change come two new contractors that will administer services: Humana Military and Health Net Federal Services. TRICARE’s hope is that this change will make it easier for military treatment facilities and civilian providers to work together.

What you need to do: Talk to your health care provider to make sure your provider will continue to accept TRICARE. It’s also a good time to check that your personal information is up to date in DEERS.