You asked, MOAA answered: How will TRICARE’s new enrollment rules work?
About the Author

Gina Harkins is MOAA's Senior Staff Writer. She can be reached at ginah@moaa.org. Follow her on Twitter at: @ginaaharkins.

Starting in November, many TRICARE users will have about six weeks to select and enroll in the health care plan they want to use in 2018. This is a new process for TRICARE users and means that troops, retirees, and their families will need to be more proactive when electing their health care coverage. 

In 2018, existing TRICARE members will be auto-enrolled in either TRICARE Prime or Select. They won’t have to take any action if they want to enroll in the same program they have now. But if they want to change or drop their coverage, they’ll have to do so during the open enrollment period. 

MOAA is working with the Defense Health Agency to make sure TRICARE users are getting all the info they need about the changes, but many still have questions about how the enrollment period will work. In Part 2 of our series on the upcoming changes to TRICARE, Capt. Kathy Beasley, USN (Ret), director of MOAA’s government relations health affairs, addresses questions about the new open-enrollment process.

Be sure to check out Part 1 of our series on the changes, which covers who’s affected by the TRICARE changes. And stay tuned for Part 3 in this series, which will address members’ concerns about accessing their health care.

When is the 2018 open-enrollment period?

Beasley: It’s scheduled to run from mid-November through mid-December. The exact dates will be announced later this year.  

How will that enrollment process work?

Beasley: I think some of those details are still in the works, but I would presume a lot of it will be web-based, so people can enroll online. TRICARE users can sign up here to get emails about the upcoming changes so they can stay up-to-date on new information. 

What happens if someone misses the open-enrollment period? 

Beasley: While MOAA didn’t advocate for these changes, we did lobby successfully for a year-long grace period. That means that in 2018, people will still be able to enroll or change their plans throughout the year. MOAA recognized that there will be people out there who don’t get the word about these big changes, so it’s important to provide that grace period. 

Starting in 2019, though, that grace period won’t apply. So they’ll only be able to choose their TRICARE plan, or unenroll from the plan — and that’s during open season. They can also make enroll or make updates within 90 days of a life-changing event.

Once the grace period for missing the enrollment period is over in 2019, what happens if someone forgets to enroll? 

Beasley: The fallback is that you become eligible for space-available care at military treatment facilities (MTFs). However, we know there’s not always a capacity to treat everyone on a space-available basis at MTFs, so it’s best to pay attention to open-enrollment dates. You’ve got to be proactive. 

What about those who need to make a change outside of that enrollment period, say if they get married or have a child?

Beasley: They can make a change if they have what is called a qualifying life event. Qualifying life events are such things as marriage, divorce or annulment, birth or adoption of a child, a death, or loss or gain of other health insurance. When these things occur, they’ll have to make a change within 90 days.

If someone ages into TRICARE For Life once they turn 65, the enrollment process will be the same it is currently.

Will TRICARE users have to deal with this new open enrollment process every year going forward?

Beasley: Only if they want to make a change to their plan or drop their coverage. Otherwise, once the 2018 grace period is over, people will be auto-enrolled in their existing plan.

That means if someone is enrolled in TRICARE Select in 2018, they’ll automatically be enrolled in that same plan in 2019. They don’t need to take any action during the open enrollment period unless they want to switch to a different plan or drop that coverage.

 
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