ALTUS AIR FORCE BASE, Okla. --
TRICARE beneficiaries will be affected by new policy changes starting Jan. 1, 2018. TRICARE will be consolidated to TRICARE East and West. Each region will have their own network providers.
Members in the current TRICARE North or South region will soon fall under TRICARE East. Altus AFB will fall under the new East region. Beneficiaries residing in the current TRICARE West region will remain in TRICARE West, but may have changes to their regional contractors. TRICARE members will be notified if the changes will affect their Primary Care Manager (PCM) previously assigned to them.
The new TRICARE policy changes also affect coverage policies. TRICARE Standard and TRICARE Extra are no longer an option for TRICARE beneficiaries.
“TRICARE Standard and Extra will be consolidated into a new program named TRICARE Select,” said U.S. Air Force Tech. Sgt. Amanda Gilbert, TRICARE Operations and Patient Administration representative assigned to the 97th Medical Support Squadron. “Beneficiaries that currently have Standard or Extra have the option to enroll in TRICARE Prime or TRICARE Select from Jan. 1, 2018 through Dec. 31, 2018.”
TRICARE Prime will have minimal changes. Prime members who were enrolled before Jan. 1, 2018, will remain in Prime unless they choose to change coverage or lose their eligibility. These members will continue to see their PCM and their costs will depend on their beneficiary category.
TRICARE Select requires enrollment unless the beneficiary was part of TRICARE Standard or Extra prior to Jan. 1, 2018. Those members will be automatically enrolled in the new Select program. As of Jan. 1, 2018, the new Select policy will mostly mirror Standard’s policy. Select’s coverage is different from Standard so it is important to review the upcoming changes.
New TRICARE Select members don’t require a referral, can see any TRICARE authorized provider and are able to obtain additional preventive care services from any network provider. This added benefit was previously only available under TRICARE Prime. Staying within your network is key to making sure TRICARE will reimburse the care received.
Even though a member’s policy will automatically transfer over to the new equivalent come Jan. 1, 2018, there will be plenty of time to change policy plans.
“On Jan. 1, 2019, the plan a beneficiary is enrolled in at the time will be their plan until the next open enrollment season,” said Gilbert. “Open enrollment season will be from Nov. 21 through Dec. 31, 2019. At this point in time, beneficiaries can choose to enroll in a new plan.”
The policy enrollment timeframe is the same for those who have major life changing events like marriage, birth or divorce. They regularly would have 90 days to switch policies, but because of the transition they will have all year to switch polices.
In addition to the policy enrollment changes, the cost of TRICARE benefits, regardless of your plan, will also change. The enrollment fees will be billed by calendar year rather than fiscal year, as was done in the past. Medication costs will also be increasing for generic drugs, brand name drugs, and non-formulary drugs if the beneficiary chooses to purchase off-base or through home delivery. The cheapest way to fill medications is through military facility pharmacies. The price will not have a co-pay.
Members should be prepared for the new policy changes by updating their personal information in DEERS, sign up for TRICARE benefit updates, and update their payment information if paying electronically. Be aware that Explanation of Benefits are now entirely paperless and accessible online unless the member elects to receive them by mail.
Certain TRICARE programs such as TRICARE for Life, the US Family Health Plan, TRICARE Dental Program, and the TRICARE Retiree Dental Program will be unaffected by the new policy changes.
For more information on what policy changes are happening with TRICARE, visit their website https://tricare.mil/changes or call TRICARE East at 1-800-444-5445.