The Military Times guide to Tricare and FEDVIP open season

Tricare Open Season runs through Dec. 14, and this is the only time of year you can enroll in Tricare or make changes, unless you have a qualifying life event — such as a marriage or birth, permanent change of station move, or retirement .

If you’re in Tricare Select or Tricare Prime, and you want to stay in that plan, you don’t need to re-enroll.

But if you’re a working-age retiree in Tricare Select, you need to take action. Retirees and their families in Group A (the sponsor entered the military before Jan. 1, 2018) must now pay monthly enrollment fees for Tricare Select, and you should set up the payment so that you’ll pay the required enrollment fees by Dec. 31, to avoid losing your coverage on Jan. 1.

The fees will be $12.50 per month for an individual; or $25 per month for a family. Previously, these retirees didn’t pay enrollment fees. But under Tricare reform in the Fiscal 2017 National Defense Authorization Act, DoD must charge an enrollment fee starting in 2021. The enrollment fee doesn’t apply to active duty family members, survivors of deceased active duty members or medically retired members and their family members.

What’s the deadline for enrollment in or changing Tricare plans, and when do the enrollment choices take effect?

Tricare Open Season ends Dec. 14. Enrollment choices take effect Jan. 1.

Who can participate in Tricare Open Season?

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Anyone enrolled in or eligible for Tricare Prime, Tricare Prime Remote, Tricare Select, Tricare Overseas Program Prime, Tricare Overseas Program Select and U.S. Family Health Plan. You can stay in your plan or enroll in a plan. Or you change plans if you’re already enrolled in a Tricare Prime or Tricare Select plan.

Open season doesn’t apply to active duty members.

And it doesn’t apply to retirees who are in Tricare for Life. Coverage is automatic if you have Medicare Part A and Part B.

It also doesn’t apply to those who have premium-based plans: Tricare Young Adult, Tricare Retired Reserve, and Tricare Reserve Select. You can buy these plans at any time.

Are costs going up?

Yes and no.

Many costs will be relatively stable in the coming year for military families in Tricare, and pharmacy costs won’t increase for beneficiaries across the board.

Active duty families in Tricare Select will see increases of up to a few dollars in the cost-shares they pay for certain health care services in 2021.

But starting in January, fees for those in the Tricare Young Adult program will increase sharply: $459 per month for Prime, an increase of 22 percent; or $257 for Select, an increase of 12 percent.

“Gray area” retirees using Tricare Retired Reserve will see enrollment fee increases by about $40 a month for individuals, to $484.83 a month; and by about $99 for families, to $1,165.01 a month.

Of most other Tricare plans with enrollment fees, increases ranged from $3 to $10, depending on the plan. There are no enrollment fees for active duty families in Prime or Select.

What’s the difference between Tricare Prime and Tricare Select?

Tricare Prime is a health maintenance organization, HMO-style plan, where you get most of your care from a primary care manager, and referrals are required for specialty care. There is no deductible; co-payments are required except for active duty service members and their family members.

Tricare Select is a preferred provider organization, PPO-style plan, where you choose your Tricare-authorized provider and don’t have to get referrals for most services. Deductibles, co-payments and cost-shares apply.

For a Tricare comparison tool click here.

How do I enroll in or change my Tricare plan?

Log in to milConnect at https://milconnect.dmdc.osd.mil; click on “Benefits,” then click on Beneficiary web Enrollment, BWE from the menu.

You can also call your Tricare contractor. Find contact information here. You can also submit your enrollment form to your Tricare contractor by mail. Forms and addresses are here.

What about dental and vision insurance?

*Dental: Family members of active duty family members, National Guard and Reserve, as well as Guard and Reserve members who aren’t on active duty are eligible for the Tricare Dental Program. That requires separate enrollment.

Most retirees and their family members are eligible for dental and vision coverage under the Federal Employees Dental and Vision Insurance Program, or FEDVIP, which is administered by the Office of Personnel Management. As the result of a new, seven-year contract signed this year, there will be more dental and vision insurance options for 2021. If you’re already enrolled in a FEDVIP dental and/or vision plan and don’t want to make a change, your enrollment will automatically continue.

*Vision: You must be enrolled in a Tricare health plan to be eligible for FEDVIP vision coverage. Those eligible include active duty family members, retirees and their eligible family members, and Selected Reserve members and their family members.

How do I enroll in or change FEDVIP coverage?

Visit https://www.benefeds.com/ to enroll and to get more information. The open season enrollment period is the same –through Dec. 14. Coverage takes effect Jan. 1.