TRICARE Open Season for enrollment changes is from Nov. 12, 2018 – Dec. 10, 2018.
TRICARE Prime and TRICARE Standard members need to review their healthcare options to ensure they have the best plan for their needs. Starting in 2019, members will no longer be able to switch plans at will – they will only be able to do so during Open Enrollment, or when they have a qualifying life event.
In addition, members of the TRICARE Dental and Vision plans also need to spend some time reviewing their options. Membership eligibility for some military members or retirees is transitioning to the Federal Employees Dental and Vision Insurance Program (FEDVIP).
Let’s dive into this a little more to explain this change and what it means for current TRICARE members.
What is Open Season, and What Does it Mean for Military Members & Military Retirees?
Open Season, or Open Enrollment, is the time of year when participants can change their healthcare plans. These are very common in the civilian world. In general, participants can change their healthcare selection once per year, unless they have a qualifying life event. There are many life events that may qualify, such as the member or the spouse taking a new job, losing a job, getting married, moving, and more. We’ll cover qualifying events in more detail later in this article.
Open Enrollment helps healthcare providers reduce costs by maintaining more consistent enrollment throughout the year. It also reduces the associated costs of people changing plans at will.
Current TRICARE members need to be aware of two different Open Enrollment seasons, TRICARE Open Season, and the Federal Benefits Open Season.
TRICARE Open Season
TRICARE Open Season is from Nov. 12, 2018 – Dec. 10, 2018. It applies to enrollment in a TRICARE Prime or TRICARE Select healthcare plan. It does not apply to other TRICARE plans, such as:
- TRICARE For Life
- TRICARE Reserve Select
- TRICARE Retired Reserve
- TRICARE Young Adult
- Continued Health Care Benefit Program
Federal Benefits Open Season
Federal Benefits Open Season is also from Nov. 12, 2018 – Dec. 10, 2018. It applies to military members or retirees who choose to purchase dental care or vision care through the Federal Employees Dental and Vision Insurance Program (FEDVIP).
FEDVIP Dental Program: the FEDVIP Dental program only applies to military retirees (TRICARE Dental is no longer available for military retirees, starting in 2019). All other military members will continue to be eligible for the TRICARE dental program. We have more information on the Military Retiree Dental Insurance program change.
FEDVIP Vision Program: The FEDVIP vision plan does not apply to active duty military members.
When is Open Enrollment, and What Do I Need to Do?
TRICARE Open Season for enrollment changes is from Nov. 12, 2018 – Dec. 10, 2018. The FEDVIP program has the same open enrollment dates.
You need to do one thing today: Review your current healthcare selection and ensure it still meets your needs.
If your current plan is the one you want to continue using, then you don’t need to take any action. Your current enrollment should automatically roll over for next year. Keep in mind that once 2019 rolls around, you won’t be able to change your healthcare plan unless you have a Qualifying Life Event (see next section for more information on this topic).
Each year you will need to review your healthcare selection to determine which plan you should be in. You should also review your health care plan each time you have a major life event or qualifying life event.
Qualifying Life Events
A Qualifying Life Event (QLE) is a major change in your life situation. QLEs allow you to enroll in or make changes to your healthcare plan outside of the normal Open Enrollment Season.
It’s important to understand that each healthcare plan may have its own rules for Qualifying Life Events. For example, the TRICARE website lists 90 days as the window to make changes. The Healthcare.gov website lists 60 days as the window in which you can change your plan for healthcare plans available on the ACA Exchanges. Rules may also be different for federal healthcare plans such as FEDVIP, FEHB, FSAFEDS, or FEGLI.
A plan through your civilian employer may also have different rules (this could apply to those who have insurance through a spouse’s civilian employer, or for retirees who choose to use their employer’s health care plan). I recommend you check with your specific plan for more information.
Qualifying Life Events for TRICARE
You can make changes to your TRICARE plan within 90 days of a qualifying life event. However, note that some other healthcare plans may have a smaller window in which to make changes.
Below is a list of qualifying life events from the TRICARE website. The TRICARE website has much more information for each of these situations. I recommend doing a little more research into these life events to ensure they will qualify for your specific situation.
Military-Related Qualifying Life Events:
- Activating or Deactivating
- Injured on Active Duty
- Moving or PCS
- Separating from Active Duty
- Retiring
Family-Related Qualifying Life Events:
- Getting Married or Divorced
- Having a Baby or Adopting
- Children go to College
- Children Become Adults
- Becoming Medicare-Eligible
- Moving
- Death in Family
- Loss or Gain of Other Health Insurance
Qualifying Life Events for FEDVIP
The Benefeds.gov website has more information regarding Qualifying Life Events for the FEDVIP healthcare plans. You can read more here. The Benefeds website lists the following QLEs:
- Marriage
- Lose Other Dental or Vision Coverage
- Acquire a Family Member
- Lose a Family Member
- Return from Leave Without Pay
- Return from Active Duty
- Annuity or Compensation Restored
- Move
- Return to Active Duty
- Transfer Positions
When and How Can I Change My Healthcare Plan?
You can only change your TRICARE plan during TRICARE Open Season, or when you have a Qualifying Life Event. The option you choose will remain in place for the duration of the calendar year, unless you opt to change it after a qualifyingevent.
You can change your TRICARE enrollment in the following ways:
- Online: Beneficiary Web Enrollment website (members who live in the US).
- Phone: Call your regional contractor
- Mail: Mail in your enrollment form
You will be required to pay any enrollment costs (if any) at the time of enrollment.
Enrollment Eligibility:
The TRICARE website has this helpful chart to help you determine when you can make changes to your TRICARE healthcare or FEDVIP healthcare plan:
| Military Status | I want to change my TRICARE plan | I want to enroll in a FEDVIP vision plan | I want to enroll in a FEDVIP dental plan |
|---|---|---|---|
| Active Duty Service Member | You can only change plans if you’re retiring. At retirement, coverage ends. | You do not qualify to purchase a FEDVIP vision plan. You will continue to get care as you do now. | You do not qualify to purchase a FEDVIP dental plan. You will continue to get care as you do now. |
| Active Duty Family Member* *Not including adult children enrolled in TRICARE Young Adult | You can change plans during the TRICARE Open Season. | You must enroll during Federal Benefits Open Season. | You do not qualify to purchase a FEDVIP dental plan. You can get your dental care through the TRICARE Dental Program. |
| Reserve Component Member or Family Member Enrolled in TRICARE Reserve Select | No action needed. This doesn’t apply to you. | You must enroll during Federal Benefits Open Season. | You do not qualify to purchase a FEDVIP dental plan. You can get your dental care through the TRICARE Dental Program. |
| Retired Service Member or Family Enrolled in TRICARE Prime, TRICARE Select | You can change plans during the TRICARE Open Season. | You must enroll during Federal Benefits Open Season. | TRDP ends on Dec. 31, 2018. You must enroll in a FEDVIP dental plan during Federal Benefits Open Season to maintain coverage. |
| Retired Service Member or Family Member using TRICARE For Life | No action needed. This doesn’t apply to you. | You must enroll during Federal Benefits Open Season. | TRDP ends on Dec. 31, 2018. You must enroll in a FEDVIP dental plan during Federal Benefits Open Season to maintain coverage. |
Where Can I Get More Information?
Healthcare benefits frequently change. This is true for TRICARE, FEDVIP, civilian healthcare plans, and plans you may get through an employer. It’s not possible for our site to track all changes for all plans. So please consider this aritcle to be informational only.
I strongly recommend you check regularly with your specific healthcare provider for more information. You can also see the TRICARE website for some current open season FAQs.