Like any new year, there are a lot of changes coming for us all. While I know we could have a great deal of fun identifying them all, I’ll keep the list short and only talk about one thing: Tricare.
Right away we know this can get complicated and there will be a lot of terms which sound alike Brace yourselves. I’ll do my best to make this easy. If you would like to double check what I’m about to describe or just want more information, I’m going to include a LOT of references from the Tricare website. Don’t be overwhelmed by the number of them. Like anything, take them one bite at a time and they will be understandable. Hopefully, my summary of these topics will help, as well.
For anyone who may not know, Tricare is the health care program for military members and their families. There is a separate purchase option for dental coverage called Tricare Dental (there is also a retiree version called the Tricare Retiree Dental Program). There are several different versions of Tricare available to service members. Which type is used is often based on the member’s duty status and personal choice.
The two most common types of Tricare coverage, Tricare Standard and Tricare Extra, are going to be replaced by a single coverage type which will be called Tricare Select. If you are using Tricare Standard or Extra on 31 December 2017, you should be enrolled automatically into Tricare Select on 1 January 2018. Tricare for Life, the US Family Health Plan, Tricare Dental, and the Tricare Retiree Dental Program will remain unchanged. All other Tricare types will change in one way or another. See https://www.tricare.mil/About/Changes for more information.
For those of us in the Tricare North and South regions, we have a significant change coming our way. Tricare North and South will be merging into the Tricare East region. There will also be a new contractor, Humana Military, to manage the new region. The states in the Tricare West region will be unchanged, but it will now be under the management of the contracting company known as Health Net Federal Services. These contracting companies will be responsible for customer service, claims processing, and prior authorizations, when needed.
There is already a question as to whether you will be able to keep your current doctor and other health providers. Except for those people under Tricare Prime (not Prime Remote), if your contractor is changing (meaning everyone in the new Tricare East region) it looks like the answer depends on whether those providers are in the new network. You may get a notification of a change in your primary physician and will have to request to switch to another one. I am posting links to the providers in these new regions in the references section below.
The least surprising aspect of the changes we as reservists will be facing is that of changes to the monthly premiums. For those of you currently enrolled in Tricare Reserve Select (a premium-based version of Tricare Select available to drilling reservists), the premiums will be as shown in the table below.
Gray-area retirees (retired reservists who are not yet eligible for retired pay) will also see a change in their monthly premiums. They are shown below.
Tricare Dental and the Tricare Retiree Dental Program
New premiums for Tricare Dental for next year have not been published yet. Here is what they are currently.
In 2019, the Tricare Retiree Dental Program will end and will be replaced by the Federal Dental and Vision Program (FEDVIP). This program will be administered by the Office of Personnel Management (OPM) which manages all benefits for federal employees. You can start enrolling for this new program in November 2018. Coverage will start on 1 January 2019.
The premiums for the Tricare Retiree Dental Program will be as shown below. This is only for one region, though. Your actual rate may be slightly different depending upon where you live.
Tricare and the Affordable Care Act
While the recently passed tax bill removed the individual mandate for health insurance, we still do not know all of the specifics of the change and how it will affect us. Until we know more, it may still be a good idea to keep the thought of minimum essential coverage in mind.
You have minimum essential coverage if you’re using any of the following health plans:
- Tricare Prime
- Tricare Prime Remote
- Tricare Prime Overseas
- Tricare Prime Remote Overseas
- Tricare Select
- Tricare Select Overseas
- Tricare For Life
- Tricare Reserve Select (if purchased)
- Tricare Retired Reserve (if purchased)
- Tricare Young Adult (if purchased)
- US Family Health Plan
- Transitional Assistance Management Program (transitional)
- Continued Health Care Benefit Program (if purchased)
To avoid confusion, Tricare Standard has been substituted for references to Tricare Standard and Extra in this list.
If you are currently enrolled in Tricare, you will not need to do anything in order to be enrolled in the new version (if it applies to you). This should happen automatically.
Another major change coming in 2018 will be greater access to military hospitals and clinics. You will also have improved access to urgent care services without a referral if you are already enrolled in Tricare and are not on active duty. Go to https://www.tricare.mil/About/Changes/General-TRICARE-Changes/Access for more information.
The types of services covered by Tricare will be expanded in 2018. Some of the new services which will be covered are:
- Coverage of medically necessary foods and vitamins
- Eligibility of Certain Enrollees for Participation in Federal Employees Dental and Vision Insurance Program (FEDVIP) beginning in 2019
- Extended coverage for certain members of the National Guard and Reserve dependents during certain disaster response duty
In 2019, members who are enrolled in Tricare Select will need to re-enroll and will likely have to pay an annual fee (possibly in addition to the monthly premiums). You don’t have to enroll for 2018, but don’t forget to do so toward the end of next year so you’ll be good to go for 2019.
Service members eligible for Tricare coverage will divided into two groups next year. If you or your sponsor’s initial enlistment or appointment occurred before January 1, 2018, you are in Group A. Other members will be in Group B. Monthly premiums and catastrophic caps (the maximum you will pay out-of-pocket) will be different for each group.
The last change I will cover is the ending of paper-based notifications of pre-authorizations and of benefits paid. These will now be available online. Don’t look for them in the mail anymore. They will only be available electronically.
Here are contact numbers for the new Tricare contractors.
- For enrollment questions or help only, call after November 21, 2017.
- For general information or help, call after January 1, 2018.
- East: 1-800-444-5445. Monday thru Friday, 8AM-6PM member time.
- West: 1-844-866-WEST (9378). Monday thru Friday, 5AM to 9PM Pacific time.
There is a great deal more information about next year’s Tricare changes. I have only hit some of the highlights. This is quite a bit to absorb already so I will call it quits for today.
Please contact me if you have specific questions about these revisions. The best places to do this are the comments section and by emailing me. I will dig up the information you need. If I cannot, I will let you know who can answer your questions.
As always, thanks for joining me today and being part of this audience. Lastly, but not the least, of course, thank you for your service. Have a great day.
New TRICARE Regions
Tricare Reserve Select Costs
Tricare Retired Reserve
Tricare Retired Reserve Costs
General Tricare Changes
Improving What’s Covered
Improving Access to Health Care
New Stateside Regions and Contractors
Facts and Figures
2018 Tricare East Network Provider Directory
2018 Tricare West Network Provider Directory
Frequently Asked Questions
Sample Tricare Dental Premiums for 2018
Tricare and the Affordable Care Act