En español | Retired service members with Tricare Select health insurance who enlisted in the military before 2018, known as Group A retirees, must start paying an annual enrollment fee beginning next year to remain insured. Members must arrange their payment before Tricare's open enrollment period ends Dec. 14.
How much is the annual enrollment fee?
The annual fee is $150 for those on an individual plan and $300 for a family plan. To ease the financial strain, Tricare has broken the fee into monthly payments. This equates to $12.50 a month for individuals or $25 a month for a family plan.
The enrollment fee will apply toward the catastrophic cap, the most you will pay out of pocket annually, which will increase from $3,000 to $3,500 beginning Jan. 1.
Is anyone exempt from the new Tricare Select enrollment fee in 2021?
- Active duty family members
- Survivors of a service member who died on active duty
- A medically retired retiree or family member
How do I pay?
In order to maintain health coverage, affected retirees need to set up their monthly payment method during Tricare's open season (Nov. 9 to Dec. 14) with their regional contractor, such as Humana Military in the East, HealthNet Federal Services in the West, and International SOS Government Services overseas.
Members are encouraged to pay by allotment, in which a deduction is made from their retired pay account. If you do not receive retired pay though a military pay center, the fee can be paid by providing bank account, credit card or debit card information.
What happens if I don't do anything?
You will be disenrolled from Tricare Select on Jan. 1 due to nonpayment. However, you will have 180 days from your termination date to contact your regional contractor and request to be reinstated.
Otherwise, you will be able to receive health care from a military hospital or clinic only if space is available.
Why is this happening?
The new fees are being put in place as a result of the National Defense Authorization Act of 2017 (NDAA-17), which outlined the types of expenses military families and retirees would have, based on when the military member first enlisted. Those who enlisted after Jan. 1, 2018, are in Select Group B and already pay the fee.
Will Tricare contact me about this?
Tricare will send a letter to the approximately 650,000 retiree households affected, directing them to contact their regional contractor.
How does Tricare Select differ from Tricare Prime?
Tricare Select, a preferred provider option (PPO), offers more flexibility for family members. Beneficiaries can see any provider they choose, both for primary and for specialist care.
Tricare Prime is a managed care option, often referred to as a health maintenance organization (HMO), with a primary care manager responsible for an individual's medical care. Members of Prime can see any Tricare-authorized provider, who will charge a copayment depending on the service provided. The care manager will make referrals when necessary and help get the proper authorization.
Of those eligible to enroll, 58 percent of retirees chose Tricare Prime and 42 percent are enrolled in Tricare Select.