Tricare's rules around military families and retirees changing coverage moved to an open enrollment system in 2019, forever altering how and when those users move between coverage plans.
In the past, changing between Tricare Prime and Tricare Select, previously known as Tricare Standard, was easy and typically not time sensitive for active-duty families and retirees. If you wanted to change and your military status or location qualified you to do so, you could simply call your Tricare regional contract and ask to be swapped. Sometimes, there was a waiting period before you could switch from Tricare Select to Tricare Prime, but it was often waived.
Starting Jan. 1, 2019, however, the ability to switch back and forth went away.
So what do you need to know about Tricare's open enrollment program? Here's five thing:
1. To change plans, you must have a "qualifying life event." To change plans you need to experience a "qualifying life event" (QLE). What does that mean? Tricare officials created a list based off industry standards. It includes things like a move, job loss, having a forced reassignment to a new primary care provider and being recaptured from a civilian doctor into the Military Treatment Facility system. You can see a complete QLE list on Tricare's website.
2. Tricare's QLE list does not include pregnancy. While giving birth is a qualifying event that would let you switch between plans, pregnancy is not. That means military spouses who think they might get pregnant and who do not want to be seen for their pregnancy within the military treatment facility system should register for Tricare Select during the annual open enrollment period. You have 90 days to change plans after experiencing a QLE.
3. Open enrollment happens only one time each year. Once a year, all Tricare users will have the chance to switch plans without first having one of those QLEs. That window typically runs from mid-November to mid-December. If you miss the window and do not have a QLE, you are not able to change plans.
4. Other Tricare users can switch at any time. Tricare users on Tricare Reserve Select, Tricare Retired Reserve and Tricare Young Adult don't have to worry about QLEs. Instead, they can enroll or un-enroll at any time. That's because those programs, known as "purchased plans," are based on other eligibility factors such as age and Guard or Reserve status.
5. FEDVIP Dental plans for retirees and vision plans for active-duty families and retirees also have enrollment rules. Looking to take advantage of the vision plans available for military families and retirees or the dental plans available for retirees through the Federal Employees Dental and Vision Insurance Program (FEDVIP)? That program has its own open enrollment rules. You will also need to enroll or make changes to your coverage during the annual open enrollment or during a qualifying life event.
