June 14, 2017
NCCOC 2nd VP Harley Ellinger posted:
- "As we become ready for our August Recess Legislative Visits in North Carolina, I would like you to review the latest version of TRICARE (not TRICARE FOR LIFE – over age 65). I am sure this will be a topic of the NATIONAL MOAA POINT PAPERS. Rest assured the other topics: commissary, housing, Widow’s Tax, sequestration, COLA, and overall compensation or military pay. It is now time to become informed on these subjects."
- "I will continue to pass on information, and of course the POINT PAPERS OF NATIONAL MOAA when they arrive."
TRICARE Changes Coming Soon...from a June 9, 2017 message from David B. Lobb, COL US Army (Ret.)SC MOAA Council President
- The 2017 National Defense Authorization Act (NDAA) brought sweeping health care reforms, many of which will take effect in just a few months. MOAA is working closely with TRICARE program officials to learn what new processes and responsibilities these changes will bring for TRICARE beneficiaries and when they will occur.
- The new TRICARE Select option, which replaces TRICARE Standard and Extra, begins Jan. 1, 2018 - just 6 short months from now. TRICARE Select is the self-managed preferred provider organization (PPO) option. It provides freedom of choice of providers, with reduced/fixed fee beneficiary out-of-pocket costs for care in the network. TRICARE Prime, TRICARE Reserve Select, TRICARE Retired Reserve, and TRICARE Young Adult and TRICARE for Life will remain as is.
- Under the new model, beneficiaries must make an active, annual choice of health plan for themselves and/or their family. Because 2018 is the first year of the plan, there will be a grace period, and beneficiaries will be automatically renewed in their existing TRICARE option as of Dec. 31, 2017. This means beneficiaries currently in TRICARE Standard or Extra will be converted automatically into TRICARE Select.
- Active duty family members newly entitled to TRICARE will be automatically enrolled in TRICARE Prime if they live in a Prime Service Area (generally around a military treatment facility). If not, they will be enrolled in TRICARE Select.
- Two populations may be at risk of losing coverage:
* Active duty members who retire and do not elect to enroll in an option. MOAA is advocating for a seamless enrollment default option for this population, as well as increased transition education services.
* Retiree beneficiaries who fail to pay their enrollment fees. Officials have stated that eligible beneficiaries will never lose their benefit, as they will always be eligible for care at military hospitals. However, this would most likely be on a space-available basis.
- Enrollment Details
* Year 1 (2018): Auto renewal (Jan. 1, 2018) and grace period: Can change TRICARE Prime or Select at any time in 2018
* Year 2 (2019) and beyond: Can elect TRICARE Prime or TRICARE Select coverage (enroll, dis-enroll, or change) only during annual open season (1 Nov - 20 Dec) or if the beneficiary has a qualifying life event:
- Marriage, divorce, or annulment
- Birth or adoption of a child
- Placement of a child by a court in a member's home
- Change in sponsor status
- Loss of eligibility (due to age, Medicare, etc.)
- Move to a new ZIP code
- Loss/gain of other health insurance
- Death of a sponsor, spouse, or child
- Change in eligibility status of any single family member in another family ( e.g. joint service member)
- All qualifying life events require a Defense Enrollment Eligibility Reporting System (DEERS) update. If beneficiaries request a change in coverage, it must occur within 90 days of the life event.
- Beneficiary cost shares will be based on the sponsor's “date initially entered into service” (DIEMS). Per the 2017 NDAA, those who have entered into service prior to Jan. 1, 2018, are grandfathered into existing cost shares - unless the 2018 NDAA incorporates provisions from the administration's budget proposal to repeal grandfathering (see “ TRICARE Fees to Get a Big Raise”).
- As many of these changes show, beneficiaries will be expected to take more responsibility for their health care. MOAA will continue to work closely with DoD to ensure program changes will be beneficiary-centered and clearly communicated to all stakeholders.
What is the most important thing you can do right now? Make sure your DEERS information is updated for both you and your family. Here's how to update DEERS.