The Tricare Prime for retirees enrollment fee for 2021 is $606 per family, or $303 for an individual. Enrollment fees may be paid by military allotment, by electronic funds transfer, by credit or debit card. If you have Tricare Prime, you do not pay for your medical care at MTFs, but you will have co-pays when you use a civilian provider. . “Gray area” retirees using Tricare Retired Reserve will see enrollment fee increases by about $40 a month for individuals, to $484.83 a month; and by about $99 for families, to $1,165.01 a.
By now the cat is out of the bag and you’ve probably heard and maybe even read about all of the changes to Tricare coverage for active duty personnel starting in 2018.
But what about the changes to plans offered to military retirees?
Much like the changes for Tricare Prime and Tricare Select (formerly known as Tricare Standard and Tricare Extra), the changes depend on the plan you use.
Yes, there are changes and increases to fees, and yes, there are also some increases in coverage for certain types of care.
Retired Service Members may be eligible for both TRICARE and VA benefits. This means that health care may be covered by TRICARE and/or VA benefits. For most health care needs, TRICARE may be the main source of coverage. Most VA facilities are TRICARE network providers. Pay your enrollment premiums online. TRICARE Prime, TRICARE Select, TRICARE Reserve Select (TRS), TRICARE Retired Reserve (TRR), TRICARE Young Adult (TYA) beneficiaries living in the East Region and Continued Health Care Benefit Program (CHCBP) beneficiaries worldwide, may pay their enrollment premiums online by credit card.
The good news is that 2018 will be a transition year for the permanent changes and just as in years past, retirees will be able to switch plans as they wish. However, starting in 2018 for coverage beginning in 2019, Tricare for Retirees and Tricare for Life will see enrollment periods opening once per year and any changes to plan enrollment will need to take place during the open-enrollment period from the middle of November to the middle of December.
Will you be impacted by Tricare changes this year? What’s changing for your health insurance plan?
Changes in Prescription Fees
All beneficiaries will see a change in prescription fees starting in February 2018. A 30-day supply of name brand drugs will run retirees $28, while generics will cost $11. Ninety-day supplies via home delivery will be $24 for name brand and $7 for generics. There will continue to be no co-pay for prescriptions filled at military treatment facilities for eligible plans. Non-formulary co-pays will be $53 for both 30-day retail in-network filled and home delivery.
Changes to the Retiree Dental Plan
The current Retiree Dental Plan will be retired in December 2018. The plan will be replaced with the same plan currently offered to federal employees and more information about the plan and any additional changes will be put out later this year.
Changes to Tricare Retirees – Select
All retirees using Tricare were notified late last year about the enrollment requirement. Enrollment is required in order to continue care. Current Tricare Retirees-Standard (now called Select) will see out-of-network fees charged for any care received without enrollment, so if you use this plan and haven’t already enrolled, take the time to do so. It will save you money if you end up needing care this year.
In addition, Tricare Retirees-Select will continue to see no enrollment fees until 2021. After that an annual enrollment fee will be charged, similar to the Tricare Retirees-Prime fees already in place. These annual enrollment fees will be due in January 2021.
Medical retirees and survivors of service members killed in action using Tricare Retirees-Select however, will be exempt from the fee.
Other changes include upping the the catastrophic cap for retirees using the Standard plan staring in 2021 from the current $3,000 to $3,500.
For Select users starting in January 2018, in-network primary care visits will cost $35 and in-network specialty care will cost $45 per visit. In-network emergency room visits will run $116 per visit and urgent care $35 per visit.
Changes to Tricare Retirees – Prime
Tricare Retirees-Prime will continue to see much of the same coverage currently offered. Annual enrollment rates will see annual increases equal to COLA rates. Enrollment dates and fees will move from October to January starting in 2018.
For any point-of-service visits outside of a military treatment facility, retirees using Prime will pay $20 for in-network primary care and $30 for in-network specialty care. In-network emergency room visits will cost $60 and urgent care, $30.
Changes to Tricare for Life
Retirees using Tricare for Life will see almost no changes to their current coverage. The current $150 (single rate) and $300 (family rate) will remain the same for costs not picked up by Medicare.
Tricare Prime Retired Copay 2020
Additionally, the catastrophic cap will remain the same. The only change Tricare for Life users will see is a change in the reset date for deductibles and cap. Instead of October, the plan will reset in January just like all of the other Tricare plans starting in 2018.
Tricare has done a pretty decent job of notifying its beneficiaries of the changes and more information about changes to specific plans can be found on their website.
Now that you know how military retirees will be impacted by major changes from Tricare, what other questions do you have?
Voluntary disenrollment: You may voluntarily disenroll from TRICARE Prime. However, eligible beneficiaries not enrolled in a TRICARE plan are only covered for care at the military hospital or clinic under direct care if space is available. Beneficiaries can only re-enroll during the open enrollment season and/or in the event of a QLE.
You may disenroll by:
- Beneficiary Web Enrollment (BWE)
- Mailing or faxing a TRICARE Prime Enrollment, Disenrollment and PCM Change Form.
- Telephone at 1-844-866-WEST (9378), Monday through Friday, 5:00 a.m.–9:00 p.m. (PT).
Tricare Prime Retired Copay 2020
If voluntarily disenrolling, you can request a specific disenrollment date. Otherwise, the disenrollment will be effective the day after your paid-through date.
Non-payment: If HNFS does not receive your premium payment within 30 days from the due date, you will be disenrolled for failure to pay. Your disenrollment will be effective the day following your policy paid-through date. Once disenrolled from TRICARE Prime, you will be only eligible for coverage at the military hospital/clinic under direct care if space is available. Claims for services after your disenrollment date will not be paid under your TRICARE Prime coverage.
Reinstatement
If you are disenrolled from TRICARE Prime for failure to pay, you have 90 days from your disenrollment date to be reinstated. A full payment is required to bring the policy current.
Tricare Prime Retiree Prescription Copay
- Visit our Make a Payment tool to determine your payment amount, bring your policy current and set up future automatic payments.
- After 90 days, you must wait until the next TRICARE Open Season or for a qualifying life event to occur to re-enroll.
Comments are closed.