Are you enrolled in or eligible for a TRICARE Prime option or TRICARE Select? If yes, open season applies to you. However, it doesn’t apply to active-duty service members, or ADSMs. To learn more and to help prepare you for open season, follow this five-step checklist.
Know the dates and your choices
Open season starts Nov. 14 and ends Dec. 13, 2022. When considering your options you have these three choices:
· Stay in your plan.
· Enroll in a health plan.
· Change health plans or switch between individual and family enrollment.
Review coverage details
Being familiar with the plan types can help you pick one to fit your budget and your health care needs. TRICARE Prime is your managed care option. It offers the most affordable coverage. With TRICARE Prime, you have a primary care manager (PCM) to manage your routine care and refer you to specialists for specialty care.
TRICARE Select is a self-managed care option. It offers the most freedom of choice. You aren’t required to have a PCM. You can choose your own TRICARE-authorized provider and manage your own health care. You’ll have lower out-of-pocket costs if you use a network provider. Compare TRICARE plans to learn more about each health plan.
Consider all cost factors The amount you pay for coverage depends on your health plan and who you are. For example, costs vary if you or your sponsor is an ADSM, a National Guard or Reserve member, or a retiree. To find your health plan costs and to compare costs, use the Compare Costs tool.
Consider your needs for next year Do you expect any big life changes in the upcoming year? The open season may not be the only time you can update your coverage. As outlined in the TRICARE Qualifying Life Events Fact Sheet, certain life events may change your health plan options. Moving, marriage, birth of a child, or retirement from active duty are all Qualifying Life Events (QLEs). A QLE opens a 90-day period for you to make eligible enrollment changes. If you take no action during open season, you’ll have to wait until you or a family member experiences a QLE to make changes to your TRICARE Prime or TRICARE Select plan.
Update your information in DEERS Being able to use TRICARE depends on you keeping your information current in the Defense Enrollment Eligibility Reporting System (DEERS). If you don’t show as eligible for TRICARE in DEERS or your information is incorrect, it could prevent you from using your TRICARE benefit. You may also miss important information and enrollment deadlines.
Remember, you don’t have to wait until open season to think about your options. Start planning now. Find more info and resources on the TRICARE website.
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