About 124,000 working age retirees and their family members are finding their Tricare Select coverage has been dropped, because they haven’t set up a payment plan for new fees that went into effect Jan. 1.
But beneficiaries in this group have been getting the message. More than 54,000 beneficiaries took the action to restore their Tricare Select coverage in January. Defense Health Agency officials have given beneficiaries until the end of June to reinstate coverage.
As of Jan. 27, about three out of four beneficiaries, or 648,952 of the 876,531 working age retirees and their family members who were covered under Tricare Select in 2020, have set up payments for new fees in order to continue their coverage. That’s 74 percent who have taken the action, up from the 68 percent at the end of December, according to information provided by the Defense Health Agency. But about 14 percent, or 124,000 beneficiaries, haven’t set up payments.
The remaining 12 percent, about 104,000, had actively opted out of setting up payments as of Jan. 7 — thus opting out of the Tricare Select coverage. Information was not available on how many additional beneficiaries have actively opted out of the payments since Jan. 7.
By law, in order to continue coverage under Tricare Select, retiree sponsors were required to start paying new monthly enrollment fees as of Jan. 1, and they were required to set up a payment plan by the end of 2020 by allotment, bank account or credit card. Retiree sponsors can contact their Tricare contractor to reinstate the coverage.
Payments are $12.50 per month for individuals; or $25 per month for families. If they didn’t set up their payment, their coverage ended Dec. 31.
Anyone who is dropped from Tricare Select will have access to direct medical care only at a military treatment facility, and only if space is available. Claims for medical treatment after Dec. 31 will be denied. The good news is that coverage can be reinstated within 180 days (end of June) if back enrollment fees are paid, and claims will be paid retroactively to Jan. 1. Defense officials extended the reinstatement period from 90 days to 180 days; advocates want that extended to a year and senators have introduced legislation to that effect.
Tricare contractors have been contacting these beneficiaries about their lapsed coverage and newly required payment. Defense Health Agency officials are asking beneficiaries to let their Tricare contractor know if they have chosen not to continue their Tricare Select coverage, and are purposefully declining coverage.
These are so-called “Group A” retirees and their dependents — working-age retirees under age 65 who entered the military before Jan. 1, 2018, their family members and survivors. Previously, these beneficiaries didn’t have to pay enrollment fees for Tricare Select, but a 2017 law required the Defense Department to start charging the fees by Jan. 1, 2021.
Here are the numbers, as of Jan. 27:
• Humana Military (Tricare East): 77 percent of the 594,201 beneficiaries enrolled in 2020 have set up payment arrangements, up from 72 percent as of Jan. 7.
• Health Net Federal Services (Tricare West): 72 percent of the 225,777 enrolled beneficiaries have set up payment arrangements, up from 64 percent as of Jan.7.
• International SOS (Overseas): 54 percent of enrolled beneficiaries had set up payment arrangements, up from 45 percent as of Jan. 7.
This doesn’t affect retirees who are in Tricare for Life, Tricare Prime, or those using a premium-based plan. Nor does it affect active duty families on Tricare Select, survivors of deceased active duty members, or medical retired retirees and family members.
Karen has covered military families, quality of life and consumer issues for Military Times for more than 30 years, and is co-author of a chapter on media coverage of military families in the book "A Battle Plan for Supporting Military Families." She previously worked for newspapers in Guam, Norfolk, Jacksonville, Fla., and Athens, Ga.