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How to Make Enrollment Changes Outside of TRICARE Open Season

If you missed it, the annual TRICARE Open enrollment 2020 and the Federal Benefits Open Season ended on Dec. 9. The next open season will occur in the fall of 2020. If you did not enroll or make a change to your TRICARE health plan during open season, you must wait until the next open season lest you have a TRICARE Qualifying Life Event (QLE).

“If you or a family member experiences a life event that TRICARE deems a QLE, you may be able to change your current coverage without waiting until the next open season,” said Mark Ellis, chief of the Policy and Programs Section of the TRICARE Health Plan at the Defense Health Agency. “If you don’t have a QLE, you’re obligated to maintain your TRICARE Prime or TRICARE Select coverage until the following open enrollment period.”

Enrollment Options Outside of TRICARE Open Season

Outside of TRICARE Open enrollment dates, you can only enroll in or make changes to your TRICARE Prime (as well as US Family Health Plan) or TRICARE Select plan if you experience a TRICARE QLE. If you opt to make a change to your enrollment, you must make the change within 90 days of the QLE.

TRICARE Open enrollment period does not apply to TRICARE for Life (TFL). TFL plan is automatic if you have Medicare Part A and Medicare Part B. With the premium-based health insurance programs, you can enroll anytime throughout the year. These plans comprise TRICARE Retired Reserve, TRICARE Young Adult, TRICARE Reserve Select, and Continued Health Care Benefit Program.

TRICARE QLEs

What is a QLE? A QLE is a particular change in your life, like a move, marriage, birth of a child, or retirement from active duty. This means TRICARE health plan choices for you and your family may change. A QLE for one family member creates a chance for all qualified family members to change their TRICARE health plan. If you need to enroll in or change your plan, you must do so within 90 calendar days of the date of the QLE. Your coverage begins the period of the QLE and continues until you lose qualification or disenroll.

Making Enrollment Changes Due to a QLE

If you require enrolling in or changing your health plan after a QLE, you must:

• Update your and your household member’s information in the Defense Enrollment Eligibility Reporting System (DEERS). After your change shows in DEERS, you may make any eligible changes to your TRICARE enrollment.
• Make the enrollment changes in 90 days of the QLE.
• Pay any enrollment dues or premiums due during that period.

“Simply updating DEERS isn’t similar to enrolling in a TRICARE health plan,” said Ellis. “You must then make any enrollment action online through milConnect or by contacting your regional contractor by phone, mail, or fax to enroll in a TRICARE health plan.”

Check out Enroll or Purchase a Plan for information on enrolling in a TRICARE health plan or changing your enrollment. If you are qualified to enroll in a dental or vision plan through the Federal Employees Dental and Vision Insurance Program (FEDVIP), remember that FEDVIP QLEs may differ from TRICARE QLEs. Also, they follow different timelines for enrollment.

Now that open season is over; you may still have choices to enroll or change your TRICARE enrollment.

Resources and References:

• Continued Health Care Benefit Program
• Federal Employees Dental and Vision Insurance Program