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/ Published October 12, 2017
Starting Jan. 1, 2018, cost changes for TRICARE benefits transition from a fiscal year period to a calendar year period. Changing from fiscal year (Oct. 1 – Sept. 30) to calendar year (Jan. 1 – Dec. 31) makes the TRICARE benefit consistent with civilian health plans. The change will largely affect those plans which have an enrollment fee and are currently billed by the fiscal year.
TRICARE is changing. Here is what you need to know:
Enrollment fees apply to retirees and their family members enrolled in TRICARE Prime, those enrolled in the premium-based plans, and several others to include:
If you are in a plan now that requires enrollment fees, there will be a transition period, from Oct. 1, 2017 to Dec. 31, 2017, so you will not experience additional costs in 2017. During this time, you will continue to pay your enrollment fees. However, enrollment fees will be prorated for the three-month period and billed accordingly for enrollees who pay on a monthly or quarterly basis. If you pay enrollment fees on an annual basis, you will be billed for the fees to cover the three-month period and sent a billing notice for the annual fee for calendar year 2018.
Catastrophic Caps and Deductibles
TRICARE will extend payments (for example, catastrophic caps and deductibles) that usually reset on Oct. 1 through the end of the calendar year. Any enrollment fees you pay during the transition period will continue to count against the catastrophic cap until it resets on Jan. 1, 2018. This means that if you reach your fiscal year 2017 catastrophic cap, you will not have additional out-of-pocket costs for authorized TRICARE-covered services for the last three months of the year. On Jan. 1, 2018, new rules for deductibles and catastrophic caps will apply to some costs.
This is your benefit. Here is what you need to do:
If you pay your enrollment fees by allotment, you do not need to do anything. You will continue to pay your enrollment fees automatically. Unless you cancel your allotment, TRICARE will continue to deduct enrollment fees starting Jan. 1, 2018. If you pay enrollment fees by electronic funds transfer (for example, debit card, credit card and electronic check) and are in an area where a new regional contractor will be delivering services, you will need to update your payment method with your new regional contractor in December.
Are you ready?
Visit the TRICARE Changes page to learn more about the upcoming changes to your benefit. You can also stay in the know by signing up for our email updates. Take command of your health care by staying informed!