Tricare Extends Window for Choosing Coverage After Retirement

Tricare After Retirement

 

Retiring service members now have up to a year to decide whether to stay with Tricare Prime or choose Tricare Select for their family's health coverage after they leave military service.

Effective immediately, the health care selection period for retirement -- one of eight lifetime events considered by Tricare to be significant enough to warrant reconsideration of a beneficiary's health plan -- is now 365 days rather than the 90-day window for any other qualifying circumstance.

The change does not impact currently enrolled retirees, active-duty families, Tricare for Life users or other categories of beneficiaries.

The change was made, Defense Health Agency spokesman Kevin Dwyer explained, to ensure that a service member's retirement status has been recorded in the Defense Enrollment Eligibility Reporting System before they select their health coverage.

"We extended it to 365 days to account for the gap in time it sometimes takes for the services to update sponsors' statuses in DEERS," Dwyer said in an email to Military.com on Monday.

As retirement approaches, retirees can't enroll in a new health program until their actual retirement date, when their active-duty Tricare Prime coverage expires. After retirement, they can choose to remain in Tricare Prime or Tricare Select. Retirees and family members on Tricare Prime pay enrollment fees; most using Tricare Select do not.

Coverage is backdated to the retirement date, according to Tricare. They pay back their enrollment fees to the date of retirement.

While the new retiree or family member is deciding which program to choose, they are eligible to be seen at a military treatment facility. This eligibility lasts the full 365 days. After that, they will not be able to enroll in Tricare until a life qualifying event or open season.

"The Defense Health Agency recognizes that it sometimes takes time for the services to update sponsors' statuses from active duty to retired in DEERS," Dwyer said.

In addition to retirement, changes in family makeup, such as divorce, retirement, death or childbirth; a move; loss of eligibility or change in eligibility status; or a Defense Department-directed change or change in overseas command sponsorship are considered qualifying life events, or QLE. Pregnancy is not considered a QLE.

Tricare beneficiaries who want to change health programs outside a QLE must wait until open enrollment season, which will be Nov. 11 to Dec. 9 this year.

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