DHA Announces TRICARE Open Season and Federal Benefits Open Season

The Defense Health Agency announced the two open seasons for military beneficiaries:  TRICARE Open Season and Federal Benefits Open Season.

TRICARE Open Season applies to anyone enrolled in or eligible for TRICARE Prime (including the US Family Health Plan) or TRICARE Select.  Federal Benefits Open Season is for enrollment in the Federal Employees Dental and Vision Insurance Program (FEDVIP).  Both the TRICARE and FEDVIP open seasons begin on Nov. 11 and end on Dec. 9. Enrollment choices made during this period will take effect on Jan. 1, 2020.

If you are now enrolled in US Family Health Plan, you will be automatically re-enrolled in the Plan for the coming year.  This means you don’t need to do anything during Open Season.  However, if you want to change your TRICARE coverage for 2020, you must make this change during Open Season.

To get ready for open season, you can use tools on the TRICARE website, like the TRICARE Plan Finder and TRICARE Compare Cost Tool.  These resources help you see which plans you’re eligible for and help you to compare plans and costs.  On the FEDVIP enrollment website, you can enroll in or make changes to your FEDVIP plan.  The website also provides tools to help you find the right dental and/or vision plans for you and your family.

If you’re eligible to participate in TRICARE Open Season, you have three choices for your 2020 health coverage:

  • Do nothing. If you want to stay in your current TRICARE health care plan, you don’t have to take any action. You’ll continue in your current health plan through 2020 or as long as you’re eligible.
  • Enroll in a plan. If you’re eligible for TRICARE Prime or TRICARE Select but not enrolled, you can enroll in a plan.
  • Change plans. If you’re already enrolled in a TRICARE Prime or TRICARE Select plan, you can switch plans and switch between individual and family enrollment.

TRICARE Open Season doesn’t apply to TRICARE For Life (TFL).  TFL coverage is automatic if you have Medicare Part A and Medicare Part B. Open season also doesn’t apply to premium-based plans:

As described in the TRICARE Plans Overview, you can purchase premium-based plans any time.

Outside of TRICARE Open Season, you can only enroll in or make changes to your TRICARE Prime or TRICARE Select plan following a Qualifying Life Event (QLE).  A QLE is a certain change in your life, such as marriage, birth of a child, change of address, or retirement from active duty.  Different TRICARE health plans may be available to you and your family members after a QLE.  For a current list of QLEs, go to www.tricare.mil/LifeEvents.

If you have US Family Health Plan and other health care coverage (for example, Medicare or insurance through your employer) it’s important to understand which insurance pays first.

  • If you have Medicare, only US Family Health Plan pays.  Members may not use their Medicare benefit for services covered by US Family Health Plan.  The only exception is for members who have End-Stage Renal Disease (ESRD).  Medicare is the primary payer for all ESRD-related services.
  • If you have other health coverage, US Family Health Plan pays last.  If you have any health coverage through an employer or a private insurance program, with a very few exceptions, US Family Health Plan pays after that insurance.  Your other health coverage processes your claim first.  Then you or your doctor file your claim with US Family Health Plan.
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