Nearly 175,000 military retirees, family members may soon have no Tricare Select coverage
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 Dec. 31 by allotment, bank account or credit card.
About 20 percent of this population, or 174,754 out of 872,886 beneficiaries, haven’t taken action to set up their payments, or to actively opt out, according to data provided by the Defense Health Agency. Payments haven’t yet been set up for 278,497 beneficiaries; but of those, 103,743 have actively opted out of setting up payments, thus effectively discontinuing coverage. Those beneficiary numbers include the retiree sponsor as well the retiree’s eligible family members enrolled in Tricare Select.
Anyone who is dropped from Tricare Select will have access to direct medical care only at a military treatment facility, and only if space if available. Claims for medical treatment after Dec. 31 will be denied, but coverage can be reinstated within 180 days if back enrollment fees are paid.
At the end of January, regional Tricare contractors will start sending out letters to these beneficiaries notifying them about their disenrollment, according to DHA spokesman Peter Graves. He said health officials expect “some number of those eligible” to request reinstatement. Contractors have also started sending emails to those who haven’t yet paid, he said.
“Overall, the numbers are very concerning, but we’re really not surprised,” because of traditional difficulties in communicating with beneficiaries, said Karen Ruedisueli, director of health affairs for the Military Officers Association, .
She said she was concerned that too many beneficiaries won’t find out their coverage has been dropped until their medical provider tells them when they go to seek care.
The enrollment fees are:
*for individuals: $12.50 per month or $150 a year
*for families: $25 per month or $300 per year
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.
Overall, payments had been set up for 68 percent of affected beneficiaries by the end of December, according to information provided by the Defense Health Agency.
But that varies by region. The overseas region has the lowest percentage of those who have set up payments, at 45 percent. In the Tricare East region, payments have been set up for 72 percent of enrolled beneficiaries. In Tricare West, payments have been set up for 64 percent of beneficiaries.
In 2021, for the first time, retirees and family members enrolled in Tricare Select, must pay enrollment fees in order to continue their coverage. If you haven’t responded to the Defense Department’s clarion call to contact your Tricare regional contractor to set up a payment process, you lost coverage as of Jan. 1, and you’ll soon find your health care claims are denied.
https://www.militarytimes.com/pay-benefits/2021/01/08/nearly-175000-military-retirees-family-members-may-soon-find-their-tricare-select-coverage-has-been-dropped/