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FALLS CHURCH, Va. — Starting Jan. 1, 2018, cost changes for TRICARE benefits transition from a fiscal year period to a calendar year period. “Changing from a fiscal year (Oct. 1 – Sept. 30) to a calendar year (Jan. 1 – Dec. 31) makes the TRICARE benefit consistent with civilian health plans,” said Capt. Nicholas Edvarchuk, 86th Medical Group Tricare Operation and Patient Administration Flight Commander. The change will largely affect those plans which have an enrollment fee and are currently billed by the fiscal year. This includes retirees and their family members in TRICARE Prime, TRICARE Retired Reserve, TRICARE Reserve Select and those in TRICARE Young Adult plans. This change is one of several changes that TRICARE is adopting in 2018.
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:
- TRICARE Young Adult-Prime Option
- TRICARE Young Adult-Standard Option
- TRICARE Retired Reserve
- TRICARE Reserve Select
- Continued Health Care Benefit Program (this will continue to follow a fiscal year cycle)
- US Family Health Plan
If you’re in a plan now that requires enrollment fees, there will be a transition period from Oct. 1, 2017, to Dec. 31, 2017, so you won’t experience additional costs in 2017. During this time, you’ll 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’ll be billed for the fees to cover the three-month period and sent a billing notice for the annual fee for calendar year 2018.
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. Regional contactors have discovered some errors in processing claims and are working aggressively to fix them. If you think you were charged a deductible in error, call your contractor.
On Jan. 1, 2018, new rules for deductibles and catastrophic caps will apply to some costs.
If you pay your enrollment fees by allotment, you don’t 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.
Visit the TRICARE Changes page to learn more about the upcoming changes to your benefit. You can also sign up for our email updates.
