Tricare beneficiaries need to be aware of changes taking place in both the East and West regions that could, at worst, get many users inadvertently kicked off their health care plans come next year if they don’t take certain steps.
The insurance program available to active-duty military, reservist and retiree households is transitioning to a new set of so-called “T-5” contracts for the management of its two regions starting Jan. 1, 2025. The West Region is getting a new contractor and a new network of health care providers, while six states are moving from the East Region to the West.
The open enrollment season for Tricare Prime and Tricare Select users is currently underway for 2025 coverage. Neither the contract changes nor open enrollment apply to the Tricare for Life automatic wraparound coverage for Medicare Part A and Part B users.
Tricare says the new contracts “will improve the delivery, quality, and cost” of its services for beneficiaries who live in the U.S. by providing better “network flexibility,” “beneficiary choice” and telehealth appointments. Meanwhile, future congressional oversight included in both House and Senate committee reports, made during the drafting of the 2025 National Defense Authorization Act, will purportedly address the ability of Tricare’s provider networks to entirely meet beneficiaries’ needs.
Karen Ruedisueli, director of government relations for health affairs for the Military Officers Association of America (MOAA), shared some of the following advice for navigating 2025’s Tricare changes, including the possibility of “a large number of people being disenrolled as of Jan. 1” if they don’t provide their payment information to a new contractor.
Here’s what you need to know:
Six States Are Switching Tricare Regions
The U.S. government’s goal in moving six states from the East Region to the West was to better balance Tricare’s beneficiaries between the two regions, Ruedisueli said. The six states where 1.1 million eligible beneficiaries will move from the East Region to the West are Arkansas, Illinois, Louisiana, Oklahoma, Texas and Wisconsin.
New Tricare West Region Contractor Brings New Provider Network
While Humana Military Health will continue to manage the Tricare East Region under Humana’s new T-5 contract, the West Region will transition from Health Net Federal Services to TriWest Healthcare Alliance.
Now that Tricare open enrollment has begun, West Region beneficiaries can find out whether their doctors are still in the network by signing in with their plan information to the 2025 West Region provider directory.
Tricare Open Enrollment is Underway
Now through Dec. 10, Tricare Prime and Select members can change their coverage for 2025. Outside annual open enrollment, these beneficiaries can change coverage only when they experience a qualifying life event such as a move or the birth of a child.
See Also: Tricare Costs Are Going Up Again in 2025
Coverage Changes Can’t Be Made in milConnect
The Defense Department’s milConnect system won’t be available for beneficiaries to enter their enrollment changes to their medical plans during the transition. To change plans, users need to contact their regional contractor by phone, mail or fax. For the West Region, including those newly in the West, users should direct their open enrollment plan changes to the new contractor, TriWest.
Tricare West Region Users Need to Update Their Payment Information -- or Regret It
Ruedisueli at MOAA said the organization is most concerned that Tricare users in the West Region who pay a premium or enrollment fee for their coverage will get kicked off their health plans Jan. 1 if they don’t realize they need to provide their payment information to the new contractor TriWest before that date.
“It’s the contractors who handle the payment information, and right now in the West region, Health Net has that payment information, and they can’t just send it to TriWest,” Ruedisueli explained. “Beneficiaries who are paying by credit card or electronic funds transfer -- and I think it’s not an insignificant number; I think it’s in the hundreds of thousands -- are going to have to provide that payment information to TriWest.”
Users will need their primary email address on file with the Defense Enrollment Eligibility Reporting System (DEERS) to log in to TriWest and set up automatic payments. Members paying by paycheck allotment don’t need to do anything.
Everyone Should Update Their Contact Info in DEERS
Not all beneficiaries will need to take action during the contract transition, but Tricare advises that everyone should check to make sure their contact information is correct in DEERS. Confirming that your contact info is up to date will “help make sure you don’t miss important communications” during the transition.
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