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Retirees: Some Start Paying for Tricare Select Now or Lose Coverage in January


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Salty Dog
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Retirees: Start Paying for Tricare Select Now or Lose Coverage in January

19 Oct 2020 Military.com | By Jim Absher

Most retirees enrolled in Tricare Select will soon be required to pay a new monthly premium or lose their health insurance coverage.

A little noticed provision in the 2017 National Defense Authorization Act is going into effect next year. It authorized the new fees, which will impact only retirees, their family members and survivors on Tricare Select.

You are not affected if you use other Tricare programs such as Tricare For Life, Tricare Prime, Tricare Reserve Select, Tricare Retired Reserve or Tricare Young Adult.

And there is no enrollment fee for active-duty members and their family members.

Beginning Jan. 1, 2021, anyone who is enrolled in the Tricare Select program and is a recipient of retired pay must pay a monthly enrollment fee or their health insurance will be canceled. 

Tricare requires most retirees to pay the enrollment fee via allotment. Surviving spouses and recipients of Survivor Benefit Plan payments will have to pay the fee via recurring payments from their debit or credit cards or Electronic Funds Transfer from their bank. 

The last day retirees can start an allotment to ensure the payment is made on time is Nov. 20. If you don't start an allotment by that date, you will have to make special arrangements with Tricare for payment of the fees.   

If you don't pay the fees before Jan. 1, 2021, your coverage will end and you will have 180 days from your last paid-through date to request reinstatement of coverage.

If you don't start the allotment on time, you may also have to pay for one or more months coverage upfront while waiting for the allotment to process. 

Depending on your Tricare contractor, you can set up your monthly payment by online self-service, phone or mail.

These fees are new to retirees who are considered "Group A" beneficiaries by Tricare.

Tricare Groups

Two years ago, Tricare instituted two different groups of beneficiaries, Group A and Group B

Group A includes those who entered the service before Jan. 1, 2018; Group B is for those who entered after that date.

Previously, only Group B members had to pay an enrollment fee for Tricare Select.  

How Much Is The Tricare Select Enrollment Fee?

For Group A, the new enrollment fee is $150 annually for an individual and $300 for a family. This equals $12.50 monthly for individual coverage and $25 monthly for family coverage. 

For family members of veterans/retirees in Group B, there is a $471 individual or $942 family enrollment fee each year.

Contact your Tricare Regional Contractor to set up an allotment or to get more details.

https://www.military.com/daily-news/2020/10/19/retirees-start-paying-tricare-select-now-or-lose-coverage-january.html

 

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Salty Dog

Just because you are using TRICARE for Life, your wife and dependents aren't. Make sure you check these new requirements out. If you aren't currently enrolled in TRICARE Prime, than you're probably using TRICARE Select. TRICARE Select is the normal TRICARE where you didn't pay an annual fee and had to pay an annual deductible and a percentage of allowable fees.

Those living in the Philippines might fall under some other TRICARE program. I would certainly make sure if this new change applies to your dependents. 

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Chris24

Thanks Salty.  I've been paying more attention to Tricare options and specifics over the past year-plus as the date approaches where I'll be enrolling my family and I.  Thus far I'm truly grateful for this often-underestimated benefit that you, I and many others earned through our service. 

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Headshot
19 hours ago, Salty Dog said:

Just because you are using TRICARE for Life, your wife and dependents aren't. Make sure you check these new requirements out. If you aren't currently enrolled in TRICARE Prime, than you're probably using TRICARE Select. TRICARE Select is the normal TRICARE where you didn't pay an annual fee and had to pay an annual deductible and a percentage of allowable fees.

Those living in the Philippines might fall under some other TRICARE program. I would certainly make sure if this new change applies to your dependents. 

So, you are saying that even if you are on TFL (which I am), your wife and children are not? Where did you get that bit of information?

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Salty Dog
30 minutes ago, Headshot said:

So, you are saying that even if you are on TFL (which I am), your wife and children are not? Where did you get that bit of information?

I've been on TFL for several years and my wife is TRICARE Prime because she isn't 65 and on Medicare. She could have used TRICARE Select, but I like Prime better because it pays more for hospitalization.

Only TRICARE-eligible beneficiaries who have both Medicare Part A and B can use TRICARE For Life. https://tricare.mil/Plans/HealthPlans/TFL

When retired service members and their families become eligible for TRICARE For Life, typically at 65, they are no longer able to enroll in TRICARE Prime. https://tricare.mil/Plans/HealthPlans/TFL

Your wife and daughter are probably covered by TRICARE Select Overseas that currently doesn't have an annual fee.

However Beginning Jan. 1, 2021, Group A retirees will have to pay enrollment fees. https://tricare.mil/Plans/HealthPlans/TSO

Don't take my word for it though. Call TRICARE and ask them...

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Chris24
4 hours ago, Salty Dog said:

TRICARE Select Overseas /////// currently doesn't have an annual fee.

However Beginning Jan. 1, 2021, Group A retirees will have to pay enrollment fees. https://tricare.mil/Plans/HealthPlans/TSO

 

For an individual plan, you’ll pay $12.50 per month or $150 annually.

For a family plan, you’ll pay $25.00 per month or $300 annually.

(and it says that if you are on Tricare For Life and have only one family member on Tricare Select / Tricare Select Overseas, they just pay for just the individual plan not the family plan.

TRICARE For Life, TRICARE Prime, TRICARE Reserve Select, TRICARE Retired Reserve, or TRICARE Young Adult are unaffected.

============

This is a change but not too bad.   But if it can go from zero to $300, then of course more changes are possible in the future and they likely won't be downward.    I also see that the annual max out of pocket changes from $3,000 to $3,500.

As our Marine brothers and sisters would say, Semper Gumby.

 

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Headshot
On 10/21/2020 at 5:03 PM, Salty Dog said:

I've been on TFL for several years and my wife is TRICARE Prime because she isn't 65 and on Medicare. She could have used TRICARE Select, but I like Prime better because it pays more for hospitalization.

Only TRICARE-eligible beneficiaries who have both Medicare Part A and B can use TRICARE For Life. https://tricare.mil/Plans/HealthPlans/TFL

When retired service members and their families become eligible for TRICARE For Life, typically at 65, they are no longer able to enroll in TRICARE Prime. https://tricare.mil/Plans/HealthPlans/TFL

Your wife and daughter are probably covered by TRICARE Select Overseas that currently doesn't have an annual fee.

However Beginning Jan. 1, 2021, Group A retirees will have to pay enrollment fees. https://tricare.mil/Plans/HealthPlans/TSO

Don't take my word for it though. Call TRICARE and ask them...

No, I believe you. Tricare treats expats like orphan step-children anyway. When I am in the Philippines, Medicare doesn't pay anything, so it is as if I am on TRICARE Select as well as my wife and daughter. If I am in the US, then I am on TFL. I haven't ever checked to see how they classified my wife and daughter when in the US, though. I guess I will enroll between November 9 and December 14 for my wife and daughter. It is great that they are sucking $25 out of our monthly retirement checks for TRICARE now. So much for promises.

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Chris24
On 10/22/2020 at 5:59 AM, Headshot said:

 so it is as if I am on TRICARE Select as well as my wife and daughter. If I am in the US, then I am on TFL..

I'm curious how that works, do you have to notify Tricare or proactively change between plans, or do they take care of it automatically based on where the claim is made?  Also, have you found a healthcare provider in Cebu that submits claims directly or is it always out of your pocket and you submit the receipts yourself for reimbursement?  (just trying to understand generally how it works).  I've also read that we have to enroll in Medicare Part A and B and pay the $144.60/month fee for Part B, despite not being able to use Medicare outside of the U.S. 

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Salty Dog
1 hour ago, Chris24 said:

I've also read that we have to enroll in Medicare Part A and B and pay the $144.60/month fee for Part B, despite not being able to use Medicare outside of the U.S. 

That's why many retired military expats don't have TFL. They don't want to pay that monthly fee, usually deducted from their Social Security.

Even in the USA, there are many Vets who don't have Medicare Part B because they depend entirely on the VA for their medical and don't want to pay the monthly fee. Of course they still have free Medicare Part A for hospitalization.

I have TFL and in the past 3 years the Medicare fees have added up each year to more than I paid when I was just on Tricare Prime. Of course if I were going to the doctor more often, things might have been different. As it is, I only go to my doctor 3 or 4 times a year. Under Tricare Prime there was a fixed copay at the time of around $15 per visit. Add that to the yearly fee of only a few hundred dollars and I was sending about $300 a year. Now even if I don't go to a doctor, I still pay Medicare around $1,600 a year. My neighbor who has a good high paying pension pays around $450 a month for his Medicare which is around $4,500 a year. So your Medicare payment can vary greatly depending on the size of your pension.

I have a friend who isn't old only enough for Medicare and isn't a Vet. He pays around $1,000 a month for health insurance and it has outrageous deductibles (in the thousands) on top of that. Those of us with Tricare should feel lucky.

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Soupeod
17 hours ago, Chris24 said:

I'm curious how that works, do you have to notify Tricare or proactively change between plans, or do they take care of it automatically based on where the claim is made?  Also, have you found a healthcare provider in Cebu that submits claims directly or is it always out of your pocket and you submit the receipts yourself for reimbursement?  (just trying to understand generally how it works).  I've also read that we have to enroll in Medicare Part A and B and pay the $144.60/month fee for Part B, despite not being able to use Medicare outside of the U.S. 

Tricare canceled my Tricare Prime when mypay address changed to RAO Cebu and without my permission.

Now I have no tricare.

I need to call tricare overseas to get reenrolled. 
Tried to enroll online and it didnt work.

Tricare - :angry:

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Headshot
On 10/24/2020 at 1:48 AM, Chris24 said:

I'm curious how that works, do you have to notify Tricare or proactively change between plans, or do they take care of it automatically based on where the claim is made?  Also, have you found a healthcare provider in Cebu that submits claims directly or is it always out of your pocket and you submit the receipts yourself for reimbursement?  (just trying to understand generally how it works).  I've also read that we have to enroll in Medicare Part A and B and pay the $144.60/month fee for Part B, despite not being able to use Medicare outside of the U.S. 

I'm still on TFL, but because Medicare won't pay anything when I am out of the US, Tricare becomes the primary insurance. In that way, it is just like Tricare Select. If I am in the US, Medicare pays what they will, and TFL takes care of the balance.

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Headshot

There is no healthcare provider that I know of that submits claims to Tricare. If you want any reimbursement, you have to submit the receipts with details to Tricare yourself. Personally, I haven't had much luck with that. Tricare uses a subcontractor in Singapore that believes that all charges coming out of the Philippines are fraudulent.

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Chris24

Thanks Headshot, on your first post today that's how I had understood the reimbursement was supposed to work, but have had no direct experience.  Was also not sure whether we have to switch back and forth between T-Select (under 65) / TFL (over 65) and Tricare Select Overseas if accessing healthcare outside of the U.S.

Soupeod, your post makes me think that maybe we do have to switch, especially if "traveling" turns into "relocating". 

Headshot on your second post, yikes, I hope that reimbursements eventually come through.  I wonder if paying with a US credit card and being able to show dual receipts (hospital receipt and credit card receipt) would make any difference.   Additional hassle of course. 

It's interesting when planning that things seem so orderly, but then when you talk to people that have actually tried to make it work, the reality is far from orderly.  I imagine some of the worst cases where a person with serious health issues has to take on the added frustration of becoming their own claims manager, or even worse, discovering that their insurance doesn't really pay for much. 

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Salty Dog

I don't think Soupeod is old enough for TFL and Medicare. You can't be on Tricare Prime when overseas. Tricare should have sent him a letter that it was being canceled and why. At least in the US you didn't use to have to signup for basic Tricare (now Tricare Select) as long as DEERS was up to date. When my Prime was canceled they sent me a letter. I'll see if I can find it and post it. Now that Select has a fee, you might have to sign up for it now. I'm not familiar with it's current rules. It looks like you will still be on it, but it will be canceled if the new fee isn't paid. 

When in the Philippines if you're on TFL, you don't have to actually switch to TSO. It's much like using a procedure and service in the US that isn't covered by Medicare, but is covered by Tricare. You have to pay a deductable and a percentage of allowable charges. Usually 15%-20%. It just happens to be managed by TCO. They have different rules for the Philippines. As pointed out by Headshot, they are more restrictive. 

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Soupeod
10 hours ago, Headshot said:

There is no healthcare provider that I know of that submits claims to Tricare. If you want any reimbursement, you have to submit the receipts with details to Tricare yourself. Personally, I haven't had much luck with that. Tricare uses a subcontractor in Singapore that believes that all charges coming out of the Philippines are fraudulent.

I was told last year by two retired military guys, that Medical City accepts tricare and will bill tricare directly.  I personally have not done this because of Covid; I had planned to fly to Clark and get my knee fixed.

1 hour ago, Chris24 said:

Thanks Headshot, on your first post today that's how I had understood the reimbursement was supposed to work, but have had no direct experience.  Was also not sure whether we have to switch back and forth between T-Select (under 65) / TFL (over 65) and Tricare Select Overseas if accessing healthcare outside of the U.S.

Soupeod, your post makes me think that maybe we do have to switch, especially if "traveling" turns into "relocating". 

Headshot on your second post, yikes, I hope that reimbursements eventually come through.  I wonder if paying with a US credit card and being able to show dual receipts (hospital receipt and credit card receipt) would make any difference.   Additional hassle of course. 

It's interesting when planning that things seem so orderly, but then when you talk to people that have actually tried to make it work, the reality is far from orderly.  I imagine some of the worst cases where a person with serious health issues has to take on the added frustration of becoming their own claims manager, or even worse, discovering that their insurance doesn't really pay for much. 

Aye, I am not 65 yet.   They did send me a letter which I received 3 months later canx my tricare... haha Who do you call then?   

Chris, as to serious health issues, according to tricare and FMP, go to the emergency room wherever (in the US) and be reimbursed.  No idea how that would work here... my guess as Headshot said is to decline all charges! LOL who knows. Who has done this?

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