What are the New Fees for Tricare for Vets?


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Defense health officials are encouraging the hundreds of thousands of military retirees who will have to start paying enrollment fees for their Tricare Select health care coverage as of Jan. 1 to take action now to set up their payment process.
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If you were to take action now to set up your payment process prior to November 20, you can avoid having to pay enrollment fees in advance.

The Military Times’ recent article entitled “Here’s what military retirees who are affected by new Tricare Select fees should do now” explains that beginning on January 1, these individuals, generally working-age retirees under age 65, will pay $12.50 a month for individual coverage, or $150 annually. Enrollment fees for those with families will be $25 a month, or $300 annually. These fees were put into effect in the Fiscal 2017 National Defense Authorization Act, but delayed until January 2021.

There were 407,431 military retirees and 764,936 retiree family members in Tricare Select at the end of last year, according to a Department of Defense report. It also applies to retirees in the Tricare Overseas Program Select.

These new fees don’t apply to retirees in the Tricare for Life program, and it doesn’t impact Chapter 61 retirees (those getting disability retirement) and their family members, and survivors of deceased active duty service members. Active duty family members don’t pay Tricare Select enrollment fees.

It’s important for affected retirees to set their payment up as soon as possible, says Mark Ellis, chief of policy and programs for the Tricare Health Plan, to avoid having to pay one or two months of premiums in advance. The call takes no more than three minutes, he said.

Retirees should contact their regional Tricare contractor by phone or through their website to set up their fee payment. Officials ask retirees to pay for their Tricare Select coverage by military allotment, if possible, for security. If the premium isn’t paid by January 1, coverage could be forfeited. Under federal law, “we don’t have legal authority to provide care or process claims,” if the fees aren’t paid, Ellis said.

“We realize things happen,” he said, noting that there is a process in place for the Tricare Select retirees to be notified, if, for example, an electronic funds transfer or credit card payment fails to go through. There is a reinstatement period of 90 days, and if the back fees are paid, the coverage can be reinstated back to the day after the retiree stopped paying fees, and coverage is brought up to date. “As long as back fees are paid, we can process denied claims,” Ellis said. “We can’t do it forever, but we do have processes in place.”

The new fees impact retirees and their family members in the so-called “Group A,” which is where the sponsor’s initial enlistment or appointment was before January 1, 2018. The retirees in that group are generally working-age retirees under age 65. They don’t currently pay enrollment fees, but under the National Defense Authorization Act of 2017, Congress required defense officials to start charging these working-age retirees enrollment fees in 2021. The 2020 Tricare open season concludes on December 14.

Reference: Military Times (Oct. 26, 2020) “Here’s what military retirees who are affected by new Tricare Select fees should do now”