Missed Open Season? How to Get TRICARE Coverage
If you missed the Dec. 14 deadline for open season, you’ll have to wait until next year’s open season to change your existing coverage unless you have a Qualifying Life Event (QLE). A QLE—at any time of the year—allows you to enroll in or change your TRICARE Prime (including US Family Health Plan) or TRICARE Select plan.
“A lot of TRICARE families may think they have to stick with the plan they have,” said Mark Ellis, chief of the Policy and Programs Section of the TRICARE Health Plan with the Defense Health Agency. “In many cases, this is true because of sponsor status or location. But for those who are eligible to switch from TRICARE Prime to TRICARE Select or able to enroll in either plan, QLEs allow you to change your health plan if you need to at a time other than the annual open season.”
With the next open season not set to arrive until the fall of 2021, you need to understand the options available to you now.
Check out the TRICARE Plan Finder to learn about which plans you may be eligible for based on your current or a future situation. For a list of the different types of QLEs, visit Qualifying Life Events. You can also download the TRICARE Qualifying Life Events Fact Sheet to learn more.
If you’re eligible for TRICARE, but don’t enroll in a plan during open season or within 90 days of a QLE, you’ll only be eligible for care and pharmacy services at a military hospital or clinic, if space is available.
If you’re a qualified member of the Select Reserve or Retired Reserve and you aren’t in an active status, you may be eligible to purchase a premium-based plan for you and your family. The same is true if you have an eligibility change, like aging out of regular TRICARE coverage. Available options include:
Are you eligible for TRICARE For Life? This is another option that doesn’t follow open season rules. Coverage is automatic if you have Medicare Part A and Part B.
If you’re a Group AIf you or your sponsor’s initial enlistment or appointment occurred before January 1, 2018, you are in Group A. retiree enrolled in TRICARE Select, don’t forget to set up payment for your new monthly 2021 enrollment fees. The deadline is Dec. 31 if you want to maintain your TRICARE Select coverage next year.
Last Updated 12/22/2020