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Changes to TRICARE begin Jan. 1


TRICARE logo (U.S. Air Force contributed graphic)


Changes are coming to TRICARE that should be transparent for most beneficiaries enrolled for care at the 82nd Medical Group at Sheppard Air Force Base.

Master Sgt. Luis Caracosa, TRICARE Operations and Patient Administration flight chief, said a freeze began Dec. 1 while the Defense Health Agency transitions to a new TRICARE contract. The freeze ends Dec. 22.

“How this is going to affect our beneficiaries here at Sheppard is that existing members will not see that much of a challenge,” he said. “It’s going to be transparent, with the exception if they want to change a primary care provider. Due to the system being frozen, we’re actually going to keep the request on file, but we’re not going to be able to process them until the freeze is over.”

Of the more than 19,200 eligible beneficiaries in the Sheppard AFB prime service area, about 13,600 are enrolled for care at the 82nd MDG.

Caracosa said beneficiaries will still be able to get care if needed, but a requested change won’t be made until Dec. 22. For example, he said if a child is born during the freeze, they can still enroll in DEERS and be seen at the clinic, but they won’t have a PCP assigned until the freeze is lifted.

Airmen in Training arriving at Sheppard during the freeze will also be assigned a PCP after the period, but they will be able to get medical care if needed.

Caracosa said a big change beginning Jan. 1 includes TRICARE Standard and Extra combining into a single plan called TRICARE Select. Under the new plan, beneficiaries can go to any TRICARE-authorized provider without referral or authorization. Cost sharing amounts will also be lower for those seeing TRICARE network providers.

Another significant change coming to TRICARE is when beneficiaries can make changes to their plans. In years past, changes could be made at any time during the year. But, beginning Jan. 1, beneficiaries will only be able to make plan changes during an open enrollment period in November and December, much like the enrollment cycle for civilian insurance providers.

Also like civilian insurance, there are exceptions – or life changing events – that would allow a beneficiary to make change to their plan. Some examples include marriage, divorce, birth of a child and retirement.

Notification of referrals is also part of the change coming to TRICARE. Humana Military, the managed care provider for Sheppard, is no longer required to mail paper copies of referrals and authorizations to beneficiaries, however, they will continue to do so for the time being.

Caracosa said beneficiaries are asked to go to www.tricare-west.com to register for a secure account to receive electronic notifications of referrals and authorizations. He said instead of a 10 business-day time period to receive notification through regular mail, the process will take three days.

The flight chief said there are many more benefits to having an online account.

Beneficiaries will also see changes to some costs with TRICARE Select.

For example, retirees with an enlistment or commission date before Jan. 1, 2018, or Group A, will go from paying an annual enrollment fee of $289.08 for an individual or $578.16 for a family to having no annual enrollment fee. Group B retirees – those with an enlistment or commission date after Jan. 1, 2018 – will see their annual enrollment fee go from $350 for an individual or $700 for a family to $450 for an individual and $900 for a family.

Click here to see more information on cost changes for active duty members, retirees and dependents.

Finally, TRICARE is also changing the existing regions of managed care, but Sheppard won’t see the impact. TRICARE has three regions including North, West and South, but that will change as the North and South will merge and form an East region.

The East region will have Humana Military as its managed care provider. But, since the existing South region is already covered by Human Military, only the converting North region bases will be affected.

Click here for more information on changes to TRICARE.