Have you experienced a major life event like moving or getting married? If so, you might qualify to enroll in TRICARE or switch your TRICARE plan outside of the normal open enrollment period. This means you’ll also be eligible to enroll in TRICARE Supplement. But the opportunity doesn’t last long, so you need to act quickly.
TRICARE is the health insurance system of the U.S. military. It provides health care coverage to uniformed service members and retirees as well as their families. The system includes multiple plan types such as TRICARE Prime, which is a managed care option, and TRICARE Select, which is a fee-for-service option. Qualifying enrollees can also enroll in TRICARE Supplement, an optional plan that provides additional coverage to help pay for out-of-pocket costs.
Enrollment normally occurs during TRICARE Open Season, which happens every fall from the Monday of the second full week in November to the Monday of the second full week in December. During this time, people can switch their TRICARE plan. For example, someone enrolled in TRICARE Prime could decide to enroll in TRICARE Select instead or vice versa.
Enrollees can also use the TRICARE Open Season to change their enrollment type. For example, someone might switch from individual enrollment to family enrollment.
People who miss TRICARE Open Season will continue in their current plan. They won’t lose coverage, but if they want to make changes in their enrollment, they might have to wait another year to do so.
But what happens if someone gets married or has a baby outside of TRICARE Open Season? They won’t want to wait months to get coverage – but luckily, they don’t have to. Getting married and having a baby are among the triggers that count as Qualifying Life Events, allowing enrollment changes to happen outside of TRICARE Open Season. Other events can trigger this opportunity as well.
Qualifying Life Events
Qualifying Life Events often involve a change to who is in the family or where the family lives.
- A change to who is in the family includes marriage or divorce as well as a birth or adoption. A death in the family also counts as a Qualifying Life Event as does a child becoming an adult at age 21.
- A change in where the family lives can involve one individual or the entire family. For example, if the family moves to a new zip code, it counts as a Qualifying Life Event. It’s also a Qualifying Life Event when a child moves away to college.
Other Qualifying Life Events may involve a change to the sponsor’s status, such as retirement from active duty. Losing or gaining other health insurance coverage also counts as a Qualifying Life Event, such as an individual losing employer-based coverage or aging into Medicare.
See the TRICARE website for a complete list of Qualifying Life Events.
Making Enrollment Changes
When one person in a family experiences a Qualifying Life Event, everyone in the family has the opportunity to make enrollment changes.
If you have experienced a Qualifying Life Event, you have 90 days to enroll in a new plan or change your coverage type. During this time, you must update DEERS with information about the event and make the desired enrollment changes. You must also pay any enrollment fees or premiums that are due.
TRICARE plans can leave enrollees with out-of-pocket costs, including co-pays and deductibles. TRICARE Supplement can cover up to 100 percent of these costs. This makes health care costs more affordable and predictable. When individuals change their enrollment after a Qualifying Life Event, they should also consider enrolling the family in TRICARE Supplement.
Click below to learn more about how the TRICARE Supplement plan can wrap around your TRICARE coverage.