How to Make Enrollment Changes Outside of TRICARE Open Season

12/12/2019

In case you missed it, the annual TRICARE Open Season and the Federal Benefits Open Season ended on Dec. 9. The next open season will take place in the fall of 2020. If you didn’t enroll or make a change to your TRICARE health plan during open season, you must wait until the next open season unless you have a TRICARE Qualifying Life Event (QLE).

“If you or a family member experiences a life event that TRICARE deems a QLE, you may be able to change your existing coverage without waiting until the next open season,” said Mark Ellis, chief of the Policy and Programs Section of the TRICARE Health Plan at the Defense Health Agency. “If you don’t have a QLE, you’re required to maintain your TRICARE Prime or TRICARE Select coverage until the following open enrollment period.”

Enrollment Options Outside of TRICARE Open Season

Outside of TRICARE Open Season, you can only enroll in or make changes to your TRICARE Prime (including US Family Health Plan) or TRICARE Select plan if you experience a TRICARE QLE. If you choose to make a change to your enrollment, you must make the change within 90 days of the QLE.

TRICARE Open Season doesn’t apply to TRICARE For Life (TFL). TFL coverage is automatic if you have Medicare Part A and Medicare Part B. With the premium-based health plans, you can enroll anytime throughout the year. These plans include TRICARE Reserve Select, TRICARE Retired Reserve, TRICARE Young Adult, and Continued Health Care Benefit Program.

TRICARE QLEs

What is a QLE? A QLE is a certain change in your life, such as a move, marriage, birth of a child, or retirement from active duty. This means TRICARE health plan options for you and your family may change. A QLE for one family member creates a chance for all eligible family members to change their TRICARE health plan. If you want to enroll in or change your plan, you must do so within 90 calendar days of the date of the QLE. Your coverage starts the date of the QLE and continues until you lose eligibility or disenroll.

Making Enrollment Changes Due to a QLE

If you want to enroll in or change your health plan after a QLE, you must:

  • Update your and your family member’s information in the Defense Enrollment Eligibility Reporting System (DEERS). Once your change shows in DEERS, you may make any eligible changes to your TRICARE enrollment.
  • Make the enrollment changes within 90 days of the QLE.
  • Pay any enrollment fees or premiums due during that period.

“Simply updating DEERS isn’t the same as enrolling in a TRICARE health plan,” said Ellis. “You must then make any enrollment action online via milConnect or by contacting your regional contractor by phone, mail, or fax to enroll in a TRICARE health plan.”

Check out Enroll or Purchase a Plan for information on how to enroll in a TRICARE health plan or change your enrollment. If you want to explore your health plan options, download the TRICARE Plans Overview. This publication gives you an overview of TRICARE health plans, including TRICARE Prime, TRICARE Select, and premium-based plans.

If you’re eligible to enroll in a dental or vision plan through the Federal Employees Dental and Vision Insurance Program (FEDVIP), remember that FEDVIP QLEs may be different from TRICARE QLEs. Also, they follow different timelines for enrollment. Visit the FEDVIP website for a full list of FEDVIP QLEs.

Now that open season is over, you may still have options to enroll or change your TRICARE enrollment. Learn more about TRICARE QLEs and take command of your health in 2020.

Last Updated 6/23/2020