Falls Church, VA, September 22, 2021 - If you’re getting ready to retire from active duty or reserve service, your goal is likely to make a smooth transition to civilian life. TRICARE can help you do that. When you retire from active duty or retire from the National Guard or Reserve, you’ll experience a TRICARE Qualifying Life Event (QLE). QLEs open a 90-day window where you can enroll in a new TRICARE health plan or change your coverage.
“You need to actively enroll in a TRICARE plan to continue health care coverage as a retiree,” said Elan Green, chief of TRICARE Health Plan’s Member Benefits and Reimbursement Section. “It doesn’t happen automatically, so you need to take action.”
What happens if you don’t take action to enroll within 90 days from your retirement date? You and your family members will only be able to get care at a military hospital or clinic when space is available. However, after 90 days, you may be able to request a retroactive enrollment. You can do this up to 12 months after your retirement date, as outlined in the TRICARE Qualifying Life Events Fact Sheet. If you don’t request a retroactive enrollment within 12 months of retiring, you may only enroll in or make changes to your health plan during the annual TRICARE Open Season or following another QLE.
“Fortunately, the action you need to take is straightforward and some steps are already part of your military retirement process,” added Green.
Here’s a look at four steps to help you retire smoothly with TRICARE:
Step 1: Review and update your information in the Defense Enrollment Eligibility Reporting System (DEERS).
Step 2: Get a new Uniformed Services ID card for yourself and your family members.
Step 3: Reenroll yourself and eligible family members, or choose different plans. Depending on your eligibility, age, and location, your plan choices after retirement include:
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TRICARE Prime (if residing in a Prime Service Area)
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US Family Health Plan (in certain areas stateside)
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TRICARE Plus (limited availability)
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TRICARE Retired Reserve (available up to age 60)
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TRICARE For Life (available if you’re entitled to Medicare Part A and have Medicare Part B)
Are you entitled to Medicare Part A? If so, be sure to sign up for Medicare Part B before you retire to keep TRICARE coverage. Once you have both Medicare Part A and Part B, you’re automatically eligible for TRICARE For Life, which is Medicare-wraparound coverage.
You can visit the TRICARE Plan Finder to learn more about which plans you’re eligible for and best fit your needs. You can also call your TRICARE contractor with any enrollment concerns.
Step 4: If eligible, you may purchase dental and vision coverage through the Federal Employees Dental and Vision Insurance Program (FEDVIP). You must be enrolled in a TRICARE health plan to qualify to purchase vision coverage through FEDVIP.
What about your pharmacy benefit? Once you enroll in a TRICARE health plan, you’ll have pharmacy coverage. This means you can still use the TRICARE Pharmacy Program. Your options for filling your prescriptions is based on the type of drug your provider prescribes and where you live. Keep in mind, most retirees and their families are required to fill certain maintenance drugs through TRICARE Pharmacy Home Delivery.
Costs and fees after retirement
You’ll pay retiree costs for all health care. Once you’re retired, you may have to pay enrollment fees or monthly premiums. This depends on which TRICARE health plan you enroll in. You may also have deductibles, copayments, cost-shares, and other fees for care. The effective date of coverage will be your retirement date. Remember, any TRICARE enrollment fees or monthly premiums must be paid retroactive to your retirement date for continuous coverage. You can review costs using the TRICARE Compare Costs Tool or by downloading the TRICARE Costs and Fees Sheet.
Understanding your TRICARE options when retiring and taking action to enroll in a health plan are critical steps. They’ll help you enjoy a seamless transition to civilian life. Check out the TRICARE Retiring from Active Duty Brochure or TRICARE Retiring from the National Guard or Reserve Brochure to learn more.