TRICARE & FEDVIP Open Enrollment Begins [updated]
Robert Haynes & Julie Provost
Open Enrollment Season to Begin for TRICARE and FEDVIP
TRICARE and FEDVIP open enrollment season has begun. This includes changing your TRICARE plan, getting or swapping dental plans and obtain vision coverage depending on your military status. Based on the most current numbers from Health.mil, there are over 9 million TRICARE beneficiaries just between the TRICARE Prime, TRICARE Select, and TRICARE for Life plans alone. Many of you reading this fall under one of those plans.
TRICARE Open Enrollment Dates & Options
For this reason, it is imperative for you to know that the 2020 TRICARE Open Season runs from November 9 through December 14, 2020.
TRICARE Open Enrollment Period is Nov 9 through Dec 14, 2020.
During this period of open enrollment, if you are enrolled in TRICARE Prime, TRICARE Prime retiree, or TRICARE select, you have a few options to consider:
- Do Nothing. If you wish to remain with your current TRICARE plan then you do not need to re-enroll. The coverage from your current plan will continue as long as you remain eligible.
- As a caveat, if you are a Group A retired beneficiary, you and your family must pay a new monthly TRICARE Select enrollment fee to maintain your TRICARE Select coverage. Please sign up during Open Season. The fees associated with this plan go into effect January 1, 2021. Read more about TRICARE Select Enrollment Fees.
- Enroll in a Plan. If you are eligible for a TRICARE Prime option or TRICARE Select but you’re not enrolled, you can enroll in a plan during open enrollment.
- Change plans. If you are already enrolled in a TRICARE Prime option, or TRICARE Select, you are able to switch plans, and switch between coverages, i.e. from individual to family enrollments and vice versa.
Please be advised, if you are not already in a plan and do not enroll in a plan during the open enrollment period (9 November – 14 December), then you will only be eligible for care at a military hospital or clinic, if space is available.
Enrollment Changes Outside of Open Season (Qualifying Life Events)
During the open season is the only time you can make these changes unless you have a qualifying life event. In order to make enrollment changes outside of the open enrollment period, you must do so only after a Qualifying Life Event (QLE).
A QLE is a specific change in your life situation that directly affects your health care coverage.
Most Common Qualifying Life Events
Here are some of the most common:
- Change in sponsor status (retiring/separating from the service)
- Change in family composition (marriage, divorce, child birth/adoption, death)
- Moving (child moving to college, relocation outside of current ZIP code)
- Losing or gaining other health insurance (OHI)
TRICARE Qualifying Life Events List
These events are:
- Activating or deactivating for Reserve & Guard service
- Deploying or mobilizing
- Being injured on active duty
- Getting married
- Having a baby or adopting a child
- Children going to college
- Children becoming adults
- Death in family
- Getting other insurance
- Becoming eligible for Medicare
- Separating from the military
A TRICARE QLE opens a 90-day period in which you can make eligible enrollment changes. A QLE for one family member means all family members are permitted to make enrollment changes.
With TRICARE, you can enroll in a plan or change your plan. Each one is a bit different. TRICARE Prime doesn’t really have any out-of-pocket expenses for active duty families. However, there are fees associated with going outside your prime network without a referral or filling prescriptions at a retail pharmacy or through the mail.
For the longer, official list, go here for the TRICARE list of QLEs.
What About Retirees?
For retirees, TRICARE Prime does require an annual enrollment fee as well as co-payments for appointments and procedures not done at a (MTF) military treatment facility. TRICARE Select will having you paying more out of pocket, but also allow you more freedom to select providers without a referral. If you are currently enrolled in TRICARE Prime or TRICARE Select you are eligible to change your plan during the open season.
FEDVIP Open Enrollment Dates and Options
The Federal Employees Dental and Vision Insurance Program (FEDVIP) is a voluntary, enrollee-pay-all dental and vision program available to Federal employees and annuitants, certain retired uniformed service members, and active duty service members.
The Federal Benefits Open Season mirrors TRICARE and runs from Nov 9 to Dec 14, 2020.
This program is sponsored by the U.S. Office of Personnel Management (OPM) and offers eligible participants a choice between 10 dental and 4 vision carriers. These include:
- Aetna Dental
- Delta Dental
- MetLife Federal Dental Plan
- United Concordia Dental
- GEHA Connection Dental Federal
- FEP Blue Dental
- And other regional plans
The 4 vision plans include:
Available to you is also a FEDVIP Plan Comparison tool, which allows you to research plans and premiums based on where you live. You can compare up to three dental or vision plans side-by-side for ease of use.
BENEFEDS, who administers the enrollment, plan change, and payment processes for FEDVIP, is offering a Virtual Benefits Fair spanning the entirety of the open enrollment period (9 November – 14 December). During this event you will have the opportunity to chat with carriers and review 2021 plan details.
Webinars are also available that should be able to answer your questions regarding FEDVIP and the Virtual Benefits Fair.
FEDVIP Qualifying Life Events
FEDVIP also maintains a list of qualifying QLEs that allow you to enroll in the FEDVIP program, or to make changes to your existing FEDVIP plan outside of open season.
Since each Federal benefits program follows its own law and regulations, do not assume that the FEDVIP QLEs will be the same as the TRICARE ones. For example, retirement is not a QLE under the FEDVIP, whereas it is a primary reason under TRICARE’s list.
The timeframe for requesting a QLE change with FEDVIP is from 31 days before to 60 days after the event.
Now, For Your Plan of Action
So, that is a lot of information, but it is only the tip of the medical coverage iceberg. Here are the three takeaways you should focus on:
- Review your current plan and medical coverage to identify gaps in coverage or needed changes to your current coverage.
- Review the links provided here and (at the respective websites) to identify opportunities to close any gaps in coverage identified above.
- Research and compare plans that would best suit your coverage needs and be ready for the open enrollment.
Your medical coverage is a most prized benefit that you deserve for your service to our great nation. Even so, you must ensure that the coverage you have is right for you and your loved ones. Thank you for your service.
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