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CALVIN KELLER:
Hello everyone, and welcome to today's webinar: "Get Ready for TRICARE Open Season and 2025

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Region Changes." I'm Calvin Keller

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with the Defense Health Agency Communications and Public Affairs

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Division, and I'm your host for today's webinar. During

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today's presentation, we'll walk you through who will be

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affected by the TRICARE region changes and

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if there's any action you need to take

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before Jan. 1, 2025.

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We'll also share an overview of TRICARE

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Open Season, which started Nov. 11 and

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lasts through Dec. 10. You'll learn if you

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need to participate in open

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season, your plan options, and how to make eligible

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enrollment changes for 2025.

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Before the Q & A portion of today's webinar, we'll

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briefly review options for changing your dental

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and vision coverage during the Federal Benefits

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Open Season,

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which lasts through Dec. 9.

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We're excited to welcome today's presenter, Ms.

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Zelly Zim, health systems specialist with the DHA, TRICARE

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Health Plan, Policy & Programs. Zelly, over to you.

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ZELLY ZIM:
Thank you, Calvin. Next slide, please.

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Again, my name is Zelly and I'm looking forward to walking

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you through actions needed due to TRICARE region

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changes for 2025 and TRICARE Open Season,

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which began on Nov. 11. Before we get started, I'd like

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to go over who this webinar applies to.

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Discussing the TRICARE region changes, which applies

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to all beneficiaries who live in the United States, we'll talk

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about which actions you may need to take. And the

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region changes portion will not apply to our beneficiaries who

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live in U.S. territories or who live overseas. This

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webinar also applies to you if open season applies

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to you. And on the right side of this slide is a list

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of those to whom open season applies. Open season does

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not apply to our beneficiaries who have TRICARE For Life

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or who are using our TRICARE premium-based plans,

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such as TRICARE Young Adult, TRICARE Retired Reserve,

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or TRICARE Reserve Select. Next slide, please.
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We'll also offer some tips for navigating the Federal

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Benefits Open Season, which is also open now.

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Though this is not managed by TRICARE, it's related to your health coverage

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if you are an active duty family member, a reservist, or

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retiree. And so we want to make sure that you understand the

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interactions between the Federal Benefits Open Season and our

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open season here with TRICARE. Next slide.

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So, now that we have that sorted out, here's our agenda for today. We'll be

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discussing what's changing in 2025, how to prepare for

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those changes, open season dates, eligibility and

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options, and so on and so forth, as you can see on this slide.

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There's also an announcement in the chat about where these slides are

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available for download, and you can go ahead and follow along

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there or refer to it afterwards. Based on this agenda, we have

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a lot to cover, so let's go ahead and jump right in. Next

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slide, please.

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If you're just joining us, we are now on slide

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6. So, what's changing in 2025? There are several updates to

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TRICARE for those living CONUS, or within the continental United States.

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We have six states that are moving from the East Region to

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the West Region.

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And for the West Region, there is a new

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servicing contractor. TriWest Healthcare Alliance will replace

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Health Net Federal Services. In the East, you'll

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remain with Humana Military as the contractor that's servicing the

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TRICARE plan. Beyond these contract transitions and

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geographical changes, though, there are a few more things that we're pleased to

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report about TRICARE in 2025. We'll be

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having more efficient transfers between the two regions. And

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what this means is in terms of referrals, if you have an

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authorized referral and then you move before you

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get a chance to go to that appointment, you'll not need to

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gain another authorized referral after your move. So, that's one

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of the things that we know will be of great benefit. There's

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also greater provider network flexibility with

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the new contract, and we also have improved beneficiary

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choice. Both regions will have an increased number of providers in the network,

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particularly in the West Region, where the total number of providers far exceeds

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the number of providers that we have in our current network

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and under their current contract, that ends at the end of

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December of this year. Finally, there will be

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enhanced access to telehealth. If you're interested in

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understanding more about

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these changes, then you can also visit our website at

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tricare.mil/changes.

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Next slide, please.

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As I mentioned on the previous slide, we have six

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states that are currently in the East, and those states will now be

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part of our West Region beginning on Jan. 1, 2025.

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So, at the bottom of this slide, you can kind of see that

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displayed for you in the two maps of the United States.

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You'll notice that currently, if you look really closely at where the

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borders are for this current

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contract,

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you'll see that there are several carveouts: for

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example, west Texas and then near the St. Louis area.

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When we move over to T-5, those carveouts no longer exist and you'll

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notice that all of those states are in the

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West Region. I'll pause just a moment to see 

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if we can address the echo.

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Hopefully that's a little bit better, but we'll go ahead and keep going.

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If you live on the cusp of the East and West Region and want to verify where

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you fall, please go to our website at tricare.mil/changes

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and keep an eye out for more details. To

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search your provider directories, if you're interested in what might be changing

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or if your provider is still a part of the new TRICARE

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networks, you can visit tricare.mil/east

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tricare.mil/west.

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Next slide, please.

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Now I'll be going over three steps to

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help get ready for the 2025 changes. 

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Step 1 is updating DEERS, and this is something that

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I really want to make sure that everybody pays attention to, regardless

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of whether or not these 

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2025 changes apply to you when you're

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updating and checking your information in DEERS. This is to make sure

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that all of the information that comes out from the TRICARE Health Plan and

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from our contractors

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gets to you specifically, and there's

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information on this slide on how you can do that.

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You can also learn more about the interaction with

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DEERS by going to our website, tricare.mil/deers.

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And as I mentioned, we were talking about this in relation to the upcoming changes

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and making sure that new contractors have your information.

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This change is important for all TRICARE beneficiaries.

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Whenever you change your address or anything about your family

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composition changes, it's important for you to have that information in DEERS,

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because if it's not in DEERS, then we don't see it on the TRICARE end.

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Next slide, please.

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So, Step 2 is to explore the

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provider networks. We have the two websites that

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I've already mentioned listed here, and you can use these websites

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to look at what the network looks like in your specific

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area, and you can find out whether or not your provider is still

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in the network. If your provider is no longer in-network, you could also

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begin researching which providers in your area are within the

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network, and that might also factor into your analysis when you look at

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whether you want to be in TRICARE Prime or

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TRICARE Select for the upcoming calendar

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year. Next slide, please.

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So, to recap so far, Step 1 was updating

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DEERS, and Step 2 was exploring your provider

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networks. That brings us to Step 3, which is updating

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automatic payment information. As you can see on this slide in the

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blue box, this applies to a wider audience. So, if

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you live in the West Region or in a state that's moving to the

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West Region, you will need to transfer your automatic payment information

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to the new West contractor, which again is TriWest, and

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you need to do that by Dec. 31, 2024.

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There's information on this slide on how to do that, but

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even if you don't live in the West, now is the time

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to review your fee or premium payment options and methods.

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If you pay by electronic funds transfer, known as EFT,

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or if you're paying by credit card or debit card, now is a good time

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to check the expiration dates on your cards. Remember

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that if you are in TRICARE Prime or TRICARE Select and choose to pay by allotment, you

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do not have to worry about transferring information

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to TriWest, and you also don't have to worry about payment expiration

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dates.

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It's honestly the most streamlined way to take care of your TRICARE

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fees. There's also a note at the very bottom of the slide that

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I want to make sure to call your attention to as you're updating

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payment information. Be sure not to cancel any autopay

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information that you have under the current West

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contractor, Health Net Federal Services. TriWest will not be

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initiating any payments from you until Jan. 1, 2025. So, we

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want to make sure that you're paid through as necessary, through the

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end of this year, under the Health Net contract.

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Next slide, please.

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So, now that we've talked about region changes, we'll shift

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our focus to open season. Open season occurs annually

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beginning on a Monday, the second full week of November and lasting at least

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30 days. So, open season this year began

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on Veterans Day, on Nov. 11, and will run through Dec.

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10, 2024. All the changes that you're making

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during open season go into effect on 

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Jan. 1, 2025.

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If you do not enroll or make changes during open season,

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your only option to do so is when you have a QLE,

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or a Qualifying Life Event. Qualifying

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Life Events are 90-day windows to make enrollment changes, and

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generally, that window begins on the date of the qualifying

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event. One important exception I'd like to point out to that 90-day window is

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retirement, and the timeframe for making changes following retirement

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can extend up to 12 months. We won't get into the specifics of that

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in this webinar. Be sure to check out our Using TRICARE After

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Retirement webinar

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or our Qualifying Life Events webinar for more details

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about those specific instances. 

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Tricare.mil/lifeevents gives more information about all the

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other various QLEs. But again, when we're looking to make a

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change or we're looking to enroll in a new plan, open

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season or QLEs are the only options for that. And that's why we want to

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make sure that you have a good understanding of what actions are

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needed during open season this year.

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Next slide, please.

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So, open season applies to the plans that are listed on the left

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side of your screen. As you can see, the main delineations in that

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column are between various types of TRICARE Prime and TRICARE Select.

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The different types of TRICARE Prime are based on your sponsor's eligibility.

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You can learn the specifics of these different plans at 

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tricare.mil/plans, and we'll be going over some of the differences

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during this webinar. Open season does not

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apply to the plans or the groups on the right side of your

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screen. So, our active duty service members, they all have TRICARE Prime options

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and they

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do not need to take action to enroll.

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TFL, or TRICARE For Life: They also do not need to

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use open season, because their coverage is automatic

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when they have Medicare Part A and are paying for Medicare

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Part B. Lastly, the premium plans, or sometimes

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called the "T" plans, TRICARE Reserve Select, TRICARE Retired Reserve, and

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and TRICARE Young Adult. They also do not

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have an open season because they don't have a special enrollment

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period. They can enroll or purchase those plans at any time

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throughout the year.

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Next slide, please.

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So, you have three options if open season does apply

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to you. #1: If you listen to this webinar, you

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look at all of your resources, and you conclude that you're in the right health

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plan option, you don't need to re-enroll. You'll continue in the same

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health plan for calendar year 2025 as long as you

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maintain eligibility for that plan. Secondly,

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#2: If you are not currently in a health plan and you're

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eligible for TRICARE Prime or TRICARE Select, you can

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use open season to enroll.

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Or #3: You can use open season to

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change between health plans. If you find that you need to change

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health plans and open season has already closed, you'll have to

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wait until you have a Qualifying Life Event or until

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the next open season, which is held at the same time each year.

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Your eligibility is managed in DEERS. You heard me mention that

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earlier, the Defense Enrollment Eligibility Reporting System. So, it's

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very important that information is up to date so that

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we can

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see what your eligibility is.

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Beyond sponsor status, DEERS

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also records your address, which may factor into which plans

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are available to you. It's important that you keep that information

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for you and your family members current. You can

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learn more about DEERS and how to make those updates at

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tricare.mil/deers. Next slide, please.

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Here's the crux of your research into the

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00:13:30.437 --> 00:13:33.717
various health plans on the left. We have some questions that are important to

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consider before you choose a health plan, and on the right is a

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00:13:36.957 --> 00:13:40.077
list of websites that can offer more information as you answer these

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questions for your family. For example, if you're curious

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about how the plans stack up in terms of cost, you

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might look at this question that says how much will you have to pay for care.

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And you can consider the enrollment fees and the cost per service

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and use our Compare Costs tool on the website.

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00:13:56.817 --> 00:14:00.037
Or you might wonder, how would I get care with my

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plan and understanding those different plan rules, such as: What's the difference between

254
00:14:03.637 --> 00:14:07.087
somebody who has the US Family Health Plan versus

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having TRICARE Prime or TRICARE Select and having TRICARE Select

256
00:14:10.677 --> 00:14:13.837
Overseas? You can find out how you would get

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00:14:13.837 --> 00:14:17.177
care with each of those plans by using our link 

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00:14:17.177 --> 00:14:20.357
tricare.mil/gettingcare. And now, moving

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on to the next slide, that would be slide 15,

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we'll answer some of these questions.

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Next slide, please.

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Let's start with TRICARE Prime. TRICARE Prime

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00:14:33.157 --> 00:14:36.197
is mandatory for our active duty service members, but again

264
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they do not need to take action during open

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season. TRICARE Prime is available to eligible beneficiaries who

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live in Prime Service Areas, or PSAs. To

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00:14:45.837 --> 00:14:48.917
find out if you live in a Prime Service Area, you can go to

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00:14:48.917 --> 00:14:52.117
tricare.mil/PSA.

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00:14:52.117 --> 00:14:55.437
The Plan Finder tool requires entering your zip code to tell you whether

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00:14:55.437 --> 00:14:58.917
or not you live in a PSA and to tell you what plans are available

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00:14:58.917 --> 00:14:59.577
in your area.

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Many of the other options that you see here, such as

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00:15:03.357 --> 00:15:07.277
TRICARE Prime Remote, TRICARE Prime Overseas, and TRICARE Prime

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00:15:07.277 --> 00:15:11.427
Remote Overseas are not options for our retirees. However,

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USFHP, or the US Family

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00:15:14.597 --> 00:15:18.407
Health Plan is an option for our retirees, so

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I just want to make sure that you understand those differences as we move forward.

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Next slide, please.

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TRICARE Prime is similar to a private

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00:15:27.957 --> 00:15:31.157
sector HMO, or a health maintenance organization.

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00:15:31.827 --> 00:15:34.877
This means that with TRICARE Prime, you have

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00:15:34.877 --> 00:15:38.037
a primary care manager, or a PCM, and they're the ones who

283
00:15:38.037 --> 00:15:41.237
coordinate all of your care. You must live in

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00:15:41.237 --> 00:15:44.397
a PSA, Prime Service Area, as TRICARE Prime

285
00:15:44.397 --> 00:15:47.677
generally features the use of our hospitals and clinics, the

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military hospitals and clinics. TRICARE Prime requires

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00:15:51.077 --> 00:15:54.357
authorized referrals for specialty care, and there are

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00:15:54.357 --> 00:15:57.557
four special cases of TRICARE Prime. We have TRICARE Prime

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00:15:57.557 --> 00:16:00.867
Remote, TRICARE Prime Overseas, TRICARE Prime Remote Overseas,

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00:16:01.027 --> 00:16:04.307
and the US Family Health Plan, which operates similarly to

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00:16:04.307 --> 00:16:08.037
TRICARE Prime and requires that you live in a specific

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00:16:08.037 --> 00:16:11.357
area. There are two helpful links at the bottom of this page, as well. You

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00:16:11.357 --> 00:16:14.917
can look up specific covered services on our website,

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00:16:14.917 --> 00:16:18.117
along with information on how to get care, and that will explain

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00:16:18.117 --> 00:16:22.277
to you exactly what needs to happen in that referral and authorization process

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00:16:22.277 --> 00:16:25.327
before you go see a provider besides your

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00:16:25.327 --> 00:16:26.827
PCM, or your primary care provider.

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00:16:27.857 --> 00:16:28.777
Next slide, please.

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00:16:30.347 --> 00:16:33.507
TRICARE Prime generally offers lower out-of-

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00:16:33.507 --> 00:16:36.677
pocket costs than TRICARE Select, so when you're following

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00:16:36.677 --> 00:16:39.957
the rules of the TRICARE Prime plan, your out-of-pocket

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00:16:39.957 --> 00:16:43.157
costs are limited to your catastrophic cap. The costs

303
00:16:43.157 --> 00:16:46.207
you pay under the point of service option don't apply

304
00:16:46.207 --> 00:16:49.557
towards your catastrophic cap. Point of service means your non-

305
00:16:49.557 --> 00:16:52.997
emergency healthcare services from any TRICARE-authorized civilian

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00:16:52.997 --> 00:16:57.237
provider, in or out of the network, without requesting a

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00:16:57.237 --> 00:17:00.757
referral from your PCM. So, to rephrase that, any costs

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00:17:00.757 --> 00:17:00.867
that you pay

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00:17:01.787 --> 00:17:05.117
without a referral do not count

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00:17:05.117 --> 00:17:09.117
towards your catastrophic cap. You can only contribute towards your catastrophic cap

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00:17:09.117 --> 00:17:12.247
with your copayments. It's also important to note that there is

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00:17:12.247 --> 00:17:15.557
not a deductible with TRICARE Prime. If you're interested

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00:17:15.557 --> 00:17:18.757
in the cost and fees for TRICARE Prime and

314
00:17:18.757 --> 00:17:21.917
looking at that, you can go to tricare.mil/costs,

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00:17:21.917 --> 00:17:25.757
and that has specific worksheets that show you all of the fees as

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00:17:25.757 --> 00:17:28.997
they are currently here in 2024, and you can also look at

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00:17:28.997 --> 00:17:30.637
all the 2025 fees as well.

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00:17:31.267 --> 00:17:34.387
You can also use the link that's at the bottom of this page, which is

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00:17:34.387 --> 00:17:37.837
tricare.mil/comparecosts, to look at

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00:17:37.837 --> 00:17:41.357
the costs of TRICARE Prime and TRICARE Select next to each

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00:17:41.357 --> 00:17:41.907
other. Next slide, please.

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00:17:43.717 --> 00:17:46.797
So, now we're moving on to TRICARE Select.

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00:17:46.797 --> 00:17:50.357
TRICARE Select is a healthcare option for our eligible beneficiaries

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00:17:50.357 --> 00:17:54.197
who are not enrolled in TRICARE Prime and they're not eligible

325
00:17:54.197 --> 00:17:57.397
for Medicare Part A. There's not a

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00:17:57.397 --> 00:18:00.557
location requirement, such as living in a PSA, for

327
00:18:00.557 --> 00:18:01.837
TRICARE Select and,

328
00:18:02.467 --> 00:18:05.477
just as a reminder, our active duty service members

329
00:18:05.477 --> 00:18:08.557
may not use TRICARE Select. All of them are in TRICARE

330
00:18:08.557 --> 00:18:11.917
Prime. And then as I mentioned before, TRICARE Select Overseas is

331
00:18:11.917 --> 00:18:15.317
available if you're living overseas, and it is an option

332
00:18:15.317 --> 00:18:16.707
for our retirees as well.

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00:18:17.917 --> 00:18:18.837
Next slide, please.

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00:18:20.587 --> 00:18:23.987
So, let's talk about getting care with TRICARE Select.

335
00:18:23.987 --> 00:18:27.187
TRICARE Select functions more like a

336
00:18:27.187 --> 00:18:30.347
private sector PPO, or preferred provider

337
00:18:30.347 --> 00:18:33.387
organization. This means that TRICARE Select allows you to choose your own

338
00:18:33.387 --> 00:18:36.467
TRICARE-authorized provider, rather than having a

339
00:18:36.467 --> 00:18:39.707
primary care manager. Essentially, you are your own primary care

340
00:18:39.707 --> 00:18:43.547
manager and you're the one that chooses where you want to go within the TRICARE

341
00:18:43.547 --> 00:18:46.747
network. Further, you don't need to live within a PSA, or Prime

342
00:18:46.747 --> 00:18:46.947
Service Area.

343
00:18:47.537 --> 00:18:50.587
You can live wherever. To find a TRICARE network

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00:18:50.587 --> 00:18:53.667
provider, you can go to the tricare.mil

345
00:18:53.667 --> 00:18:56.907
website that's on here, or you can use the ones I've mentioned before such as

346
00:18:56.907 --> 00:19:00.067
tricare.mil/east and tricare.mil/west.

347
00:19:00.067 --> 00:19:02.137
Next slide, please.

348
00:19:03.737 --> 00:19:06.747
In general, TRICARE Select has higher out-of-

349
00:19:06.747 --> 00:19:09.947
pocket costs than TRICARE Prime. With TRICARE Select,

350
00:19:09.947 --> 00:19:13.187
there's also an annual deductible for TRICARE covered

351
00:19:13.187 --> 00:19:16.667
services. Remember, TRICARE Prime did not have a deductible.

352
00:19:16.667 --> 00:19:19.897
Deductibles are just the allowable costs or charges for

353
00:19:19.897 --> 00:19:23.307
your covered outpatient services or supplies, and those deductibles

354
00:19:23.307 --> 00:19:26.907
are determined on a calendar year basis. So, with TRICARE

355
00:19:26.907 --> 00:19:30.107
Select, after your deductible is met, you only pay per-visit 

356
00:19:30.107 --> 00:19:33.947
copayments. Your out-of-pocket costs are limited to your catastrophic cap,

357
00:19:33.947 --> 00:19:34.057
and, as you're

358
00:19:34.497 --> 00:19:38.107
comparing those costs, pay attention to the differences between in-

359
00:19:38.107 --> 00:19:41.347
network and non-network costs. In general, you're

360
00:19:41.347 --> 00:19:44.547
always going to save more money if you're focusing

361
00:19:44.547 --> 00:19:48.347
in on just using those network providers.

362
00:19:48.347 --> 00:19:51.507
Next slide, please, and if you're just catching up,

363
00:19:51.507 --> 00:19:55.627
we're on slide 21. The two big cost differences

364
00:19:55.627 --> 00:19:58.907
between TRICARE Prime and TRICARE Select are as follows. First, TRICARE Select ends

365
00:19:58.907 --> 00:20:02.107
up with higher out-of-pocket costs, and this is primarily

366
00:20:02.107 --> 00:20:04.697
because of, secondly, TRICARE Select has a deductible.

367
00:20:04.937 --> 00:20:08.107
You're paying for the ability to choose where you get your

368
00:20:08.107 --> 00:20:11.147
care. TRICARE Select is most similar to the private sector PPO option, as I

369
00:20:11.147 --> 00:20:14.557
mentioned, while TRICARE Prime is most similar to the private sector

370
00:20:14.557 --> 00:20:17.787
HMO option. Another big differentiation

371
00:20:17.787 --> 00:20:20.947
between TRICARE Prime and TRICARE Select are the location requirements.

372
00:20:20.947 --> 00:20:24.187
For TRICARE Prime, you must live within a PSA, or

373
00:20:24.187 --> 00:20:27.427
a Prime Service Area, and for USFHP, you have to live

374
00:20:27.427 --> 00:20:30.587
in one of their specific coverage areas. On the other

375
00:20:30.587 --> 00:20:32.457
hand, for TRICARE Select, you can live wherever.

376
00:20:33.017 --> 00:20:36.067
There are often questions about the differences between TRICARE Prime

377
00:20:36.067 --> 00:20:39.547
and TRICARE Select as it relates to care at our military

378
00:20:39.547 --> 00:20:43.077
hospitals and clinics. If you have TRICARE Prime and your

379
00:20:43.077 --> 00:20:46.537
PCM is at the military hospital or clinic, you will

380
00:20:46.537 --> 00:20:49.827
have priority at that hospital or clinic. If you

381
00:20:49.827 --> 00:20:53.067
have TRICARE Select, you can still go to the military hospital or clinic for care,

382
00:20:53.067 --> 00:20:56.277
but you do not have priority. If you have TRICARE Prime

383
00:20:56.277 --> 00:20:59.507
through the US Family Health Plan, you do not have the option to be

384
00:20:59.507 --> 00:21:02.787
seen at the military hospital or clinic at all. So, those are just

385
00:21:02.787 --> 00:21:03.777
a couple things to keep in mind

386
00:21:04.297 --> 00:21:07.427
as you're weighing your options with the various plans that you

387
00:21:07.427 --> 00:21:11.947
may be eligible for. Next slide, please.

388
00:21:11.947 --> 00:21:15.027
Now that we've discussed your open enrollment options with

389
00:21:15.027 --> 00:21:19.267
TRICARE Prime and TRICARE Select, let's talk about how to actually make those enrollment changes for

390
00:21:19.267 --> 00:21:22.787
this year. We have some important announcements about using our Beneficiary Web

391
00:21:22.787 --> 00:21:25.947
Enrollment tool, or BWE.

392
00:21:25.947 --> 00:21:29.187
These options are a little bit different this year, so I'd like to pay special

393
00:21:29.187 --> 00:21:30.937
attention to this slide in particular.

394
00:21:31.417 --> 00:21:34.667
So, effective throughout this year, you will not be able

395
00:21:34.667 --> 00:21:37.827
to use the online web enrollment option through

396
00:21:37.827 --> 00:21:40.937
milConnect if you live within the United States or you're

397
00:21:40.937 --> 00:21:44.027
moving back and forth from the United States, to overseas or

398
00:21:44.027 --> 00:21:47.397
the other way around. You can still

399
00:21:47.397 --> 00:21:50.467
use BWE or the online option through milConnect

400
00:21:50.467 --> 00:21:53.787
if you are living overseas and you're not making that

401
00:21:53.787 --> 00:21:56.827
transition stateside. There will be some other options that we'll discuss

402
00:21:56.827 --> 00:22:00.057
little bit further if you're in that first category, that won't be

403
00:22:00.057 --> 00:22:02.057
to make the online changes, and we'll get to that

404
00:22:02.257 --> 00:22:03.297
on the next slide.

405
00:22:05.717 --> 00:22:08.877
So, if you are living stateside or

406
00:22:08.877 --> 00:22:12.507
you're moving stateside, you can choose to make your open season

407
00:22:12.507 --> 00:22:15.747
enrollment changes by phone or by

408
00:22:15.747 --> 00:22:18.987
mail. So, that information is here on this

409
00:22:18.987 --> 00:22:22.267
slide. And if you're in the East, Humana Military, that's who you're

410
00:22:22.267 --> 00:22:25.387
contacting. If you're in the West, you can make

411
00:22:25.387 --> 00:22:28.907
those changes by reaching out to TriWest.

412
00:22:28.907 --> 00:22:32.707
But if there are changes that you need to make, that must be effective

413
00:22:32.707 --> 00:22:36.277
before Jan. 1, 2025--for example, a change due to a

414
00:22:36.537 --> 00:22:39.787
life event or QLE, then those changes will

415
00:22:39.787 --> 00:22:42.947
still be managed by Health Net Federal Services and that's

416
00:22:42.947 --> 00:22:46.187
your current contractor for the West Region. 

417
00:22:46.187 --> 00:22:49.387
So, for the East Region, it's easy: Stick with contacting

418
00:22:49.387 --> 00:22:52.587
Humana Military. For the West Region, if it's for something that needs to

419
00:22:52.587 --> 00:22:56.107
go into effect before Jan. 1, 2025, please

420
00:22:56.107 --> 00:22:59.307
continue to contact Health Net Federal Services, and if 

421
00:22:59.307 --> 00:23:02.547
it's for Jan. 1 and beyond, so any open season

422
00:23:02.547 --> 00:23:05.747
changes, then you would then be contacting TriWest

423
00:23:05.747 --> 00:23:06.657
Healthcare Alliance.

424
00:23:06.897 --> 00:23:10.147
There's more information on our website about that, and it

425
00:23:10.147 --> 00:23:13.347
goes into more detail to help you navigate that process.

426
00:23:13.347 --> 00:23:16.707
I'll go on to the next slide now, which just has a reference

427
00:23:16.707 --> 00:23:20.027
for you for the phone numbers

428
00:23:20.027 --> 00:23:23.187
to contact the

429
00:23:23.187 --> 00:23:26.787
enrolling contractors. And as I mentioned, if

430
00:23:26.787 --> 00:23:30.267
you're living stateside, you will need to either contact

431
00:23:30.267 --> 00:23:34.067
them by mail or by calling, rather than using our

432
00:23:34.067 --> 00:23:35.897
online options. So, that information is here for you.

433
00:23:36.847 --> 00:23:37.527
Next slide.

434
00:23:39.867 --> 00:23:42.947
So, before we move on, I just want to address

435
00:23:42.947 --> 00:23:46.437
one question that we often receive. If you're retiring, you

436
00:23:46.437 --> 00:23:49.667
may be wondering how open season applies to you.

437
00:23:49.667 --> 00:23:52.787
Retirement is a QLE, or Qualifying Life Event, and

438
00:23:52.787 --> 00:23:56.067
a change in status to retiree means that you can make changes to your

439
00:23:56.067 --> 00:23:59.747
health plan or enroll in a new plan. Before the webinar,

440
00:23:59.747 --> 00:24:02.987
we received a question about what to do during open season if

441
00:24:02.987 --> 00:24:06.267
you have a retirement date, for example, of 

442
00:24:06.267 --> 00:24:07.147
Dec. 1.

443
00:24:07.547 --> 00:24:10.707
And if that's the case, you have a Qualifying Life Event at that period,

444
00:24:10.977 --> 00:24:14.297
and that means that you can have a change in your coverage that's

445
00:24:14.297 --> 00:24:17.427
effective on Dec. 1. That means that in this

446
00:24:17.427 --> 00:24:20.987
example that we talked about already for stateside, you would need

447
00:24:20.987 --> 00:24:24.507
to call or mail the current contractors

448
00:24:24.507 --> 00:24:28.067
if you live in the West, so that would be the Health Net Federal Services,

449
00:24:28.067 --> 00:24:31.227
in order to make that change for retirement. Now that we're

450
00:24:31.227 --> 00:24:34.387
talking about these changes overseas, if you are

451
00:24:34.387 --> 00:24:37.987
living overseas, then your option would still continue,

452
00:24:37.987 --> 00:24:40.377
you would still be able to make those changes

453
00:24:40.537 --> 00:24:43.747
online or even in person. So, that brings me to

454
00:24:43.747 --> 00:24:47.027
this slide that's in front of us. So, if you choose to make enrollment

455
00:24:47.027 --> 00:24:50.507
changes and you're overseas, you have the same options that you've had in

456
00:24:50.507 --> 00:24:53.747
previous years. So, you can make those changes online, you can make them over

457
00:24:53.747 --> 00:24:56.867
the phone, you can do those by mail, and you can even go into a

458
00:24:56.867 --> 00:25:00.147
TRICARE Service Center. For our retirees,

459
00:25:00.147 --> 00:25:03.347
I would just like to remind you that you need to actively choose and

460
00:25:03.347 --> 00:25:06.907
enroll in a TRICARE plan if you desire coverage for civilian or

461
00:25:06.907 --> 00:25:10.067
private sector care. If you do not take action, you'll lose

462
00:25:10.067 --> 00:25:11.137
TRICARE coverage and may only be

463
00:25:11.257 --> 00:25:14.547
eligible for care at our military hospitals and clinics if

464
00:25:14.547 --> 00:25:17.747
space is available, or you'd have to wait until the next

465
00:25:17.747 --> 00:25:21.227
open season if you're outside of the window for your retirement

466
00:25:21.227 --> 00:25:23.857
Qualifying Life Event. Next slide, please.

467
00:25:25.737 --> 00:25:28.787
So, similar to TRICARE

468
00:25:28.787 --> 00:25:31.987
with the open season, QLE structure or Qualifying Life

469
00:25:31.987 --> 00:25:35.187
Event structure, but not managed by the Defense Health Agency

470
00:25:35.187 --> 00:25:38.427
or the TRICARE Health Plan, you also have the Federal Benefits

471
00:25:38.427 --> 00:25:43.137
Open Season. This is managed by the U.S. Office of Personnel Management, or

472
00:25:43.137 --> 00:25:46.187
OPM. You might have heard that acronym before,

473
00:25:46.187 --> 00:25:49.707
and you must be enrolled in a TRICARE health plan to be eligible for

474
00:25:49.707 --> 00:25:51.257
some of the OPM options.

475
00:25:51.787 --> 00:25:54.907
What you'll notice is that the Federal Benefits Open

476
00:25:54.907 --> 00:25:58.107
Season nearly mirrors the TRICARE Open Season. It's just one

477
00:25:58.107 --> 00:26:01.587
day shorter. So, they also started this past Monday, on Nov. 11,

478
00:26:01.587 --> 00:26:02.907
and it runs through Dec. 9.

479
00:26:03.337 --> 00:26:07.187
And again, just like ours, the

480
00:26:07.187 --> 00:26:10.457
enrollment choices that you make during this time go into effect on 

481
00:26:10.457 --> 00:26:13.987
Jan. 1, 2025. If you don't need

482
00:26:13.987 --> 00:26:17.467
to make changes to your existing FEDVIP plans,

483
00:26:17.467 --> 00:26:20.577
you don't have to do anything and then you'll be automatically

484
00:26:20.577 --> 00:26:23.867
enrolled in that same plan for 2025. But if you need more

485
00:26:23.867 --> 00:26:27.027
information on what's available through FEDVIP, you can

486
00:26:27.027 --> 00:26:28.817
visit the Benefeds website at

487
00:26:29.627 --> 00:26:32.747
benefeds.gov to check your eligibility to

488
00:26:32.747 --> 00:26:34.827
compare those plans and to enroll in a plan.

489
00:26:35.497 --> 00:26:38.537
So, outside of the FEDVIP Open

490
00:26:38.537 --> 00:26:41.827
Season, they also have QLEs that are specific

491
00:26:41.827 --> 00:26:45.067
to the FEDVIP plan, and so it's important to understand the differences

492
00:26:45.067 --> 00:26:48.427
between those, because they though they mirror TRICARE in a lot of

493
00:26:48.427 --> 00:26:51.747
ways, there are a few aspects where they're different. And I'll move on to the

494
00:26:51.747 --> 00:26:55.267
next slide so that you can see a little bit of information

495
00:26:55.267 --> 00:26:59.027
about the eligibility for FEDVIP and how

496
00:26:59.027 --> 00:27:02.667
that mirrors your eligibility and ties into your eligibility for TRICARE.

497
00:27:02.667 --> 00:27:03.737
So, for example, if you look at

498
00:27:04.867 --> 00:27:08.027
active duty service members, they do not they

499
00:27:08.537 --> 00:27:11.667
qualify for any care through FEDVIP because all of that is

500
00:27:11.667 --> 00:27:14.867
covered by TRICARE programs for vision and for dental;

501
00:27:14.867 --> 00:27:18.307
whereas for active duty family members, some of them

502
00:27:18.307 --> 00:27:21.867
would then qualify for vision through FEDVIP, but they

503
00:27:21.867 --> 00:27:24.897
don't qualify for dental, because they still have access to TRICARE

504
00:27:24.897 --> 00:27:28.307
Dental Program. So, you can use this chart to see whether you

505
00:27:28.307 --> 00:27:31.867
qualify for FEDVIP, and then, once you need more information on

506
00:27:31.867 --> 00:27:34.417
on how to enroll, go to the Benefeds website.

507
00:27:35.457 --> 00:27:36.457
Next slide, please.

508
00:27:37.977 --> 00:27:41.387
So, this is contact information for our TRICARE

509
00:27:41.387 --> 00:27:46.507
contractors. They can also help you understand enrollment. And

510
00:27:46.507 --> 00:27:50.317
remember that if your question is about eligibility specifically, those

511
00:27:50.317 --> 00:27:54.107
should be directed to your uniformed services personnel offices.

512
00:27:54.107 --> 00:27:57.347
If you have questions about FEDVIP, dental or vision, those

513
00:27:57.347 --> 00:28:00.537
questions should be directed to the Federal Benefits staff and you can see

514
00:28:00.537 --> 00:28:03.417
benefeds.gov for all of their contact information.

515
00:28:04.017 --> 00:28:05.017
Next slide, please.

516
00:28:07.897 --> 00:28:10.987
So, as we round this out, first I would like to share some

517
00:28:10.987 --> 00:28:14.107
materials in the TRICARE Publications library that you might

518
00:28:14.107 --> 00:28:17.387
find helpful during open season. The TRICARE Choices in the

519
00:28:17.387 --> 00:28:20.827
United States Handbook and the TRICARE Overseas Program Handbook

520
00:28:20.827 --> 00:28:24.067
both have useful information about your TRICARE options based on where

521
00:28:24.067 --> 00:28:27.227
you live. You can also check out the TRICARE Plans

522
00:28:27.227 --> 00:28:30.507
Overview Fact Sheet, which summarizes a lot of the information we've

523
00:28:30.507 --> 00:28:33.907
discussed today, and even more information about TRICARE

524
00:28:33.907 --> 00:28:37.187
Prime and TRICARE Select. You can download these handbooks, the fact

525
00:28:37.187 --> 00:28:38.257
sheet and other helpful resources

526
00:28:38.567 --> 00:28:41.577
by going to tricare.mil/publications.

527
00:28:41.577 --> 00:28:44.777
When you're using these resources or

528
00:28:44.777 --> 00:28:47.847
other online tools to help you as you

529
00:28:47.847 --> 00:28:51.177
manage your open season research, you may notice references

530
00:28:51.177 --> 00:28:55.297
to Group A and to Group B for the purposes of enrollment fees,

531
00:28:55.297 --> 00:28:58.577
cost-sharing, deductibles, and catastrophic caps. TRICARE Prime and

532
00:28:58.577 --> 00:29:02.777
TRICARE Select are classified into one of these two groups. They're

533
00:29:02.777 --> 00:29:05.447
generally based on the sponsor's date of initial service.

534
00:29:06.217 --> 00:29:08.497
Before Jan. 1, 2018 is Group A

535
00:29:09.167 --> 00:29:12.777
and after Jan. 1, 2018 is Group

536
00:29:12.777 --> 00:29:15.967
B. You just need to take note of that and use that information as you

537
00:29:15.967 --> 00:29:19.127
navigate these tools. If you're a surviving family member

538
00:29:19.127 --> 00:29:22.377
or you are medically retired, there are cost considerations that are

539
00:29:22.377 --> 00:29:26.097
specific to you and that you'll discover as you're using our various

540
00:29:26.097 --> 00:29:29.307
tools. For example, if your sponsor was Group A, which

541
00:29:29.307 --> 00:29:32.337
means that initial service date before Jan. 1 of 2018, you

542
00:29:32.337 --> 00:29:35.537
do not pay TRICARE Select enrollment fees.

543
00:29:35.537 --> 00:29:35.967
Next slide, please.

544
00:29:37.977 --> 00:29:41.217
I want to remind you that there are many ways to stay up to date with

545
00:29:41.217 --> 00:29:41.537
TRICARE.

546
00:29:41.847 --> 00:29:45.057
If you're looking for more information about the 2025

547
00:29:45.057 --> 00:29:48.297
region changes, I encourage you to check out tricare.mil/changes,

548
00:29:48.297 --> 00:29:51.497
and if you're looking for more information about

549
00:29:51.497 --> 00:29:54.697
open season, be sure to check out tricare.mil/openseason.

550
00:29:54.697 --> 00:29:58.327
You can visit newsroom.tricare.mil

551
00:29:58.327 --> 00:30:01.417
to see the latest articles and news about region changes,

552
00:30:01.417 --> 00:30:04.737
open season, and other information about your TRICARE benefit.

553
00:30:04.737 --> 00:30:07.857
You can go to tricare.mil/subscriptions

554
00:30:07.897 --> 00:30:10.377
to subscribe to benefit update emails and newsletters.

555
00:30:11.047 --> 00:30:14.527
As a reminder, you can find this information by

556
00:30:14.527 --> 00:30:17.857
going to tricare.mil/webinars and downloading a copy of

557
00:30:17.857 --> 00:30:21.057
this presentation, and you can also follow tricare.mil

558
00:30:21.057 --> 00:30:24.647
on social media at any of these "Connect With

559
00:30:24.647 --> 00:30:27.747
Us" spots that you see on this next slide. So

560
00:30:27.747 --> 00:30:30.827
now, I will hand things back over to Calvin to start

561
00:30:30.827 --> 00:30:34.027
our Q & A session. 

562
00:30:34.027 --> 00:30:37.657
KELLER:
All right, thank you, Zelly. A lot of important information for everyone

563
00:30:37.657 --> 00:30:38.247
to take heed to.

564
00:30:39.057 --> 00:30:42.457
So, we've already received many questions during

565
00:30:42.457 --> 00:30:45.657
the presentation, but I do want to take a moment to quickly explain

566
00:30:45.887 --> 00:30:49.447
how to submit a question, First, click

567
00:30:49.447 --> 00:30:52.527
the speech bubble icon at the top of the Q & A

568
00:30:52.527 --> 00:30:56.257
pane. Then click the My Questions tab and

569
00:30:56.257 --> 00:30:59.377
enter your question into the Ask A

570
00:30:59.377 --> 00:31:02.657
Question box. We are going to try to get to

571
00:31:02.657 --> 00:31:05.857
as many of your questions as we can

572
00:31:05.857 --> 00:31:09.967
today, so let's get started with our first question. My

573
00:31:09.967 --> 00:31:13.217
state is moving regions. Will this affect the

574
00:31:13.217 --> 00:31:15.207
referrals I have with TRICARE Prime?

575
00:31:16.257 --> 00:31:19.377
ZIM:
That's a good question. So, if your referral has

576
00:31:19.377 --> 00:31:22.017
already been authorized, then that means that

577
00:31:23.817 --> 00:31:27.097
you can keep that authorized referral as

578
00:31:27.097 --> 00:31:30.457
you change plans. So, referrals that have not already been authorized would

579
00:31:30.457 --> 00:31:33.657
need to be redone. If you live in the

580
00:31:33.657 --> 00:31:36.777
East Region, your scheduled care won't be affected, and

581
00:31:36.777 --> 00:31:40.017
then if you live in the West Region, TriWest will accept

582
00:31:40.017 --> 00:31:43.497
unexpired referrals and authorizations

583
00:31:43.497 --> 00:31:46.777
from Health Net that were issued before Jan. 1, 2025.

584
00:31:46.777 --> 00:31:49.977
Those will be valid through their expiration or

585
00:31:49.977 --> 00:31:50.617
through the middle of next year.

586
00:31:51.007 --> 00:31:54.297
You can also see tricare.mil/changes to understand

587
00:31:54.297 --> 00:31:57.657
a little bit more about how the referrals process

588
00:31:57.657 --> 00:32:02.367
nests with our changes for the 2025 contract.

589
00:32:02.367 --> 00:32:05.417
KELLER:
Let's go to question 2. So, what if my providers

590
00:32:05.417 --> 00:32:09.807
aren't in the new West Region network? Can I still see them?

591
00:32:09.807 --> 00:32:13.777
ZIM:
If you're enrolled in TRICARE Prime, you'll need an authorization

592
00:32:13.777 --> 00:32:16.857
prior to seeing them to avoid point

593
00:32:16.857 --> 00:32:20.057
of service costs. However, if you're enrolled in TRICARE Select, you can

594
00:32:20.057 --> 00:32:21.217
see any provider of your choice.

595
00:32:21.327 --> 00:32:24.897
But if they're not a TRICARE network provider, 

596
00:32:24.897 --> 00:32:28.337
your cost share will still be higher. So, this comes down to two

597
00:32:28.337 --> 00:32:31.377
things, whether you're in TRICARE Prime or you're in TRICARE Select, and then

598
00:32:31.377 --> 00:32:34.617
also looking at whether or not that person is in

599
00:32:34.617 --> 00:32:35.367
network or out of network.

600
00:32:37.217 --> 00:32:40.537
KELLER:
OK, So, what would I need to do if my

601
00:32:40.537 --> 00:32:44.217
primary care manager is no longer a network provider? 

602
00:32:44.217 --> 00:32:47.577
ZIM:
Yes, that's pretty similar to the previous question. So

603
00:32:47.577 --> 00:32:50.777
as a TRICARE Prime beneficiary with a PCM, or

604
00:32:50.777 --> 00:32:51.097
a primary care manager,

605
00:32:51.487 --> 00:32:54.497
you have two options if your PCM is no longer a network

606
00:32:54.497 --> 00:32:57.577
provider. You could switch your plan to TRICARE Select during

607
00:32:57.577 --> 00:33:00.817
open season and continue to see your provider but pay

608
00:33:00.817 --> 00:33:04.337
a higher out-of-pocket cost for seeing a non-network provider,

609
00:33:04.337 --> 00:33:08.257
or you could find a new network provider still within TRICARE Prime.

610
00:33:08.257 --> 00:33:12.297
Use the regional contractor's directory

611
00:33:12.297 --> 00:33:15.337
or contact your regional contractor for help with that. And if that's the

612
00:33:15.337 --> 00:33:18.537
case, you can also go look at our website,

613
00:33:18.537 --> 00:33:20.207
tricare.mil/east and tricare.mil/west,

614
00:33:21.097 --> 00:33:23.257
to do some research on providers.

615
00:33:24.007 --> 00:33:28.017
KELLER:
OK, excellent. Let's go to the next question.

616
00:33:28.017 --> 00:33:31.537
My family just moved to Illinois. If we need to

617
00:33:31.537 --> 00:33:34.817
change plans before next year, which contractor should we call?

618
00:33:34.817 --> 00:33:38.297
ZIM:
Tricky one. All right, so currently

619
00:33:38.297 --> 00:33:41.497
Illinois falls under the East Region, so you would

620
00:33:41.497 --> 00:33:44.697
need to contact Humana Military, the East Region contractor,

621
00:33:44.697 --> 00:33:47.937
to make any plan changes that take place before

622
00:33:47.937 --> 00:33:49.327
Jan. 1, 2025.

623
00:33:50.367 --> 00:33:53.607
KELLER:
All right, excellent. Next question:

624
00:33:53.607 --> 00:33:56.937
I'm retired from active duty. Can I use TRICARE

625
00:33:56.937 --> 00:33:59.987
Prime if I live overseas? 

626
00:33:59.987 --> 00:34:03.207
ZIM:
No, because TRICARE Prime Overseas is only available to active duty

627
00:34:03.207 --> 00:34:06.497
service members stationed overseas and their command-sponsored

628
00:34:06.497 --> 00:34:10.217
family members that are living together in non-remote overseas

629
00:34:10.217 --> 00:34:13.257
locations. So, if you retired from active duty and you're living

630
00:34:13.257 --> 00:34:16.777
overseas, your option is going to be TRICARE Select up

631
00:34:16.777 --> 00:34:20.017
until you become eligible for TRICARE For Life. And I would

632
00:34:20.017 --> 00:34:21.047
direct you to all the

633
00:34:21.127 --> 00:34:24.177
resources that we have for TFL that talk a little bit

634
00:34:24.177 --> 00:34:26.687
more about those interactions.

635
00:34:28.457 --> 00:34:31.977
KELLER:
Do my husband and kids all need to enroll in the same TRICARE plan?

636
00:34:31.977 --> 00:34:35.377
ZIM:
No, that's actually one of the things that's

637
00:34:35.377 --> 00:34:38.497
really great about the TRICARE health plans is that flexibility.

638
00:34:38.497 --> 00:34:42.057
All members of your family do not have to enroll in the same TRICARE

639
00:34:42.057 --> 00:34:45.217
plan, and split enrollment allows for some family members to be in

640
00:34:45.217 --> 00:34:48.737
one plan versus another, and that includes USFHP,

641
00:34:48.737 --> 00:34:51.977
but you would pay a single enrollment fee for the family

642
00:34:51.977 --> 00:34:52.737
if that applies.

643
00:34:53.007 --> 00:34:56.217
And that split enrollment feature, I just want to clarify, does

644
00:34:56.217 --> 00:34:59.617
not apply to TRICARE Young Adult plans. It's just

645
00:34:59.617 --> 00:35:04.297
for the TRICARE Prime, TRICARE Select, USFHP plans.

646
00:35:04.297 --> 00:35:07.377
KELLER:
OK, next question: Can you explain

647
00:35:07.377 --> 00:35:10.587
again what a QLE is?

648
00:35:10.587 --> 00:35:14.177
ZIM:
Absolutely. A QLE is a Qualifying Life Event, and it's a

649
00:35:14.177 --> 00:35:17.337
specific change in your life such as marriage, birth, or

650
00:35:17.337 --> 00:35:20.497
retirement that may mean that

651
00:35:20.497 --> 00:35:23.527
you have a different health plan option open to you.

652
00:35:23.807 --> 00:35:26.897
And it opens up a 90-day window for you

653
00:35:26.897 --> 00:35:29.987
to make those changes. And it's also important to remember

654
00:35:29.987 --> 00:35:33.057
that a QLE for one family member means a QLE

655
00:35:33.057 --> 00:35:36.257
for all family members. So, anyone in your family can make a change

656
00:35:36.257 --> 00:35:39.417
during that period. And you can visit our website if you

657
00:35:39.417 --> 00:35:42.977
go to tricare.mil/QLE,

658
00:35:42.977 --> 00:35:44.647
you can also find that information.

659
00:35:46.007 --> 00:35:49.137
KELLER:
Right. Next question: If we have

660
00:35:49.137 --> 00:35:52.937
TRICARE Prime and are happy and want no

661
00:35:52.937 --> 00:35:56.897
changes, do we need to do anything during open enrollment?

662
00:35:56.897 --> 00:36:00.047
Is there anything to be done with Express Scripts? 

663
00:36:00.047 --> 00:36:03.377
ZIM:
No. If you are happy with your plan, whether that's TRICARE Prime or any

664
00:36:03.377 --> 00:36:08.137
of the other ones, you do not need to take action during open enrollment if

665
00:36:08.137 --> 00:36:11.337
you're not living in an area where the regions are changing.

666
00:36:11.337 --> 00:36:14.497
So, if you are in an area that is now going to be in the

667
00:36:14.497 --> 00:36:16.367
West Region or you're with the West contractor,

668
00:36:16.847 --> 00:36:19.937
the changes that you need to make are just based off of

669
00:36:19.937 --> 00:36:23.177
the need to make sure that your allotment is set up, if that's how

670
00:36:23.177 --> 00:36:27.057
you're paying, or making sure that TriWest has your contact information. But

671
00:36:27.057 --> 00:36:30.217
in terms of your actual enrollment at which plan that you're

672
00:36:30.217 --> 00:36:33.497
in, you would be good to go there. The same goes for Express Scripts. There's no

673
00:36:33.497 --> 00:36:36.657
action that you need to take related to that

674
00:36:36.657 --> 00:36:39.807
going forward.

675
00:36:39.807 --> 00:36:43.347
KELLER:
OK, this next question is kind of long, so let me take a look at

676
00:36:43.347 --> 00:36:46.817
it. I have entered my banking information for the new

677
00:36:46.817 --> 00:36:47.327
TriWest contractor

678
00:36:47.447 --> 00:36:50.857
on Nov. 7 using the link provided

679
00:36:50.857 --> 00:36:54.267
on tricare.mil/west.

680
00:36:54.267 --> 00:36:57.827
I wanted to confirm that the information was successful, but

681
00:36:57.827 --> 00:37:01.017
when I try to sign into the above link, it says we can't seem

682
00:37:01.017 --> 00:37:04.097
to find your account. I confirmed that

683
00:37:04.097 --> 00:37:07.377
my email address is in DEERS. Is there a phone number

684
00:37:07.377 --> 00:37:10.407
I can call to verify that my payment information was updated

685
00:37:10.407 --> 00:37:12.807
into the new TRICARE contractor?

686
00:37:13.537 --> 00:37:16.977
ZIM:
Good question. I completely understand wanting that confirmation.

687
00:37:16.977 --> 00:37:20.097
You can reach out to TriWest at their number, which

688
00:37:20.097 --> 00:37:21.817
is 888-TRIWEST.

689
00:37:22.367 --> 00:37:25.377
And when

690
00:37:25.377 --> 00:37:28.617
you reach out to them, or if someone else has a similar question like this, but

691
00:37:28.617 --> 00:37:32.007
it's for one of the other contractors, if you go back up

692
00:37:32.007 --> 00:37:35.577
in our slides, you'll find the phone numbers for the various contractors

693
00:37:35.577 --> 00:37:39.887
if you need to verify this sort of information.

694
00:37:39.887 --> 00:37:43.147
KELLER:
OK, next question: Is there an app for TriWest?

695
00:37:45.657 --> 00:37:49.017
ZIM:
You can visit tricare.mil/west for a link

696
00:37:49.017 --> 00:37:52.217
to the West patient portal. They don't have an app per

697
00:37:52.217 --> 00:37:53.897
se, but that's their patient portal

698
00:37:54.047 --> 00:37:57.327
and you can go ahead and sign into it. The full

699
00:37:57.327 --> 00:38:07.447
address for that is TRICARE-bene.TriWest.com/signin,

700
00:38:07.447 --> 00:38:10.457
and you can also

701
00:38:10.457 --> 00:38:13.487
use that link to update your automatic payment information with TriWest.

702
00:38:15.257 --> 00:38:18.337
KELLER:
OK. Next question: Will my information

703
00:38:18.337 --> 00:38:21.897
on the Humana Military site transfer over, like EOBs

704
00:38:21.897 --> 00:38:22.897
and authorizations?

705
00:38:24.647 --> 00:38:28.047
ZIM:
For this one, you need to reach out to Humana Military to

706
00:38:28.047 --> 00:38:31.057
validate all that information, and they can be

707
00:38:31.057 --> 00:38:34.257
contacted at

708
00:38:34.257 --> 00:38:37.207
800-444-5445.

709
00:38:38.737 --> 00:38:42.097
KELLER:
OK, so now let's move over and change up some.

710
00:38:42.097 --> 00:38:45.167
Let's answer some questions about

711
00:38:45.167 --> 00:38:48.687
open season. Can you please confirm

712
00:38:48.687 --> 00:38:52.177
if open season is available for me? My husband

713
00:38:52.177 --> 00:38:55.487
is a Navy retiree.

714
00:38:55.487 --> 00:38:58.687
ZIM:
Yes. So, if you're a retiree or in

715
00:38:58.687 --> 00:39:01.887
the family of a retiree, open season is an option for you

716
00:39:01.887 --> 00:39:02.337
to make changes.

717
00:39:03.127 --> 00:39:06.247
The only nuance would be if that's a recent

718
00:39:06.247 --> 00:39:08.487
retirement and you also have a Qualifying Life Event

719
00:39:08.917 --> 00:39:11.967
that you could use concurrently. But you would

720
00:39:11.967 --> 00:39:15.087
have to use either open season to make the change or you

721
00:39:15.087 --> 00:39:18.327
can also use that QLE, but if he's been retired for a while, then

722
00:39:18.327 --> 00:39:21.567
absolutely you can use open season to make changes that are

723
00:39:21.567 --> 00:39:25.007
effective Jan. 1, 2025.

724
00:39:25.007 --> 00:39:28.087
KELLER:
OK, so now, this next question is kind

725
00:39:28.087 --> 00:39:31.717
of three-part. So, the first part of it is: How

726
00:39:31.717 --> 00:39:35.237
often is open season offered? 

727
00:39:35.237 --> 00:39:36.357
ZIM:
Once a year, typically starting on

728
00:39:37.207 --> 00:39:40.887
Veterans Day, or close to it, so the second Monday in November 

729
00:39:41.317 --> 00:39:44.607
and then 30 days from there, so through the

730
00:39:44.607 --> 00:39:47.807
beginning of December, so once a year.

731
00:39:47.807 --> 00:39:50.967
KELLER:
OK, so next year, it will follow along that same time period,

732
00:39:50.967 --> 00:39:54.057
correct? 
ZIM:
Yes.

733
00:39:54.057 --> 00:39:57.327
KELLER:
OK, staying with this question, will the rates go up between this

734
00:39:57.327 --> 00:40:02.157
open season and the next open season? 

735
00:40:02.157 --> 00:40:05.367
ZIM:
Good question. So, one of the things that we're very proud of is how low the TRICARE rates are

736
00:40:05.367 --> 00:40:08.607
in general, but in terms of year over year,

737
00:40:08.607 --> 00:40:11.807
there are increases to TRICARE health plan, but those are tied

738
00:40:11.807 --> 00:40:12.557
directly to the

739
00:40:12.677 --> 00:40:15.687
cost of living adjustment for our retirees.

740
00:40:15.687 --> 00:40:18.927
So, there are statutory requirements for how the rates

741
00:40:18.927 --> 00:40:22.407
go up, and those are minimized as much as possible.

742
00:40:22.407 --> 00:40:25.567
So, you will see, one thing you could do now is look at the 2024

743
00:40:25.567 --> 00:40:29.327
rates and look at the 2025 rates and that'll give you an

744
00:40:29.327 --> 00:40:32.647
idea generally of how they go up from year to year or

745
00:40:32.647 --> 00:40:35.767
throughout the year. You can watch how the COLA

746
00:40:35.767 --> 00:40:39.047
is progressing, or the cost of living adjustment is progressing, to kind of get

747
00:40:39.047 --> 00:40:41.317
an idea of where rates might be for the following year.

748
00:40:42.587 --> 00:40:46.167
KELLER:
All right, so the next question:

749
00:40:46.167 --> 00:40:49.647
I understand that open season does not apply to

750
00:40:49.647 --> 00:40:52.887
TRICARE For Life members. Does the change of

751
00:40:52.887 --> 00:40:54.987
regions apply to TRICARE For Life members?

752
00:41:00.717 --> 00:41:05.927
ZIM:
So, the change of regions is primarily for

753
00:41:05.927 --> 00:41:09.207
issuing of TRICARE Prime and TRICARE Select enrollments, so that

754
00:41:09.207 --> 00:41:12.327
would not apply for TRICARE For Life members.

755
00:41:12.327 --> 00:41:15.567
Your TRICARE For Life eligibility is based on your Medicare eligibility,

756
00:41:15.567 --> 00:41:18.767
so that's an entirely different timeline than what we're talking about in

757
00:41:18.767 --> 00:41:21.967
this presentation. One thing I would say is important

758
00:41:21.967 --> 00:41:25.487
to look into, of course, is whether or not your payment

759
00:41:25.487 --> 00:41:28.767
information is up to date with Medicare, but for TRICARE

760
00:41:28.767 --> 00:41:31.397
For Life, you're not paying anything to the TRICARE enrollment

761
00:41:31.477 --> 00:41:34.807
contractors beyond cost-shares and things of that

762
00:41:34.807 --> 00:41:38.927
nature. So, make sure to look into the

763
00:41:38.927 --> 00:41:42.367
literature and other webinars that we

764
00:41:42.367 --> 00:41:46.207
have related to TRICARE For Life for more information on

765
00:41:46.207 --> 00:41:46.237
that, OK?

766
00:41:48.237 --> 00:41:51.607
KELLER:
Another move. So, I'm moving from California

767
00:41:51.607 --> 00:41:55.007
to New York City, but not until next

768
00:41:55.007 --> 00:41:59.177
year. Do I need to make any changes to my TRICARE Prime coverage now?

769
00:41:59.177 --> 00:42:02.207
ZIM:
No. Once you move, that'll be a Qualifying Life Event. And you can

770
00:42:02.207 --> 00:42:05.967
use that Qualifying Life Event as a special enrollment period to

771
00:42:05.967 --> 00:42:07.237
make any changes that you need.

772
00:42:09.687 --> 00:42:12.967
KELLER:
So, this next question is similar to the

773
00:42:12.967 --> 00:42:16.087
last one. If we're moving halfway through

774
00:42:16.087 --> 00:42:18.887
the year and it moves us from West to East,

775
00:42:19.637 --> 00:42:22.647
can we change plans, or are we stuck

776
00:42:22.647 --> 00:42:26.407
with either TRICARE Prime or TRICARE Select after we move to a new area?

777
00:42:26.407 --> 00:42:29.727
ZIM:
Yeah, good question. So, I'd really encourage you to look

778
00:42:29.727 --> 00:42:32.927
at our webinar about Qualifying Life Events to understand

779
00:42:32.927 --> 00:42:36.087
all of those. But moving is one of our Qualifying Life Events.

780
00:42:36.087 --> 00:42:39.367
So, that's something that opens one of those 90-day

781
00:42:39.367 --> 00:42:42.527
windows for you to make a change. So, if you're moving

782
00:42:42.527 --> 00:42:45.767
next year, or you're moving in the future from one

783
00:42:45.767 --> 00:42:49.727
place to another, whether those are within the same region,

784
00:42:49.727 --> 00:42:50.317
or across various regions, or

785
00:42:50.397 --> 00:42:53.687
moving overseas, those are all opportunities that you

786
00:42:53.687 --> 00:42:55.757
have to change your plan, so you're not stuck.

787
00:42:57.527 --> 00:43:00.647
KELLER:
OK. Next question:

788
00:43:00.647 --> 00:43:03.847
What is the reason for moving some states

789
00:43:03.847 --> 00:43:05.287
to the West from the East?

790
00:43:06.877 --> 00:43:10.087
ZIM:
So, one of the major regions for this is

791
00:43:10.087 --> 00:43:13.127
just to align our two contracts a little bit more closely. We had

792
00:43:13.127 --> 00:43:16.247
a lot more beneficiaries in the East Region than in

793
00:43:16.247 --> 00:43:19.727
the West Region, and that made it so that between the two contracts,

794
00:43:19.727 --> 00:43:23.647
one was more burdened than the other. And we're hoping that, and

795
00:43:23.647 --> 00:43:26.807
what we've seen with the analysis of that change,

796
00:43:26.807 --> 00:43:30.047
is that we'll be able to provide a more robust

797
00:43:30.047 --> 00:43:33.167
network when those two contracts are more equally aligned. So, though

798
00:43:33.167 --> 00:43:35.917
the West Region looks like it's much bigger geographically,

799
00:43:36.077 --> 00:43:39.327
in terms of number of beneficiaries on either

800
00:43:39.327 --> 00:43:42.727
side, that is much more even than where we were under our

801
00:43:42.727 --> 00:43:46.047
current contracts. But good question.

802
00:43:46.047 --> 00:43:49.167
KELLER:
OK, next question: Do I need to re-enroll in

803
00:43:49.167 --> 00:43:52.407
TRICARE Prime due to the East

804
00:43:52.407 --> 00:43:55.647
moving to the West? 

805
00:43:55.647 --> 00:43:59.087
ZIM: 
It depends on where you live. If you live in one of those areas that's moving--so we mentioned

806
00:43:59.087 --> 00:44:02.317
six states, but you can go on our website to specifically look at your

807
00:44:02.317 --> 00:44:05.607
specific area--then you do need to update your payment

808
00:44:05.607 --> 00:44:05.967
information.

809
00:44:06.397 --> 00:44:09.487
But you could stay in TRICARE Prime, you just have to make

810
00:44:09.487 --> 00:44:12.927
sure that payment information is up to date, because of course, if your payment

811
00:44:12.927 --> 00:44:16.047
information is not up to date, then you run the risk of having a

812
00:44:16.047 --> 00:44:20.607
failure to pay on your account, which would put your enrollment in

813
00:44:20.607 --> 00:44:23.807
jeopardy. So, we don't want that. So, making sure that you

814
00:44:23.807 --> 00:44:27.247
look at where you are in relationship to those states

815
00:44:27.247 --> 00:44:30.037
moving and then take the appropriate action.

816
00:44:31.127 --> 00:44:34.247
KELLER:
Next question: My TRICARE Prime is

817
00:44:34.247 --> 00:44:37.767
paid for by a direct disbursement from my Air Force

818
00:44:37.767 --> 00:44:38.367
retirement check,

819
00:44:38.957 --> 00:44:41.997
and yet the payment set-up request form does

820
00:44:41.997 --> 00:44:44.797
not seem to have that as an option. Why?

821
00:44:46.487 --> 00:44:49.927
ZIM:
So, if you're paying directly by allotment, you

822
00:44:49.927 --> 00:44:53.767
shouldn't need to make any changes as

823
00:44:53.767 --> 00:44:56.967
we change the regions and as we move some of the states over to

824
00:44:56.967 --> 00:45:00.167
the West Region. And so that might be why you're not seeing it

825
00:45:00.167 --> 00:45:03.367
as an option, but I would encourage you to reach out to your regional

826
00:45:03.367 --> 00:45:06.447
contractor just to make sure that your payment information

827
00:45:06.447 --> 00:45:09.767
is up to date and has the allotment as

828
00:45:09.767 --> 00:45:11.687
you intend it to be from your retired pay.

829
00:45:13.497 --> 00:45:17.607
KELLER:
All right, so we have a couple questions about TRICARE

830
00:45:17.607 --> 00:45:20.927
Select. With TRICARE Select, what happens if there are not

831
00:45:20.927 --> 00:45:23.017
participating providers in our area?

832
00:45:24.967 --> 00:45:28.647
ZIM:
So, I would first

833
00:45:28.647 --> 00:45:32.127
ask you to make sure and to double check on the website, and

834
00:45:32.127 --> 00:45:35.967
then after you do that, you can also reach out to the contractor,

835
00:45:35.967 --> 00:45:39.047
whether that's in the East or in the

836
00:45:39.047 --> 00:45:42.727
West, to get some information on what providers may be available just in case

837
00:45:42.727 --> 00:45:45.847
there is information that's not up to date. But then if you don't see any

838
00:45:45.847 --> 00:45:46.647
participating providers,

839
00:45:46.797 --> 00:45:50.447
then you would be given authorization to see other providers

840
00:45:50.447 --> 00:45:53.897
in the area and with TRICARE Select, there would

841
00:45:53.897 --> 00:45:57.447
be flexibility for that, though it would be at a higher cost.

842
00:45:57.447 --> 00:46:00.647
KELLER:
OK, and of course dependents can use

843
00:46:00.647 --> 00:46:05.127
TRICARE Select, correct? 
ZIM:
Yes. 

844
00:46:05.127 --> 00:46:08.677
KELLER:
Next one: Are you going to talk about TRICARE Standard?

845
00:46:08.677 --> 00:46:11.767
ZIM:
I'd love to talk about TRICARE Standard. So, TRICARE Standard

846
00:46:11.767 --> 00:46:15.407
no longer exists. That's a change as of 2018.

847
00:46:15.407 --> 00:46:17.437
So, what replaced TRICARE Standard is the

848
00:46:17.517 --> 00:46:21.087
structure that we have now with open season, with QLEs, 

849
00:46:21.087 --> 00:46:24.407
with TRICARE Prime and TRICARE Select. So, great question, not much to say

850
00:46:24.407 --> 00:46:27.757
about it, but good question in terms

851
00:46:27.757 --> 00:46:31.087
of a baseline for what TRICARE plans are offered.

852
00:46:31.087 --> 00:46:34.767
Now we have both TRICARE Prime and TRICARE Select and the differences between those.

853
00:46:34.767 --> 00:46:37.967
KELLER:
All right, so let's look at a couple US Family

854
00:46:37.967 --> 00:46:38.557
Health Plan questions.

855
00:46:41.447 --> 00:46:44.127


856
00:46:46.597 --> 00:46:49.607
Is TriWest automatic payment

857
00:46:49.607 --> 00:46:52.797
connected with USFHP or is USFHP

858
00:46:52.797 --> 00:46:56.017
a separate entity?

859
00:46:56.017 --> 00:47:00.037
ZIM:
USFHP is a separate entity, so though they're offering

860
00:47:00.037 --> 00:47:03.127
a plan that's similar to TRICARE Prime, it's a

861
00:47:03.127 --> 00:47:06.287
separate entity and you would do all of your payment

862
00:47:06.287 --> 00:47:09.407
information through their designated providers. And you can go

863
00:47:09.407 --> 00:47:12.447
to our website tricare.mil/USFHP,

864
00:47:12.447 --> 00:47:15.647
for more information on how to contact those individuals.

865
00:47:15.647 --> 00:47:15.997
And then

866
00:47:16.757 --> 00:47:19.767
our contact slide in this deck,

867
00:47:19.767 --> 00:47:25.807
as well, has the USFHP contact information.

868
00:47:25.807 --> 00:47:30.167
KELLER:
OK, now do I have to enroll

869
00:47:30.167 --> 00:47:33.367
or to them who's asking the questions, Zelly, do I have

870
00:47:33.367 --> 00:47:37.287
to enroll in TRICARE Dental during open enrollment?

871
00:47:37.287 --> 00:47:40.797
I have USFHP, if that matters.

872
00:47:40.797 --> 00:47:44.407
ZIM:
So, another consideration there would be whether or not you're an active duty

873
00:47:44.407 --> 00:47:44.807
family member.

874
00:47:44.957 --> 00:47:48.207
But if you're not an active duty family

875
00:47:48.207 --> 00:47:48.357
member, then

876
00:47:50.087 --> 00:47:53.407
you don't have to take action for

877
00:47:53.407 --> 00:47:57.047
TRICARE Dental, because TRICARE Dental would not be an option for

878
00:47:57.047 --> 00:48:00.887
non-active duty family members. But remember that the dental

879
00:48:00.887 --> 00:48:04.247
options are through FEDVIP, so any information that you need about

880
00:48:04.247 --> 00:48:07.287
that is on the Benefeds

881
00:48:07.287 --> 00:48:10.327
website and their open season is also open now. So, if you're

882
00:48:10.327 --> 00:48:13.367
looking for dental coverage, then you want to go to FEDVIP

883
00:48:13.367 --> 00:48:15.487
and also go back in our slides to look at

884
00:48:16.117 --> 00:48:19.397
where we talked about what you're eligible for on the TRICARE side

885
00:48:19.397 --> 00:48:22.717
and then what your eligibility looks like for dental and vision coverage.

886
00:48:22.717 --> 00:48:26.407
That slide can also be helpful to you as you're looking at what

887
00:48:26.407 --> 00:48:30.767
you need to do next.

888
00:48:30.767 --> 00:48:33.807
KELLER:
OK, this next question is rather long. I live in

889
00:48:33.807 --> 00:48:37.127
Washington state and my family has been receiving

890
00:48:37.127 --> 00:48:40.807
their medical care from civilian network providers since we live

891
00:48:40.807 --> 00:48:41.517
pretty far from Madigan.

892
00:48:42.517 --> 00:48:46.037
We just received a letter from my provider the

893
00:48:46.037 --> 00:48:49.677
other day, stating they are going to be out of network with TRICARE

894
00:48:49.677 --> 00:48:52.917
patients starting Jan. 1, 2025,

895
00:48:52.917 --> 00:48:56.077
and that our only options are

896
00:48:56.077 --> 00:48:57.877
to either enroll with another civilian

897
00:48:59.877 --> 00:49:03.317
hospital that accepts TRICARE, or to enroll

898
00:49:03.317 --> 00:49:06.517
into the USFHP plan. If we end up

899
00:49:06.517 --> 00:49:09.997
going with the USFHP plan, do we need to

900
00:49:09.997 --> 00:49:13.197
set up automatic payment with TriWest by the Dec. 31

901
00:49:13.707 --> 00:49:14.507
deadline?

902
00:49:16.157 --> 00:49:19.437
ZIM:
Lots of background, easy question, thankfully.

903
00:49:19.437 --> 00:49:22.477
So, if you're going to go with USFHP as an option, then all of your

904
00:49:22.477 --> 00:49:25.517
payments are going to be through them and the designated providers, as

905
00:49:25.517 --> 00:49:28.557
I responded to for one of the other questions. So, I would also refer

906
00:49:28.557 --> 00:49:31.597
you to their contact information that's in our slide deck

907
00:49:31.597 --> 00:49:34.637
and then also to the tricare.mil/USFHP.

908
00:49:34.637 --> 00:49:37.837
So, the information that we

909
00:49:37.837 --> 00:49:41.157
gave during today's webinar about setting

910
00:49:41.157 --> 00:49:44.197
up automatic payments or other payment options with TriWest

911
00:49:44.197 --> 00:49:46.197
versus Humana Military, that's dependent on

912
00:49:46.387 --> 00:49:49.547
those contractors

913
00:49:49.547 --> 00:49:52.797
being your regional contractor. So, if you're not going with a plan

914
00:49:52.797 --> 00:49:55.877
that they're the ones who are the enrollment contractors, then you need

915
00:49:55.877 --> 00:49:56.227
to go with

916
00:49:57.997 --> 00:50:01.037
checking your payment information with the appropriate

917
00:50:01.037 --> 00:50:04.277
entity--so that could be USFHP-designated

918
00:50:04.277 --> 00:50:07.517
providers and working through them, or if you are TRICARE

919
00:50:07.517 --> 00:50:10.717
For Life patient, that could be going

920
00:50:10.717 --> 00:50:13.957
through Medicare to make sure that everything is good on that end. 

921
00:50:16.587 --> 00:50:20.077
KELLER:
If switching from TRICARE Prime to TRICARE

922
00:50:20.077 --> 00:50:23.317
Select for active duty family members, is it possible to

923
00:50:23.317 --> 00:50:26.507
switch only one child or will the switch apply to all dependents?

924
00:50:26.507 --> 00:50:29.757
ZIM:
Good question. So, I mentioned this a little bit. So

925
00:50:29.757 --> 00:50:32.877
we do have split enrollment, which means that

926
00:50:32.877 --> 00:50:36.157
each person in your family can be in a different plan. So, if you switched

927
00:50:36.157 --> 00:50:39.317
one of your children, then it doesn't necessarily apply

928
00:50:39.317 --> 00:50:42.597
to the other children. You can have them in different plans just based

929
00:50:42.597 --> 00:50:44.227
off of the needs for your family.

930
00:50:45.487 --> 00:50:48.797
KELLER:
OK, so let's

931
00:50:48.797 --> 00:50:52.927
see here. This is a good one: I just wanted to clarify: I

932
00:50:52.927 --> 00:50:56.157
live in Arkansas and I will go from East

933
00:50:56.157 --> 00:50:59.407
to West. I have an allotment

934
00:50:59.407 --> 00:51:02.517
for my retirement pay. I will need to start another

935
00:51:02.517 --> 00:51:05.757
allotment for the West, but shouldn't cancel my East

936
00:51:05.757 --> 00:51:08.807
allotment. Will I get reimbursed

937
00:51:08.807 --> 00:51:09.327
once West starts?

938
00:51:10.077 --> 00:51:13.317
ZIM:
The direction not to

939
00:51:13.317 --> 00:51:16.517
cancel was just to not cancel it before Dec.

940
00:51:16.517 --> 00:51:17.797
31, 2024.

941
00:51:18.467 --> 00:51:22.077
So, you should not have an overlap where

942
00:51:22.077 --> 00:51:25.277
you have two allotments that are being pulled from your

943
00:51:25.277 --> 00:51:28.507
account, so that should alleviate

944
00:51:28.507 --> 00:51:32.387
that. There's not going to

945
00:51:32.387 --> 00:51:35.517
be an allotment that gets pulled from both the East contractor and the West

946
00:51:35.517 --> 00:51:38.627
contractor. So, you have that was I did

947
00:51:38.627 --> 00:51:41.837
mention in passing, and I would like to reiterate that here too, is

948
00:51:41.837 --> 00:51:45.717
allotment is the payment option that is the least hassle because in

949
00:51:45.717 --> 00:51:49.067
a situation like this, where we are transferring contractors or where states are

950
00:51:49.187 --> 00:51:52.477
moving, you don't need to change anything about your

951
00:51:52.477 --> 00:51:55.957
allotment with the end of the year coming up.

952
00:51:55.957 --> 00:51:59.237
So, no need for a reimbursement, no need to cancel your allotment, no need

953
00:51:59.237 --> 00:52:03.637
to change anything with your allotment. If you're paying by allotment, you are good to go.

954
00:52:03.637 --> 00:52:06.827
KELLER:
OK, excellent. So, next question

955
00:52:06.827 --> 00:52:10.397
is: As retired military, how do I sign up for the dental

956
00:52:10.397 --> 00:52:14.277
and vision coverage during open season benefits?

957
00:52:14.277 --> 00:52:17.477
ZIM:
So, we mentioned that FEDVIP is

958
00:52:17.477 --> 00:52:19.827
managed by the U.S. Office of Personnel Management and so,

959
00:52:19.907 --> 00:52:22.917
as a retiree,

960
00:52:22.917 --> 00:52:26.487
you do have options through them for dental and vision.

961
00:52:26.487 --> 00:52:29.637
So, I would direct you to their website, and as I mentioned before, their open season

962
00:52:29.637 --> 00:52:32.797
is open right now and then it does end on Dec. 9. So, you

963
00:52:32.797 --> 00:52:36.037
have several more weeks to make  some changes there and

964
00:52:36.037 --> 00:52:40.027
to look at your various options. 

965
00:52:40.027 --> 00:52:42.427
KELLER:
The next question, I think, is a good one.

966
00:52:43.867 --> 00:52:47.067
Between TRICARE Prime and TRICARE

967
00:52:47.067 --> 00:52:50.317
Select as a retiree, so I'm

968
00:52:50.317 --> 00:52:51.427
using other health insurance.

969
00:52:53.237 --> 00:52:56.277
Is there a big difference? 

970
00:52:56.277 --> 00:52:59.437
ZIM:
Not really. So, other health insurance, or OHI,

971
00:52:59.437 --> 00:53:02.677
is always going to be a primary payer.

972
00:53:02.677 --> 00:53:05.877
So, that means that if you receive

973
00:53:05.877 --> 00:53:09.077
care that is covered under your other health insurance and

974
00:53:09.077 --> 00:53:12.277
it's also covered under TRICARE, the other health insurance

975
00:53:12.277 --> 00:53:15.477
will pay first and then TRICARE will pay

976
00:53:15.477 --> 00:53:15.717
secondarily.

977
00:53:16.707 --> 00:53:20.117
The difference would just really be what

978
00:53:20.117 --> 00:53:23.277
your other health insurance is, but

979
00:53:23.277 --> 00:53:26.637
there's not really a difference between TRICARE Prime and TRICARE Select in that specific

980
00:53:26.637 --> 00:53:29.797
situation. The difference to look at between TRICARE Prime and TRICARE Select

981
00:53:29.797 --> 00:53:33.477
would be based off of where you live and

982
00:53:33.477 --> 00:53:36.807
whether you want to have a primary care manager or if you're

983
00:53:36.807 --> 00:53:40.037
choosing to go see specialists and manage your

984
00:53:40.037 --> 00:53:43.317
care on your own, without that need for a referral and getting that

985
00:53:43.317 --> 00:53:44.947
referral authorized. It's a good question.

986
00:53:45.547 --> 00:53:49.237
KELLER:
OK, so the

987
00:53:49.237 --> 00:53:52.277
next two questions kind of run 

988
00:53:52.277 --> 00:53:54.787
hand-in-hand. With the new contractor,

989
00:53:56.957 --> 00:54:00.277
will I need to get new referrals for my

990
00:54:00.277 --> 00:54:03.477
wife's four specialists, and if we

991
00:54:03.477 --> 00:54:06.997
currently have a referral to a doctor, will the West honor

992
00:54:06.997 --> 00:54:10.037
that until the referral expiration date? 

993
00:54:10.037 --> 00:54:13.677
ZIM:
Good questions. I'll answer the second one first, so if you

994
00:54:13.677 --> 00:54:16.917
have a current referral that's already been authorized and it has an expiration,

995
00:54:19.267 --> 00:54:22.477
it's good through that expiration date as long

996
00:54:22.477 --> 00:54:25.677
as that expiration date goes through June

997
00:54:25.677 --> 00:54:29.157
of next year. So, the other question

998
00:54:29.157 --> 00:54:32.627
about whether you need to get new referrals for your spouse

999
00:54:32.627 --> 00:54:35.717
for their specialists: if those referrals are already

1000
00:54:35.717 --> 00:54:38.837
authorized, those will transition over.

1001
00:54:38.837 --> 00:54:42.077
But if they are not yet authorized referrals,

1002
00:54:42.077 --> 00:54:45.877
then you will need to get new referrals

1003
00:54:45.877 --> 00:54:46.867
with the contract change.

1004
00:54:47.987 --> 00:54:51.437
KELLER:
OK, so I think this is going to be the

1005
00:54:51.437 --> 00:54:54.787
last question. Are we able to get a copy of the slides from this brief?

1006
00:54:54.787 --> 00:54:57.867
ZIM:
Absolutely. So, the slide

1007
00:54:57.867 --> 00:55:01.077
deck is going to be posted, or I think it has

1008
00:55:01.077 --> 00:55:04.157
been posted, yes, 

1009
00:55:04.157 --> 00:55:07.267
tricare.mil/webinars, and as you go to that

1010
00:55:07.267 --> 00:55:10.597
to that page, I'd just like to also encourage you to look

1011
00:55:10.597 --> 00:55:13.727
at the various other webinars and slide decks that are up there,

1012
00:55:13.727 --> 00:55:17.867
because those will address a lot of the other questions we received today about retirement,

1013
00:55:17.867 --> 00:55:18.467
about QLEs, about

1014
00:55:18.627 --> 00:55:21.867
TRICARE For Life.

1015
00:55:21.867 --> 00:55:25.607
We have a lot of great resources there for you and a lot of those also

1016
00:55:25.607 --> 00:55:28.677
have Q & A portions at the end of those various webinars that you

1017
00:55:28.677 --> 00:55:31.757
can look at and see if your questions are answered. But of course, you

1018
00:55:31.757 --> 00:55:35.077
can also always reach out to the contractors

1019
00:55:35.077 --> 00:55:39.437
to get more information about your enrollment options.

1020
00:55:39.437 --> 00:55:42.957
KELLER:
All right, Zelly, a lot of information

1021
00:55:42.957 --> 00:55:46.507
that you covered today, so allow me to just touch up

1022
00:55:46.507 --> 00:55:48.237
on three important facts. #1.

1023
00:55:48.787 --> 00:55:52.907
Could you just once again recap DEERS? 

1024
00:55:52.907 --> 00:55:56.407
ZIM:
Yes.

1025
00:55:56.407 --> 00:55:59.787
So, I absolutely would like to encourage everyone to review

1026
00:55:59.787 --> 00:56:02.957
DEERS for accuracy and make sure that all of your information

1027
00:56:02.957 --> 00:56:05.997
is up to date, especially if you're in one of those states

1028
00:56:05.997 --> 00:56:09.237
that's transitioning to the West Region. But

1029
00:56:09.237 --> 00:56:12.517
in general, it's important to make sure all of your information is up to date there, because

1030
00:56:12.517 --> 00:56:16.037
that's where we find out

1031
00:56:16.037 --> 00:56:19.027
everything about your eligibility, who's in your family, when they were born,

1032
00:56:19.147 --> 00:56:22.757
And all of that stuff. And so we need to make sure that

1033
00:56:22.757 --> 00:56:25.107
all that information is accurate, to include your address.

1034
00:56:26.837 --> 00:56:29.957
KELLER:
OK, the next question I have is with

1035
00:56:29.957 --> 00:56:33.157
respect to the upcoming

1036
00:56:33.157 --> 00:56:36.677
transition starting Jan. 1. What's the last

1037
00:56:36.677 --> 00:56:40.077
date that I can update my payment method

1038
00:56:40.077 --> 00:56:42.757
if I'm moving from the East to the West Region?

1039
00:56:44.717 --> 00:56:47.797
ZIM:
So, the last date to do that would be the last day of this

1040
00:56:47.797 --> 00:56:48.797
year, so Dec. 31.

1041
00:56:49.387 --> 00:56:52.597
But I would encourage you to do it much sooner so that you don't have to

1042
00:56:52.597 --> 00:56:56.037
worry about whether or not that 11:59 change that

1043
00:56:56.037 --> 00:56:59.317
you made on Dec. 31 goes through. 

1044
00:56:59.317 --> 00:57:03.117
KELLER:
And lastly, what are the dates again for open season?

1045
00:57:03.117 --> 00:57:06.357
Open season started this past Monday, Nov. 11, and goes

1046
00:57:06.357 --> 00:57:09.427
through Dec. 10. I just would like to also

1047
00:57:09.427 --> 00:57:12.917
reiterate that the FEDVIP, or the Federal Benefits

1048
00:57:12.917 --> 00:57:16.157
Open Season for dental and vision, goes only till

1049
00:57:16.157 --> 00:57:19.357
Dec. 9. So, we've got one extra day with

1050
00:57:19.357 --> 00:57:19.867
TRICARE Open Season.

1051
00:57:20.267 --> 00:57:23.317
But just make sure you look at those changes

1052
00:57:23.317 --> 00:57:24.387
here in the next couple of weeks.

1053
00:57:26.237 --> 00:57:29.557
KELLER:
Excellent. We want to thank you so much for taking

1054
00:57:29.557 --> 00:57:32.877
time and coming to share your knowledge and expertise with us today. And

1055
00:57:32.877 --> 00:57:36.157
I also want to thank all of you for participating in today's

1056
00:57:36.157 --> 00:57:39.597
webinar. If we did not answer

1057
00:57:39.597 --> 00:57:42.677
your question today, please refer to

1058
00:57:42.677 --> 00:57:45.877
tricare.mil and tricare.mil/FAQ,

1059
00:57:45.877 --> 00:57:49.317
where you will find a lot of the answers to the questions

1060
00:57:49.317 --> 00:57:52.917
that you have. As a reminder, you can download

1061
00:57:52.917 --> 00:57:56.077
slides from today's webinar on tricare.mil/webinars.

1062
00:57:56.507 --> 00:57:59.557
Also, keep an

1063
00:57:59.557 --> 00:58:02.877
eye on this page for a recording of this webinar,

1064
00:58:02.877 --> 00:58:06.227
which we'll post in the coming weeks. This concludes today's

1065
00:58:06.227 --> 00:58:09.317
webinar: "Get Ready for TRICARE Open Season

1066
00:58:09.317 --> 00:58:12.837
and 2025 Region Changes." Thank

1067
00:58:12.837 --> 00:58:13.907
you and have a great day.