TRICARE Prime Fees Changing

For most retirees enrolled in TRICARE Prime, the annual enrollment fee is rising.

BY BRIAN P. SMITH

It’s that time of year again. TRICARE Prime billing statements have gone out in the West Region. This year, enrollees will be seeing some new numbers in their statements. The individual and family annual enrollment fee rates are increasing.

 

 

Are my fees changing?

Yes, the fees are changing for most retiree TRICARE Prime enrollees. Fee-paying enrollees* were paying either (depending on the date of enrollment):

• $230 or $260 for individual coverage or
• $460 or $520 for a family coverage.

These enrollees will see their 2013 fiscal year enrollment rate change to $269.28 for individual or $538.56 for family beginning Oct. 1, 2012.

Going forward, a majority of the Prime enrollees could see fee increases at the beginning of each fiscal year. Two categories of retirees will have their rates “frozen.” Survivors of active duty deceased sponsors (following the 3-year Transitional Survivor period) and medically-retired service members will pay the same annual fee rate that was in effect the year they enrolled as fee-payers and were categorized as survivors or medically-retired. The freeze remains if Prime enrollment is not interrupted. Beneficiary status and category are recorded in the DEERS (Defense Enrollment Eligibility Reporting System) record.

The fees could change each fiscal year. TRICARE is reminding enrollees that you may have another enrollment fee increase later if new fees are included when Congress passes the final FY 2013 budget. If you don’t choose an automatic monthly payment option, it’s suggested you make quarterly payments. TRICARE.mil/Costs has more information.

*Do I pay fees? How much do I owe this year?

If you paid TRICARE Prime enrollment fees last year, and you’re still enrolled, you still owe fees. If you are recently enrolled in Prime as a retiree, you owe fees. You can always check your fees owed by logging into your secure account at TriWest.com.

What changes will I have to make?

As long as you make your payments by the due date on the statement, your TRICARE Prime enrollment continues. If you have signed up for automatic electronic payments through TriWest, you don’t have to change anything. Your payments will be automatically adjusted to the appropriate new amounts:

• monthly allotment from retired pay
• monthly electronic funds transfer from your checking or savings account
• monthly credit/debit card payment.

What if I disenroll?

You can choose to disenroll and use your TRICARE Standard coverage. You will have an annual deductible and out-of-pocket cost shares. As a retiree, you may voluntarily disenroll at the end of the enrollment year (September 30). If you enroll again, your coverage will not be continuous and will start either the month after you enroll or the month after that (based on the 20th of the month rule).

Prime enrollment fees are changing this year. Stay on top of your enrollment and help avoid any missed payments by signing up for automatic electronic payments through TriWest.