The civilian health care system isn’t the only one facing major changes under the Trump administration, whether by legislation or neglect.

The military will be looking at some pretty big changes too.

Federal News Radio reports that the Defense Department has issued new rules making significant changes to the health insurance system that serves military family members and retirees on Jan. 1.

The rules alter the structure and fees of benefit plans that, according to Defense Department health officials, will make care more accessible.

Possibly one of the biggest changes is open enrollment. Currently, TRICARE-eligible beneficiaries receive health benefits automatically, but that won’t be the case any longer.

Instead, with a few exceptions, family members and retirees who don’t sign up during the open enrollment period will lose coverage in TRICARE’s “purchased care” market for the following year.

While they would still be able to seek care in military-run hospitals and clinics, that would be only on a space-available basis.

Under the new rules, new beneficiaries will have to actively enroll in the TRICARE system and will only be able to do so during an annual open enrollment period—the schedule for that will be the same as the one used by the Federal Employee Health Benefits Program that serves civilian DoD employees: November and December of each year.

Congress ordered the change, among others, as part of the 2017 Defense authorization bill.

Officials did say the open enrollment change will not really affect beneficiaries for another year. Instead, 2018 will be treated as a “transition year,” and anyone who’s covered by TRICARE as of January 1, 2018 will be automatically enrolled in the plan that most closely matches the one that serves them today.

The plans are changing too, also as of January 1. Congress has directed DoD to merge the existing TRICARE Standard and Extra benefits, which are the department’s fee-for-service options, into a single plan called TRICARE Select.

Like Standard and Extra, Select will allow patients to use any authorized medical provider, but cost shares are lower for in-network providers.

According to the report, while cost shares are currently are based on a percentage of TRICARE’s negotiated costs with a network provider (or of that provider’s “allowable costs” if they’re out-of-network), as of next year, patients will pay a fixed, per-visit rate for in-network providers that varies according to the type of medical care they’re receiving.

Family members of active-duty personnel will pay less than TRICARE-covered retirees.

Other changes are also scheduled to take effect, but some require further study before actual implementation.

Instant Insights /

Drastic TRICARE system changes coming Jan. 1 for military, retirees

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