1. Take Command: Enhance Your TRICARE Experience
Thank you for having me with you today.
This brief provides an overview of upcoming TRICARE changes that affect your medical benefits.

2. Today’s Agenda: TRICARE is Changing
TRICARE is our health care program for uniformed service members and their families around the world.
The vision is for TRICARE to be a world-class health care system that supports the military mission by fostering, protecting, sustaining and restoring health.
The Defense Health Agency, or DHA, is modernizing the Military Health System to better serve our 9.4 million beneficiaries worldwide and respond to changes in law and policy.
On Jan. 1, 2018, there will be several changes to your TRICARE benefit. As a TRICARE beneficiary, you can expect a modernized and easier to understand plan with:
More benefit choices
Improved access to care
Simplified cost-shares, and more
This brief outlines a few of the changes you will notice in 2018 and some recent updates to your TRICARE benefit that have already occurred. Today we will talk through the seven listed on this slide:
Increasing access to care
Benefit updates
Consolidating TRICARE regions
Moving to TRICARE Select
Enrollment changes
Health plan costs
Prepare today
Take command of your health care:
TRICARE is changing: Changes are coming to TRICARE beginning Jan. 1, 2018.
This is your benefit: We want to you to be aware of the changes to your TRICARE benefit and connect you to resources to navigate your benefit.
Are you ready?: We will help you know when and how to take action to prepare for the upcoming changes.

3. Today’s Agenda: Increasing Access to Care

4. Increasing Access to Care
The Defense Health Agency, or DHA, initiated many improvements to improve the focus on patients, starting with better access to care:
Nurse Advice Line: You can talk to a registered nurse 24/7 who can help you determine the right level of care you need for yourself or your child, schedule military hospital or clinic appointments and much more.
Mobile Health/eHealth: Access to care was expanded through online and mobile apps. There are now many ways to engage with a doctor.
Urgent Care: There will be more access to urgent care services without a preauthorization.
One Call Resolution: This planned policy is intended to resolve appointment requests on the first call from the patient. Under this policy, beneficiaries will not be asked to call back for an appointment at military hospitals and clinics. This policy is already in place in Army facilities.
Expanded Hours: We understand the challenges of working families and expanded hours for primary care services to serve beneficiaries, now mandated by Congress. Check with your local military hospital or clinic for options in your area.
Put all of these together, and we have one of the most accessible primary health systems in the country. But, there are more opportunities ahead that DHA is working quickly to modernize health care benefits.
In 2018, you will have even greater access to care. At military hospitals and clinics, this will include:
More appointments available, especially after work or school.
More urgent care clinics opening at facilities with high demand and volume.
Faster specialty care appointing once you get a referral for care.
A streamlined process for getting network referred appointment results.
Also, we will partner with designated network urgent care clinics to provide integrated, seamless access to care.

5. Today’s Agenda: benefit updates

6. Expanding Mental Health Benefits
TRICARE expanded mental health and substance use disorder, or SUD, medical benefits by adding intensive outpatient programs and expanding options for opioid treatment.
Improvements in coverage now include:
Increased access to mental health and SUD programs, including opioid treatment programs and office-based opioid treatment
Inpatient, residential and outpatient care for mental health and SUD
Reduced restrictions on the number of treatments for SUD treatment, smoking cessation counseling and outpatient treatment
Lower out-of-pocket costs
In addition to other improvements, this expansion improves access to care and increases opportunities for mental health and SUD treatment. It also makes it easier for beneficiaries to access the right level of care for their health and wellness needs.
Families will pay the same out-of-pocket costs for mental health and SUD services that they pay for medical and surgical care.
The mental health and SUD benefit covers dependent beneficiaries and retirees, but doesn’t apply to active duty service members.
To find a provider, beneficiaries can contact their respective regional contractor or visit
Learn more about mental health and substance use disorder care at
When you have a mental health emergency, call 911 or go to the nearest emergency room. For emergencies overseas, call your TRICARE Overseas Program Regional Call Center and choose option 1 for medical assistance.

7. ESI Automatic Refill Program
With Express Scripts Automatic Refill program, your prescriptions are automatically refilled for you and delivered right to your home.
As of Sept. 1, 2017, Express Scripts requires annual consent from patients who want to receive automatic refills of their medications enrolled in TRICARE Pharmacy Home Delivery.
When the last refill of a medication enrolled in the Auto Refill program ships, Express Scripts will contact you by telephone and/or to know:
If you would like your doctor to be contacted to renew the prescription and
If you would like to continue in the Auto Refill program
Express Scripts will not re-enroll your medication unless they hear from you. You have several ways to respond:
Online at
Via the automated phone call from Express Scripts
By calling an Express Scripts Patient Advocate at
Learn more about this change and what action is required at

8. Today’s Agenda: Consolidating TRICARE Regions

9. TRICARE 2017: Two Regions
There are also additional changes in store that will impact how TRICARE is managed and delivered to beneficiaries.
In 2016, the Defense Health Agency, or DHA, awarded new regional contracts. These are known as the T2017 contracts that consolidate the current three regions into two.
Starting Jan. 1, 2018, TRICARE North and South will combine to form TRICARE East, while TRICARE West will remain mostly unchanged.
Humana Military, of Louisville, Kentucky, will manage the East Region contract.
Health Net Federal Services, LLC, of Rancho Cordova, California, will manage the West Region contract.
There will be added improvements in the delivery, quality and cost of your health care from previous contracts.
An example of an improvement is a hip or knee replacement. TRICARE will cover a global fee for up to 30 days post surgery, so hospitals and doctors are incentivized to get you to the right physical therapy, and the right home support services, so you recover more quickly and don’t need to be readmitted.
Such changes will address Congress’ requirement to introduce “value based payments” that means beneficiaries will pay for the outcomes they receive.
The DHA is looking for opportunities to do more around the concept of “value based care” with the patient’s needs in mind first. We want to look at simplifying the rules, and make it easier for patients to connect with their doctors without an appointment. If you have ideas, please share them.
Changes will be minimal for overseas beneficiaries.
To make sure you are prepared for the transition, please visit the TRICARE website at

10. Today’s Agenda: Moving to TRICARE Select

11. Moving to TRICARE Select
As a result of T2017, there will also be changes to TRICARE programs.
Starting Jan. 1, 2018, TRICARE Select replaces the TRICARE Standard and TRICARE Extra health plans, and act as a preferred provider organization, or PPO, style plan.
Most provisions will go into effect on Jan. 1, 2018, with full implementation occurring on Jan. 1, 2019.
Those currently eligible for TRICARE Standard or TRICARE Extra will be converted to the new plan, TRICARE Select.
New active duty family members will be enrolled in TRICARE Prime if their zip code is in a Prime Service Area. If active duty family members live outside a Prime Service Area or overseas, they will be enrolled in TRICARE Select.
Otherwise, beneficiaries eligible for TRICARE Standard or TRICARE Extra will need to select either TRICARE Prime or TRICARE Select to maintain purchased care coverage.
Beneficiaries who change to TRICARE Select will not get a decrease in coverage.
TRICARE Reserve Select, TRICARE Retired Reserve and TRICARE Young Adult plans will continue as is with comparable co-pays to TRICARE Select.

12. Today’s Agenda: Enrollment changes

13. Enrollment Changes
During open enrollment season, all eligible enrollees will be able to change their TRICARE enrollment to another TRICARE health plan or do nothing and stay in the same health plan.
Administration of the TRICARE benefit transitions from a fiscal year (October – September) to a calendar year (January – December).
There will be a transition period for beneficiaries from Oct. 1, 2017 to Dec. 31, During this time:
Enrollment fees will be prorated for the three-month period (Oct. 1, 2017 – Dec. 31, 2017) and billed accordingly for beneficiaries who pay on a monthly or quarterly basis.
Beneficiaries who pay fees on an annual basis will be billed for the fees to cover the three-month period (Oct. 1, 2017 – Dec. 31, 2017) and will receive a billing notice for the annual fee for calendar year 2018.
TRICARE Prime beneficiaries will need to pay an additional quarter’s premium to cover Oct. 1, 2017 – Dec. 31, Then actual renewal will begin on Jan. 1, 2018.
Beneficiaries may enroll and disenroll in TRICARE health plans at will during the grace period between Jan. 1, 2018 and Dec. 1, 2018.
Beginning Jan. 1, 2019, if beneficiaries choose to switch between TRICARE Prime and TRICARE Select, they must do so during an open enrollment period or within 90 days of a qualifying life event like marriage, divorce, child birth, moving and others.

14. Enrollment Freeze
Beginning Dec. 1, 2017, enrollments in TRICARE health plans will be delayed, or “frozen,” to transition to the new regional contractors that will begin delivering care in January.
This enrollment freeze will last approximately three weeks or until the data transfer is complete.
If you would like to switch to a different TRICARE health plan, or enroll in a plan for the first time, it’s best to do so as soon as possible, but especially before Nov. 20, Or you can do so after the enrollment freeze is lifted beginning Jan. 1, 2018.
Regional contractors will still be able to accept enrollment applications during the enrollment freeze through other communications channels, and will process these applications once the freeze is lifted.
You will still be able to access care during the enrollment freeze. Just be sure to save your pharmacy and other health care receipts while your enrollment is pending, so that you can get reimbursed for TRICARE-covered expenses once the freeze is lifted and your enrollment is processed.
If you experience a problem accessing care while your enrollment is pending, please contact your current regional contractor.

15. Enrollment Freeze (continued)
Beginning Nov. 20, 2017 and throughout the enrollment freeze, the Beneficiary Web Enrollment, or BWE, website will be unavailable.
Also, the Reserve Component Purchased TRICARE Application (RCPTA) for qualified National Guard and Reserve members will be unavailable, and will transition to the BWE website in January 2018.
While the BWE website is unavailable, you will only be able to enroll in a TRICARE health plan by phone or by mail. Follow the instructions on how to submit TRICARE enrollment forms on the TRICARE website at
You don’t have to enroll in TRICARE Select if you’re a TRICARE Standard beneficiary as of Nov. 30, You’ll be automatically converted to TRICARE Select on Jan. 1, 2018, as long as you’re registered in the Defense Enrollment Eligibility Reporting System, or DEERS, and are eligible for TRICARE.
Eligible beneficiaries must be registered in DEERS to enroll in a TRICARE health plan.

16. Today’s Agenda: Health plan costs

17. Health Plan Costs (2018)
Starting on Jan. 1, 2018, costs for TRICARE benefits will be charged by calendar year (January – December) instead of fiscal year (October – September).
You will fall into one of two groups based on the date when you or your sponsor entered the military.
Each group will have different enrollment fees and out-of-pocket costs: 
Group A: If you or your sponsor’s initial enlistment or appointment occurred before Jan. 1, 2018, you are in Group A.
Group B: If you or your sponsor’s initial enlistment or appointment occurs on or after Jan. 1, 2018, you are in Group B.
Effective Jan. 1, 2018, enrollees in TRICARE Reserve Select (TRS), TRICARE Retired Reserve (TRR), TRICARE Young Adult (TYA), and Continued Health Care Benefit Plan (CHCBP) have Group B cost-shares, regardless of when the sponsor first joined the military.
You may need to pay an enrollment fee, depending on your plan and when you became eligible for TRICARE.
Some costs will change annually starting on Jan. 1, 2018.

18. Costs: Active Duty Family Members
If you’re an active duty family member using a TRICARE Prime plan or TRICARE Select plan:
You won’t pay an annual enrollment fee, but you may have to pay cost-shares when you get care outside of the military hospital or clinic.
Regardless of health plan, your family catastrophic cap will be $1,000 each year.
If you use TRICARE Select, you will also have individual and family deductibles.
If you’re in TRICARE Prime and choose to get specialty care without referral or authorization, that is our point-of-service, or POS, option. With POS, you will have to pay the deductible and 50 percent of the cost for your TRICARE covered treatment. Any deductibles or cost-shares for POS don’t count toward your catastrophic cap.
TRICARE costs are subject to change. Special conditions for differing costs may exist.
Go to for the most up-to-date cost information. Additional TRICARE costs are available online.

19. Costs: Retirees, Family + Other Users
If you’re a retired service member, retiree family member or using any of the premium-based plans:
You may pay an enrollment fee depending on your group and your plan.
You may also have deductibles, copays and cost-shares.
Regardless of health plan, you will be protected by a catastrophic cap.
If you’re in TRICARE Prime and choose to get specialty care without referral or authorization, that is our point-of-service, or POS, option. With POS, you will have to pay the deductible and 50 percent of the cost for your TRICARE covered treatment. Any deductibles or cost-shares for POS don’t count toward your catastrophic cap.
Premium-based plans include:
TRICARE Young Adult (TYA)
TRICARE Retired Reserve (TRR)
TRICARE Reserve Select (TRS)
Continued Health Care Benefit Program (CHCBP)
If you have a premium-based plan, you will continue to see your yearly premiums adjusted each year on Jan. 1 the way they have been in the past. These yearly adjustments are required by law, and will be calculated the same way they are today.
Costs won’t change for TRICARE For Life, or TFL. Also, there are no changes in TFL eligibility, benefits, or the requirement to have Medicare Part A and B. 
TRICARE costs are subject to change. Special conditions for differing costs may exist.
Go to for the most up-to-date cost information. Additional TRICARE costs are available online.

20. Today’s Agenda: Are You Ready?

21. Prepare Today!
To have more control over your health care, prepare for the upcoming changes to TRICARE by taking the following actions:
Update your contact information in the Defense Enrollment Eligibility Reporting System, or DEERS, for you and your family.
Go to
Call (TTY/TDD: ).
Fax updates to
Sign up for eCorrespondence in milConnect to get notifications.
Log in to and update your profile.
Visit the TRICARE website.
Go to
Sign up for alerts about the changes at the link available at You will get an anytime this page is updated.