Two senators have introduced legislation to extend the reinstatement period for tens of thousands of military retirees who have lost their health care coverage because they didn’t set up their payments for the new enrollment fee.
By law, in order to continue coverage under Tricare Select, retiree sponsors were required to start paying new monthly enrollment fees as of Jan. 1, and they were required to set up a payment plan with their Tricare contractor by the end of 2020 by allotment, bank account or credit card. If they didn’t take this action, their coverage was dropped as of Jan. 1, and some may not realize it until they seek medical care and a claim is denied.
The proposal introduced Tuesday by Sen. Steve Daines, R-Mont., and Sen. Joe Manchin, D-W. Va., would extend the grace period from June to the end of 2021 to allow retirees to reinstate their coverage. Defense Health Agency officials had previously extended the grace period to six months, but military advocates have asked for one year’s grace period.
“This extension helps ensure no retired service member is left without health care coverage, especially during the COVID-19 pandemic,” said Manchin, in a statement announcing the proposal.
In 2021, for the first time, retirees and family members enrolled in Tricare Select must pay enrollment fees in order to continue their coverage. This doesn’t apply to retirees and family members enrolled in Tricare for Life. Nor does it affect active duty families on Tricare Select, survivors of deceased active duty members, or medically retired retirees and family members.
The new enrollment fees are:
*for individuals: $12.50 per month or $150 a year
* for families: $25 per month or $300 per year
Those affected are so-called “Group A” retirees and their dependents — working-age retirees under age 65 who entered the military before Jan. 1, 2018, their family members and survivors. Previously, these beneficiaries didn’t have to pay enrollment fees for Tricare Select, but a 2017 law required the Defense Department to start charging these enrollment fees by Jan. 1, 2021.
As of early January, about 20 percent of this population, or 174,754 out of 872,886 beneficiaries, hadn’t taken action to set up their payments, or to actively opt out, according to data provided by the Defense Health Agency. Those beneficiary numbers include the retiree sponsor as well the retiree’s eligible family members enrolled in Tricare Select.
Anyone who is dropped from Tricare Select will have access to direct medical care only at a military treatment facility, and only if space if available. Claims for medical treatment after Dec. 31, 2020 will be denied, but coverage can be reinstated if back enrollment fees are paid. Tricare will then pay the claims that were denied back to Jan. 1 because of the coverage termination.
The grace period is currently through June. Officials previously said that at the end of January, regional Tricare contractors would start sending out letters to these beneficiaries notifying them about their disenrollment. Contractors have also started sending emails to those who haven’t yet paid.
“Our bipartisan bill will help ensure we take care of our veterans and continue to provide quality health care for their service to this nation,” Daines said, in the announcement.