What to know about Tricare costs and changes as open season starts

It’s that time of year when you can make changes to your military health care plan.

The Tricare open season runs through Dec. 10. Some Tricare beneficiaries are also eligible for the Federal Employees Dental and Vision Insurance Program, or FEDVIP. That program’s open season ends on Dec. 9. It’s also the time to enroll in the dependent care flexible spending program now offered to active-duty service members.

Be aware of some changes, such as increases in some costs, as you decide what plan is best for you. A new contractor, TriWest Healthcare Alliance, is taking over for the Tricare West Region on Jan. 1. The current East Region contractor, Humana Military, remains the same.

Check the online Humana provider directory or the TriWest provider directory to see if your health care providers are in the network.

Tricare open season applies to those enrolled in or eligible for Tricare Prime or Tricare Select. During this period, enrolled beneficiaries can make changes to their health coverage — such as switching from Tricare Prime to Tricare Select, or moving from individual to family enrollment. If you’re eligible for a Tricare plan but aren’t enrolled, now is the time to do it. Otherwise, you’ll have to wait until a qualifying life event, such as the birth or adoption of a child, marriage, divorce, moving or changes to other health insurance.

Any changes you make during open season will take effect Jan. 1.

During this time, eligible Tricare beneficiaries who want to stay in their current plan can do so if they’re still eligible.

But all beneficiaries who are in the Tricare West Region should contact the new contractor, TriWest, before the start of the new contracts on Jan. 1, to make sure their contact information is up to date, and to transfer their payment information if they pay enrollment fees or premiums by credit card or bank transfer.

The new West Region includes 26 states, as beneficiaries in six states have been transferred to that region from the East Region under the new contracts. Those six states are Arkansas, Illinois, Louisiana, Oklahoma, Texas and Wisconsin.

Open season doesn’t apply to active-duty service members, or to Tricare for Life, or to the premium-based plans — Tricare Reserve Select, Tricare Retired Reserve and Tricare Young Adult. These premium-based plans can be purchased at any time during the year. But those in Tricare Young Adult with either the Prime or Select options can only change plans during open enrollment or a qualifying life event.

To enroll in a plan, or to make changes, eligible beneficiaries can either call their regional contractor, or download an enrollment form and mail it to their 2025 regional contractor. Remember, if you live in the U.S. you won’t be able to use the Beneficiary Web Enrollment self-service portal this year to make changes.

Call Humana Military for the East Region at 800-444-5445.

For the West Region, call TriWest at 888-874-9378.

The plans:

Tricare Prime is a health maintenance organization-style plan in which you get most of your care from a primary care manager, with referrals required for specialty care. There is no deductible. Active-duty service members, their family members and transitional survivors don’t pay enrollment fees or out-of-pocket costs for covered services, unless they get non-emergency care without a referral, use non-network providers without authorization, or use a pharmacy other than a military pharmacy. Retirees, their families and all others pay enrollment fees and out-of-pocket costs for covered services except for preventive care.

Tricare Select is a preferred provider organization-style plan in which you choose your Tricare-authorized provider and don’t have to get referrals for most services. There are deductibles, co-payments and cost-shares.

Cost increases

The costs for the Tricare pharmacy benefit will stay the same through 2025.

Generally, those who have been paying out-of-pocket for healthcare under Tricare in 2024 will pay extra in 2025, according to fee schedules just released by the Defense Health Agency. For those who make co-payments for covered services such as primary care visits, specialty care outpatient visits and emergency room visits, some co-pays will go up by $1 to $3 a visit.

Individual active-duty service members don’t have out-of-pocket costs. Their family members may have costs, depending on the Tricare health plan they’re enrolled in, their sponsor’s pay grade and when the sponsor entered active duty, the type of care they get, and where they get it.

There are no costs for covered preventive care visits.

Those who pay annual enrollment fees will also see increases. For example, retirees who entered the military before 2018 will pay $744 to enroll their family in Tricare Prime, an increase of $18 from $726 in 2024.

Annual deductibles will increase for some, which means the families will pay more out of pocket before Tricare kicks in. For example, active duty families in Tricare Select whose service member is E4 and below and entered the military on or after Jan. 1, 2018, will pay $128 out of pocket before Tricare kicks in, an increase of $3 compared to 2024.

By law, there are differences in some costs based on when the sponsor entered the military. Those who entered before Jan. 1, 2018, are part of Group A, while those who entered on or after Jan. 1, 2018, are part of Group B.

Costs for premium-based plans

These costs, set by the Defense Health Agency, have continued to rise over the years. The largest increase is in the Tricare Young Adult Prime option, with a 14% increase in monthly premiums. Those premiums increase by $90, from $637 to $727 a month. This “will put the plan out of reach for most young adults and their families,” said Eileen Huck, government relations senior deputy director for the National Military Family Association.

“The good news is that the cost of Tricare Young Adult Select is going up by a much smaller amount,” she said. The Tricare Young Adult Select option premium increases by 8%, from $311 a month to $337. The Tricare Young Adult Prime and Select plans are available for purchase by qualified former dependent children up to age 26. “We still think that young adults should be able to retain their Tricare coverage up to age 26 at no additional cost,” she said.

The Tricare Young Adult program must be at no cost to the government, under the rules set by Congress when it was implemented in 2013. So, the full cost of the program’s premiums is reflected in the fees charged to families. Defense officials look at the health care expenditures for the program for the previous year and calculate the costs.

The monthly premiums for Tricare Reserve Select and Tricare Retired Reserve are also increasing. For example, they’re increasing by 4% for service members in the Tricare Reserve Select program for member only, and 7% for member and family in the Reserve Select program. Those in the Tricare Retired Reserve program will pay an extra 8% in monthly premiums.

Monthly premiums for Tricare Reserve Select for member only are $53.80, up 4% from $51.95 in 2024. For member and family, cost is $274.48, up 7% from $256.87 a month in 2024.

For Tricare Retired Reserve, member only, monthly premiums are $631.26, up 8% from $585.24 in 2024. Member and family, cost is $1,513.04, up 8% from $1,406.22 in 2024.

Dental

Families of active duty, National Guard and reserve service members — as well as Guardsmen and reservists who aren’t on active duty — are eligible for the Tricare Dental Program, which requires separate enrollment. Premiums for the dental program decreased slightly in November, and remain the same until Feb. 28, 2025.

Most retirees and their family members are eligible for dental coverage under the Federal Employees Dental and Vision Insurance Program, or FEDVIP, which is administered by the Office of Personnel Management and also requires separate enrollment. For 2025, the Federal Employees Dental and Vision Insurance Program (FEDVIP) has twelve dental carriers.

Visit www.benefeds.com to enroll in FEDVIP and to get more information.

Vision

Those in the military community must be enrolled in a Tricare health plan to be eligible for FEDVIP vision coverage. Those eligible include active duty family members, retirees and their eligible family members, and Selected Reserve members and their families.

For 2025, FEDVIP has five vision carriers.

Visit www.benefeds.com to enroll in FEDVIP and to get more information.

Dependent care flexible spending

This is the second year military families can sign up for the new Dependent Care Flexible Spending Account, which allows families to set aside money before taxes for dependent care expenses. Families sign up for this benefit through the Federal Flexible Spending Account Program (FSAFEDS) during the federal benefits open season, which is now through Dec. 9.

These accounts help defray the cost of child care and other dependent care by providing tax savings. For help in determining whether to set up an account, and how much money to set aside, officials advise troops to take advantage of the Defense Department’s free counseling and advice from personal financial management counselors at many military installations, and tax counselors available all year through DoD’s Military OneSource. FSAFEDS also offers free benefits counseling.

Defense officials will later offer a health care flexible spending account, also through FSAFEDS, with a specific enrollment period in 2025.