TRICARE Changes in 2025: What Beneficiaries Need to Know
Several important changes are coming to TRICARE in 2025, some of which could result in beneficiaries getting kicked off their health plans if certain steps are not taken. Starting January 1, 2025, TRICARE is transitioning to “T-5” contracts for the management of the East and West Regions. These new contracts “will improve the delivery, quality, and cost” of TRICARE’s services for beneficiaries living in the U.S.
Here’s what TRICARE beneficiaries need to know about the changes starting in 2025 and what actions they may need to take:
Six States Switching to West TRICARE Region
Six states are moving from the East Region to the West Region in an effort to balance TRICARE’s beneficiaries between the regions. The six states that are transferring to the East Region are Arkansas, Illinois, Louisiana, Oklahoma, Texas, and Wisconsin. This change will affect around 1.1 million eligible beneficiaries.
West TRICARE Region Getting New Contractor and Network
TRICARE’s West Region will transition to a new contractor, TriWest Healthcare Alliance, moving away from Health Net Federal Services. Beneficiaries in the West Region can sign in to the 2025 West Region provider directory to see if their current doctors are still in network.
The East Region will remain under Humana Military Health’s management.
Open Enrollment for TRICARE
Enrollment for TRICARE Prime and TRICARE Select members is open now through December 10. This time period is the only time beneficiaries can make changes to their coverage throughout the year unless they experience a “qualifying life event (QLE).” QLE’s include events such as a move, the birth of a child, or a TRICARE-directed change in a primary care provider.
MilConnect System Unavailable to Make Coverage Changes
Beneficiaries will not be able to use the DOD’s milConnect system to make enrollment changes during this transition. Users must contact their regional contractor by phone, mail, or fax to change plans. Those making changes in the West Region, including those in transitioning states, should direct their plan changes to TriWest, the new contractor for the West Region.
Users in West Region Should Update Payment Information
TRICARE users in the West Region who pay a premium or enrollment fee must provide their correct payment information to the new contractor, TriWest, before January 1, 2025. Users who do not provide payment information will be kicked off of their health plans, according to Karen Ruedisueli, director of government relations for health affairs for the Military Officers Association of America (MOAA).
“It’s the contractors who handle the payment information, and right now in the West region, Health Net has that payment information, and they can’t just send it to TriWest,” said Ruedisueli. “Beneficiaries who are paying by credit card or electronic funds transfer… are going to have to provide that payment information to TriWest.”
All TRICARE Users Should Update Contact Information in DEERS
It’s a good idea for all TRICARE users to make sure their contact information is correct in the Defense Enrollment Eligibility Reporting System (DEERS) during this transition to make sure they don’t miss out on important communication.
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