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Tricare changes effective now


As of Jan. 1, previously advertised changes to TRICARE have become effective. These changes will give you more benefit choices, improve your access to care, simplify cost shares and allow you to take command of your health.

Here are some of the major changes:

-          TRICARE West regional contractor is now Health Net.

-          TRICARE standards beneficiaries have been auto-enrolled into TRICARE Select

-          Costs for TRICARE benefits will be charged by calendar year instead of fiscal year

-          Many cost shares (percentage of allowed amount) were replaced with copays (fixed amount).

-          You now fall into two groups based on when you or your sponsor entered active duty. 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. Group B: if you or your sponsor’s initial enlistment or appointment occurred after Jan. 1.

-          Increased coverage for medically necessary foods and vitamins.

-          TRICARE Select beneficiaries now have access to additional preventive care services without a copay when received from network providers.

More changes are coming in February, when TRICARE’s pharmacy copayments will change. Retail network (30-day supply) generic copays will cost $11, brand name copays $28 and non-formulary copays $53. Home delivery (90-day supply) generic copays will cost $7, brand name copays $24 and non-formulary copays $53.

Certain enrollees will become eligible Federal Employees Dental and Vision Insurance Program beginning in 2019.

For more information and questions, contact the 377th Medical Group Health Benefits Advisors at 505-853-1396 or visit https://tricare.mil/Changes

NOTE: Some Tricare patients are being informed by network providers that they may incur a cost for their care due to "expired" referrals, or being seen "out of the HealthNet network." This information is incorrect; HealthNet is honoring all previously approved United Health Care referrals through their expiration date. HealthNet is also covering all "out of network" costs with previously approved referrals, as they are still establishing their network. Patients experiencing this issue should contact the Referral Management Center at 846-3402. RMC will then note the network provider and refer their information to our liaisons at HealthNet for further guidance/education. 

Patients should continue to utilize previously approved referrals through the referral expiration date.  Patients who enrolled from November 2017 until now have not been updated in HealthNet's system. Changes have yet to reflect the patients' new status, such as a change in Tricare coverage, enrolling to Kirtland AFB after a PCS, PCM change request, etc.  If you are confronted with this issue, contact Health Benefits at 846-3335 or 846-3336.  

Patients experiencing any further issues in regards to the transition to HealthNet should contact Staff Sgt. Chelsey Barnes at 846-5594 or chelsey.l.barnes2.mil@mail.mil