It’s Open Season: Active Duty, Guard and Reserves and Retiree TRICARE, FEDVIP, and other benefits updates are here!
From November 11 through December 10, you have a chance to choose the TRICARE plan, dental and vision coverage that best works for you and your family. 2024 was the first year that military families had access to a Dependent Care Flexible Spending Account (DCFSA). The DCFSA is back for 2025 with family contribution limits of $5,000. New in 2025, active-duty service members and certain reservists will have access to a Health Care Flexible Spending Account. There will be a special enrollment period running from March 1, 2025 to March 31, 2025 for those who want to enroll. A flexible spending account can be a fantastic tool to deal with expensive out-of-pocket health care costs and childcare costs. Flexible spending accounts allow you to use pre-tax dollars to pay for eligible expenses. Participants should be sure to understand the rules, as flexible spending accounts are “use or lose” benefits.
What’s new for 2025?
New Prices:
There will be changes to the cost of many TRICARE plans. Active duty members shouldn’t see a change in out-of-pocket costs, however, their family members may. The amount individuals and families will pay depends on the plan they are enrolled in, their (or their sponsor’s) pay grade and group, what type of care you get, and where you choose to get that care.
Tricare enrollment fees and premiums depend on whether you fall into Group A or Group B.
Group A: Your or your sponsor’s initial enlistment or appointment began before Jan. 1, 2018.
Group B: Your or your sponsor’s initial enlistment or appointment began on or after Jan. 1, 2018.
For 2025, those Active Duty service members enrolled in Tricare Prime will not pay any enrollment fees or copayments unless you use the point-of-service option or fill a prescription outside of a military pharmacy. For those enrolled in Tricare Select (Group A) enrollment fees range from $50-$300.00, Group B enrollment fees max out at $386.00. Copayments for TRICARE Select enrollees have increased in most of the expense categories. For a quick synopsis of the changes refer to this TRICARE Newsroom article.
For retired service members, their families, and others enrollment fees and copayments have increased across the board. For those enrolled in TRICARE Select (Group A) the enrollment fees range from $181.92 to $364.92. While the same plan Group B enrollment fees cap out at $1158.96. Copayment fees have increased in for all the plans (TRICARE Prime and Select) and Groups (A & B), for a breakdown of these increases refer to this TRICARE Newsroom article.
Premium-based plans will also see an increase in costs for 2025. Tricare provides four premium based health plans. Premium based plans include:
Region shifts and Contractor Changes.
There will be a bit of a shake-up in the TRICARE regions for 2025. TRICARE will still be broadly broken into two main regions, however the states that make-up each region will shift around. This will not change the provided benefits, but it may change which providers are in-network. This shift will also affect how you make your enrollment payments.
Six states that are currently in the East Region will fall under the West Region in 2025. These states are Arkansas, Illinois, Louisiana, Oklahoma, Texas, and Wisconsin. In addition to the realignment of states, the TRICARE West contractor has changed. Starting in 2025 TriWest Healthcare Alliance will replace Health Net Federal Services, LLC.
What does that mean for beneficiaries? That depends on where you are living. Let’s break this down region by region.
East Region: If you are currently in the East Region and in a state that is not shifting to the West Region, you have the simplest requirements. All you have to do is:
Ensure that you are in the plan you want to be in for 2025,
Make sure your payment information is correct,
Verify your information in DEERS
West Region and States moving to the West Region: If you are currently in the West region or are living in a state that is moving to the West Region, you have a bit more work to do. What you have to do:
Ensure you are in the plan you want to be for 2025,
Verify your information in DEERS,
If you pay enrollment or premium payments by credit card or bank transfer, you will need to ensure that they are updated to reflect the new contractor (TriWest),
Ensure that your current or preferred providers and pharmacies are in the TriWest network.
Clear Insight Wealth Management is Here to Help:
Dealing with medical insurance is never an enjoyable time. This is doubly so when there are major changes to the plans and fees. At Clear Insight Wealth Management, we’re dedicated to helping military and federal families make the best choices for a secure and fulfilling life. This includes helping our clients make the most out of their earned benefits. Our mission is to empower you to live your dream life, and we’re here to turn financial challenges into success stories.
To schedule a “Get to Know You” meeting, call (509) 904-4956, email hello@myciwm.com, or schedule online.