Tricare Prime fee changes become effective, Oct. 1

| September 13, 2012 | 0 Comments

For most retirees, annual enrollment fee is rising

Brian Smith
TriWest Healthcare Alliance



PHOENIX — It’s that time of year again when Tricare Prime billing statements go out in the West Region.

This year, enrollees will be seeing some new numbers in their statements.

The individual and family annual enrollment fee rates are increasing.

Are my fees changing?

Yes, the fees are changing for most retiree Tricare Prime enrollees. Fee-paying enrollees were paying either of two rates (depending on the date of enrollment):

•$230 or $260 for individual coverage, or

•$460 or $520 for a family coverage.

These enrollees will see their 2013 fiscal year enrollment rate change to $269.28 for individual or $538.56 for the family, beginning Oct. 1.

Going forward, a majority of Prime enrollees could see fee increases at the beginning of each fiscal year. Two categories of retirees, however, will have their rates “frozen”:

•Survivors of active duty deceased sponsors (following the three-year Transitional Survivor period) and

•Medically retired service members.

These two categories will pay the same annual fee rate that was in effect the year they enrolled as fee payers and were categorized as survivors or medically retired. The freeze remains if Prime enrollment is not interrupted.

A beneficiary’s status and category are recorded in the DEERS (Defense Enrollment Eligibility Reporting System) record.

Fees could change each fiscal year. Tricare is reminding enrollees that beneficiaries may have another enrollment fee increase, later, if new fees are included when Congress passes the final fiscal year 2013 budget.

If beneficiaries don’t choose an automatic monthly payment option, it’s suggested they make quarterly payments.

Do I pay fees? How much do I owe this year?

If you paid Tricare Prime enrollment fees last year, and you’re still enrolled, you still owe fees. If you are recently enrolled in Prime as a retiree, you owe fees.

You can always check your fees owed by logging into your secure account at

What changes will I have to make?

As long as you make your payments by the due date on the statement, your Tricare Prime enrollment continues. If you have signed up for automatic electronic payments through TriWest, you don’t have to change anything. Your payments will be automatically adjusted to the appropriate new amounts:

•Monthly allotment from retired pay,

•Monthly electronic funds transfer from your checking or savings account, or

•Monthly credit/debit card payment.

What if I disenroll?

You can choose to disenroll and use your Tricare Standard coverage. You will have an annual deductible and out-of-pocket cost shares.

As a retiree, you may voluntarily disenroll at the end of the enrollment year (Sept. 30). If you enroll again, your coverage will not be continuous and will start either the month after you enroll or the month after that (based on the 20th of the month rule).

Prime enrollment fees are changing this year. Stay on top of your enrollment and help avoid any missed payments by signing up for automatic electronic payments through TriWest.

Tricare Fees

For more information on Tricare fees, go to

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Category: Community, Health

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