AUSA Led the Way – Past Successes

• Prevention of new co-pays and fees for under 65 TRICARE beneficiaries
• Elimination of the SBP – Social Security offset
• Approval of concurrent receipt
• Waiver of the Medicare Part B penalties for military Retired Soldiers(part of the Medicare legislation)
• TRICARE for Life for over 65 Retired Soldiers and the Pharmacy Benefit for all beneficiaries
• Reduction of the Catastrophic cap from $7500 to $3000
• Elimination of financial penalties for federally employed Retired Soldiers
• Full funding of TRICARE/Pharmacy Programs for all beneficiaries

 

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Attention Retired Military Members:

Beginning in 2026, the old-style, blue ID cards will no longer be accepted, regardless of the printed expiration date. In order to maintain base access, please visit your nearest DEERS/ID card office to obtain a new ID. If you’re unable to make it to a military installation, you can also request a new card through the RAPIDS ID Card Office Online: https://idoc.dmdc.osd.mil/idco/

UPDATE: This policy applies to ID cards of ALL colors (except the new white ones). They should all be updated in order to maintain base access.

 

Disenrolled From Your TRICARE Plan in the West Region? Here’s How To Reinstate Your Coverage After April 30

IMPORTANT: Do you currently live in the TRICARE West Region? Do you pay for your TRICARE coverage using a bank electronic funds transfer, credit card, or debit card?

If you haven’t done so already, you must securely provide your payment information to the West Region contractor, TriWest Healthcare Alliance, by April 30. If you haven’t submitted payment to TriWest by April 30, you and your family members will be disenrolled from your TRICARE plan on May 1. This disenrollment is retroactive to your paid-through date. You’ll receive a letter from DMDC informing you of the disenrollment. Note: You don’t need to take any action if you have TRICARE For Life, the US Family Health Plan, or a TRICARE health plan overseas.

If you haven’t made any payments for coverage this year, your disenrollment will date back to Jan. 1. This means you’ll be responsible for paying the full cost of any healthcare services you or your family members have received this calendar year.

“We want to ensure that everyone who wants to keep their TRICARE plan has a chance to reinstate their coverage,” explained Malcolm Jones, enrollment specialist, TRICARE Health Plan, at the Defense Health Agency. “But if you’re disenrolled, you must take action now to reinstate your coverage—it won’t be automatic.”

Keep reading to learn more about your reinstatement options.

How to request reinstatement

Do you want to reinstate your TRICARE coverage? You can do so any time before June 30. Call TriWest at 888-TRIWEST (874-9378) and say that you’ve been disenrolled and would like to reinstate your enrollment. (Note: You can’t request reinstatement via TriWest’s portal.)

If you don’t request reinstatement by June 30, you won’t have TRICARE medical coverage.

To be reinstated, you’ll need to provide your payment information to TriWest and pay all overdue enrollment fees or premiums back to Jan. 1.

Don’t want to reinstate your coverage?

If you don’t want to reinstate your TRICARE coverage, you don’t need to take any action. But remember: If you don’t request reinstatement before June 30, you can only get care at a military hospital or clinic if space is available.

If you’re eligible for TRICARE Prime or TRICARE Select, you’ll need to wait until the next TRICARE Open Season, which begins in November, to enroll in a plan for coverage beginning Jan. 1, 2026. Or you’ll need to wait until you have a qualifying life event, which opens a 90-day period for you to enroll in a TRICARE health plan. (QLEs include major life changes like marriage, birth, or moving, as described in the TRICARE Qualifying Life Events Fact Sheet.)

If you had a TRICARE premium-based plan, you won’t be able to purchase coverage for 12 months from your disenrollment date. These plans include:

• TRICARE Young Adult
• TRICARE Reserve Select
• TRICARE Retired Reserve

Want to avoid the need to update your TRICARE payment method in the future? Consider switching to paying by allotment. To learn how to set up payment by allotment, check out the Defense Financing and Accounting Service’s Allotments page.

If you have questions about your payment options, visit West Region Payment Options. 

Remember: Reinstating your TRICARE coverage now will ensure that you don’t need to pay the full cost of your healthcare services this year.

 

Defense Health Agency Extends Referral Approval Waiver Through June 30 for West Region TRICARE Prime Enrollees

By TRICARE Communications

FALLS CHURCH, Va.  –  Do you live in the West Region? Do you have TRICARE Prime? You should know that the Defense Health Agency has extended the West Region referral approval waiver through June 30. TRICARE-authorized specialty care providers don’t need to wait for TriWest Healthcare Alliance to approve referrals issued by your primary care manager before providing outpatient care.

“After assessing the current state of referrals, DHA has decided to extend the referral approval waiver for many beneficiaries,” said Richard Hart, Division Chief, Health Plan Design, TRICARE Health Plan, at the Defense Health Agency. “This waiver extension will ensure that West Region beneficiaries can continue getting specialty care without interruption to their care.”

However, certain military hospitals and clinics have returned to normal referral processing. This phased approach is enabling TriWest to improve its referral processing system. If your PCM is located at one these facilities, TriWest will process your referral. Keep reading to learn more.

How does the waiver work?

Through June 30, keep following the rules of your TRICARE Prime plan. These rules are described in the TRICARE Choices in the United States Handbook.

Continue seeing your PCM to get referrals for specialty care, even if your PCM isn’t currently in TriWest’s network. (Note: The point-of-service fee waiver is also extended through Sept. 30. These fees are waived for existing referrals with non-network providers in the West Region.)

During the waiver period, you don’t need to wait for TriWest to approve your referral (unless your PCM is at certain military hospitals or clinics). However, the specialist you see must be TRICARE-authorized.

Here are a few key things to remember:

• Ask your PCM for a copy of your referral. Is your PCM at a military hospital or clinic? They may send it:
  • Through the MHS GENESIS Patient Portal within 3-5 days
  • In the mail within 3-5 days
  • To a referral customer service office. You can pick up your copy after your appointment.
• When you see your specialist, bring the copy of your referral, dated Jan. 1 through June 30. You can also bring a copy of the TRICARE West Region Referral Approval Waiver Letter. This is available on www.tricare.mil/west.
• Not sure how to find a specialist? You can:
  • Ask your PCM to recommend a local TRICARE-authorized specialist.
  • See a specialist you’ve seen before, if they’re TRICARE-authorized.
  • Search TriWest’s provider directory to find specialists in your area.

Are there exceptions to the waiver?

This waiver never applies to:

• Inpatient care
• Applied behavior analysis or Autism Care Demonstration services
• Laboratory developed tests
• Extended Care Health Option services

Certain military hospitals and clinics in the West Region have returned to normal referral processing. If your PCM is located at one of these facilities, they’ll let you know. They’ll send your referral to TriWest for processing.

If this applies to you:

• Access your approved referral through TriWest’s secure portal. You can also wait to get it in the mail.
• Your TriWest portal will have instructions on how to schedule an appointment with the assigned specialist. If there’s a problem or you have questions, call TriWest at 888-TRIWEST (874-9378).

What if I have more questions?

Want to learn more about other parts of the West Region transition? Visit TRICARE West Region Transition.

Do you have questions or concerns? You can call TriWest at 888-TRIWEST (874-9378). Or you can contact the Beneficiary Counseling and Assistance Coordinator at your military hospital or clinic.

 

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