An Army retiree’s wife has a warning for other retirees and their family members: Check to make sure you are still covered under Tricare Select — even if you set up payments for the new enrollment fees last year.
“I would highly recommend anyone who believes they are enrolled in Tricare Select to verify their enrollment is active, or at least verify the monthly withdrawal is happening as expected,” said Constance Hathaway. On Feb. 8, the day before a scheduled medical procedure, she and her husband — an Army retiree — discovered they no longer had health insurance through Tricare West — although they had set up their automatic payment in October.
“My concern is that we thought we had done it all correctly and were never notified of the error. We ended up spending a month scuba diving without health insurance.
“I’m sure there are many families who are finding the same problem,” she said.
As of Jan. 1, working-age retirees in Tricare Select are required by law to pay new enrollment fees of $12.50 per month for individuals or $25 per month for family coverage. These retirees were required to set up a payment process by allotment, or automatic payments through electronic funds transfers from a bank account, debit card or credit card.
If they didn’t take that action before the end of the year, their coverage for themselves and family members was dropped. If beneficiaries have been dropped, their coverage can be reinstated through the end of June, as Defense Health Agency officials have extended the deadlines for the reinstatement period, through June 30. If the beneficiary pays enrollment fees back to January, the coverage will be reinstated, and any previously denied, eligible claims will be paid back to Jan. 1. But advocates and some lawmakers have asked that the reinstatement period be extended to the end of 2021.
This new requirement affected some 876,531 working-age retirees and their family members enrolled in Tricare Select. As of Jan. 27, payments hadn’t been set up for about 14 percent of those beneficiaries, or 124,000 people. This doesn’t affect retirees who are in Tricare for Life, Tricare Prime, or those using a premium-based plan. Nor does it affect active duty families on Tricare Select, survivors of deceased active duty members, or medically retired veterans and family members.
Hathaway said she and her husband were among those 124,000 and didn’t know it.
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“Not all retirees dropped hadn’t set up the automatic withdrawal. My husband and I were dropped in spite of setting everything up in October,” Hathaway said. She provided a copy of an email notification dated Oct. 21, confirming that their payment had been set up by way of their credit card.
The Hathaways set up the credit card withdrawals with the Tricare West contractor in October, to begin Jan. 1. The withdrawal process was approved, and confirmed by email. But the scheduled payment was never initiated by the contractor, and their coverage was terminated without notification, she said.
“I believe that there are always going to be some glitches whenever the government makes a change like this one. This is, however, people’s health and lives. Not something to be taken lightly,” Hathaway said.
“This is something we’ve been concerned about” said Eileen Huck, government relations deputy director for the National Military Family Association. She said initially, not everyone who set up their payments got confirmation emails.
“There’s always going to be some human error, and that’s something we’ve definitely been concerned about all the way through, that people would think it was taken care of, and for whatever reason, would find out it wasn’t.”
Huck said National Military Family Association has advocated for a longer reinstatement period. “We’ve been worried all along about people not realizing until after the end of the reinstatement period that they don’t have coverage, and then there’s really nothing that can be done until the next open enrollment period. That’s really not an acceptable outcome.
“I do think the Defense Health Agency and the contractors are taking this seriously and are whittling down those numbers, and trying to be proactive about reaching out to people,” Huck said.
“But it’s still something we’re watching closely and we’re concerned about.”
Health Net Federal Services, the Tricare West contractor, said the Hathaways’ problem is unique. “While we cannot comment on specific cases, the situation you are describing would be a unique circumstance and not something that is a recurring issue for our beneficiaries,” said Health Net Federal Services spokeswoman Caryn Schroeder.
The contractor encourages beneficiaries to verify Tricare eligibility through its online eligibility tool at www. Tricare-west.com or at milConnect, especially at the beginning of a calendar year,” Schroeder said. “Our customer service representatives are available Monday through Friday, 5 a.m.-9 p.m. Pacific time at 844-866-9378, should eligibility discrepancies need to be resolved.”
She said Tricare officials recommend that beneficiaries have their payments deducted automatically by allotment, when feasible. For those who can’t pay by allotment, or choose not to, the recurring payments by bank account or a debit or credit card are still an option.
Hathaway said she and her husband initially set up their payment to go through a credit card, and the representative she talked to said that may have been part of the problem. So they set up the payment through an allotment from her husband’s retirement pay.
“We were never notified our coverage had been dropped. That is the part I was most disappointed by,” she said.
When they checked their records, they saw they payments hadn’t been taken from their credit card account, and made calls to Health Net in January and February, but received no information, she said. “Feb. 8 we discovered we no longer had any health insurance through Tricare West. The issue was handled over a lengthy phone call which was recorded by Tricare.
“The payment was changed from credit card to automatic withdrawal from retirement benefits via recommendation from the Tricare representative,” she said.
Hathaway said Health Net reached out to her after being contacted by Military Times.
“They have no explanation for the lack of contact when cancelling us, but [they] think there was a miscommunication related to our plan to move overseas later this month,” she said. “I am a little skeptical, but am willing to accept the explanation as long as they are following through with taking care of everyone who had this kind of issue.”
For beneficiaries who want to reinstate their Tricare Select coverage, Defense Health Agency directs them to www.tricare.mil/selectenrollmentfees.
About Karen Jowers
Karen has covered military families, quality of life and consumer issues for Military Times for more than 30 years, and is co-author of a chapter on media coverage of military families in the book “A Battle Plan for Supporting Military Families.” She previously worked for newspapers in Guam, Norfolk, Jacksonville, Fla., and Athens, Ga.