Thousands of beneficiaries are finding out they are being disenrolled from Tricare health care coverage in the West Region because they didn’t set up recurring payments by an April 30 deadline.
“We anticipate the total being approximately 30,000 beneficiaries” who will be disenrolled in the process that is currently under way, TriWest officials said in a statement to Military Times.
Those who want to reinstate their coverage must do so by June 30.
This applies to beneficiaries who pay for their Tricare coverage using a credit card, debit card or bank electronic funds transfer and haven’t set up those payments with TriWest.
That sensitive payment information couldn’t be transferred automatically from the previous West Region contractor, Health Net Federal Services, to TriWest Healthcare Alliance, which took over the West Region on Jan. 1.
Beneficiaries are receiving letters from Defense Manpower Data Center informing them of their disenrollment, according to Tricare officials. The program set up a way for beneficiaries to request reinstatement of their coverage, but it won’t be automatic, and beneficiaries must request reinstatement before June 30.
“This disenrollment is retroactive to your paid-through date,” Tricare officials stated in an announcement. Those who haven’t made any payments for coverage this year are finding their disenrollment dates back to Jan. 1. They are responsible for paying the full cost of any health care services received by anyone in their family back to Jan. 1.
Beneficiaries in the Tricare West Region who have been disenrolled can’t request reinstatement through the TriWest portal. Instead, they must call TriWest at 888-874-9378 and say they’ve been disenrolled and want to reinstate their enrollment, according to Tricare officials.
They’ll be required to provide the payment information to TriWest and pay all overdue enrollment fees or premiums back to Jan. 1, officials said.
Many beneficiaries were having trouble getting those payments set up because of glitches in the TriWest online portal and difficulties getting through to their call center.
TriWest officials have been working to fix the problems and have added staff to the call center. After several extensions of the deadline, disenrollment of beneficiaries from Tricare began May 1 for those who didn’t submit payment information to TriWest by April 30, according to Tricare officials.
This issue doesn’t apply to those who have Tricare for Life, the U.S. Family Health Plan or a Tricare health plan overseas. Those who had set up allotments through the Defense Financing and Accounting Service previously for their payments were told they didn’t have to take action for their allotments to be automatically transferred to TriWest.
It’s not clear how many of those 30,000 beneficiaries expected to be disenrolled have actively chosen not to continue their coverage. In early January, TriWest officials told Military Times that 59% of those who needed to provide payment information had done so.
Initially, West Region beneficiaries were required to provide their information to TriWest before the Jan. 1 start date of the TriWest West Region contract. But because many beneficiaries were having difficulty setting up those payments, Tricare extended the deadline several times.
In late April, Defense Health Agency officials extended their referral approval waiver through June 30 for the West Region, which allows military families enrolled in Tricare Prime in that region an extra two months to get specialty care without having to get approval from the contractor, TriWest.
They didn’t extend the deadline for setting up recurring payments.
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.
