Humana Military assumed the TRICARE contract Jan. 1 for the newly established TRICARE East Region, which includes Scott Air Force Base.
Previous TRICARE contracts included three regions in the United States. These regions have been consolidated into two regions now known as TRICARE East and TRICARE West. This new contract comes with some significant changes.
MOVING TO TRICARE SELECT
TRICARE Standard and TRICARE Extra are no more. Welcome TRICARE Select. Beneficiaries who were using their TRICARE Standard benefit now have to elect TRICARE Select or TRICARE Prime. The election of TRICARE Select or TRICARE Prime can be made until Dec. 31. Members who do not chose a plan will remain Direct Care Only and will have to wait until the new open season that starts Nov. 1, 2019. TRICARE will now have an open season period. Members may only change from TRICARE Prime or TRICARE Select during the open season or if they have a Qualifying Life Event. Marriage, birth, divorce or moving are considered QLEs. Contact Humana Military for more information at (800) 444-5445, or create an account on the new Beneficiary Self-Service website.
HOW TO CREATE A HUMANA MILITARY SELF-SERVICE ACCOUNT
Go to www.humanamilitary.com and select the beneficiary tab to create an account. Members can process TRICARE enrollments, make payments, check referrals and authorizations, find forms and access other TRICARE resources without waiting on the phone.
There is no authorization required for TRICARE Prime Active Duty Family Members, Retirees, and Retiree Family Members for Urgent Care visits effective 1 January 2018. Active Duty Service Members must call their primary care manager for a referral. Call the Nurse Advice Line at (800) TRICARE (874-2273) or go to www.humanamilitary.com to find a TRICARE authorized provider.
HEALTH PLAN COSTS
Beneficiaries now fall into one of two groups:
▪ Group A: If the sponsor’s initial enlistment or appointment occurred before Jan. 1, 2018; and
▪ Group B: If the sponsor’s initial enlistment or appointment occurred after Jan. 1, 2018.
Those enrolled to TRICARE Young Adult, TRICARE Reserve Select, TRICARE Retired Reserve, or the Continued Health Care Benefit program fall under Group B, regardless of when sponsor joined. Active Duty members, active duty family members and transitional survivors enrolled in TRICARE Prime have no out-of-pocket healthcare costs.
ANNUAL ENROLLMENT FEES
▪ Group A: $289.08 per individual/$578.16 per family; and
▪ Group B: $350 per individual/$700 per family.
No yearly enrollment fee for active duty family members.
Retirees, their families and others:
▪ Group A: No yearly enrollment fee; and
▪ Group B: $450 per individual/$900 per family.
Beneficiaries must also meet a deductible before TRICARE cost sharing begins. For additional information on costs go to www.humanamilitary.com.
▪ Pharmacy costs: Effective Feb. 1, 2018;
▪ Retail network co-pay for 30-day supply: Generic $11, brand name $28, non-formulary $53;
▪ Home delivery co-pay for 90-day supply: Generic $7, brand name $24, non-formulary $53; and
▪ Military pharmacy: Up to a 90-day supply, $0 copay for all formulary medications; non-formulary medications may be available with medical necessity.
It is recommend that beneficiaries keep their Defense Enrollment Eligibility Reporting System up-to-date by going to www.dmdc.osd.mil/milconnect or calling DEERS at (800) 538-9552. People may also visit www.TRICARE.mil/changes for more information.