Six states will switch from Tricare’s East Region to the West Region starting Jan. 1, 2025, as announced earlier this year. However, after conducting a recent evaluation, Tricare officials announced Tuesday that they have now carved out select ZIP codes in four states where more than 2,000 beneficiaries will be in a different region from the rest of their state come Jan. 1. This includes limited ZIP codes in two states — Missouri and Indiana — that aren’t among the regional shift.

The ZIP codes are being carved out because they border another state with a nearby military hospital or clinic and are part of that military treatment facility’s prime service area, which is defined as a 40-mile geographical region around a military hospital or clinic where Tricare Prime is available, officials said.

Tricare officials conducted a “significant evaluation” of the potential for carve-outs over several months, a Defense Health Agency spokesperson told Military Times.

“Health care will not be affected by these carve-outs. They instead ensure the Prime networks will continue to function as [they] have been before the upcoming changes in regions,” the spokesperson said.

Officials have been conducting targeted outreach to beneficiaries affected by the ZIP code carve-outs, according to a source familiar with the efforts.

The ZIP code carve-outs come two years after the new Tricare contracts were awarded and it was announced that all beneficiaries in Arkansas, Illinois, Louisiana, Oklahoma, Texas and Wisconsin would move to the West Region. At the time, officials said switching the 1.5 million beneficiaries from the East Region to the West Region would provide a more equitable balance of beneficiaries.

Areas impacted by the new ZIP code carve-outs include:

• Arkansas: Most of the state is switching to the West Region, but those living in certain ZIP codes in eight counties will stay in the East Region, including certain areas in Clay, Craighead, Crittenden, Cross, Greene, Mississippi, Poinsett and St. Francis counties.
• Indiana: Those living in certain ZIP codes in Benton, Fountain, Lake, Vermillion or Warren counties will switch to the West Region, unlike the rest of their state, which stays in the East Region.
• Missouri: Those living in certain ZIP codes in Butler, Dunklin, New Madrid and Pemiscot counties will be in the East Region, unlike the rest of their state, which stays in the West Region.
• Wisconsin: Most of the state is switching to the West Region, but those living in certain ZIP codes in Florence County will stay in the East Region.

As the Dec. 10 deadline for Tricare open season changes approaches, beneficiaries should review whether these tweaks could impact their health care plan decisions. To determine your Tricare region, visit Tricare’s website, scroll down the navigation bar on the right side and enter your ZIP code in the tool labeled, “What’s my Tricare region in 2025?”

Further, some beneficiaries in new carve-out areas are now in the West Region, where a new contractor, TriWest Healthcare Alliance, takes over effective Jan. 1. All West Region beneficiaries should contact TriWest before Jan. 1 to ensure their contact information is up to date. Beneficiaries also need to transfer their payment information if they pay enrollment fees or premiums by credit card or bank transfer.

For active duty family members who don’t pay enrollment fees, these carve-outs will be transparent, officials said.

If beneficiaries don’t provide TriWest with payment information before Jan. 1, they may be involuntarily disenrolled from Tricare and potentially lose their health coverage. If they pay by military allotment, they don’t need to take action.

Beneficiaries staying in the East Region don’t need to take action, as the contractor, Humana Military, remains the same and will keep the payment information on file.

Tricare open season runs through Monday, Dec. 10. Some Tricare beneficiaries are also eligible for the Federal Employees Dental and Vision Insurance Program, or FEDVIP. That program’s open season ends Dec. 9. It’s also the time to enroll in the dependent care flexible spending program now offered to active duty service members through the Federal Flexible Spending Account Program, or FSAFEDS.

Changes made during open season take effect Jan. 1, 2025.

Here’s what beneficiaries need to know.

For those eligible for Tricare: Tricare is the health care program for service members, retirees and their families worldwide. If you want to make changes in your plan, such as moving from Tricare Prime to Tricare Select, or vice versa, the deadline is Dec. 10. For more information, visit the Tricare Open Season page. If you’re already enrolled in a Tricare plan and don’t want to make changes, you don’t have to take any action. But you should still check to see if there are changes in Tricare costs that could affect you.

If you’re eligible for a Tricare plan but aren’t enrolled, now is the time to do it. Otherwise, you’ll have to wait until the next open season or a qualifying life event, such as the birth or adoption of a child, marriage, divorce, moving or changes to other health insurance.

Because of limitations to online options through Dec. 31, beneficiaries will need to contact their regional Tricare contractor directly to change their plan during Tricare open season.

There are changes in the Tricare contracts starting Jan. 1, 2025, too. Among those changes, TriWest Healthcare Alliance is taking over the West Region contract. Humana Military will continue as the East Region contractor. But six states are switching from the East Region to the West Region. There are some carve-outs of a limited number of ZIP codes in four states where beneficiaries will be in a different region than the rest of their states. Beneficiaries should check their region, look at provider directories and other information to determine their best choice.

And all beneficiaries in the West Region who make recurring payments such as enrollment fees by electronic funds transfer, debit card or credit card need to contact TriWest to provide the new payment information. Those who pay by military allotment don’t have to take action; it will transfer automatically.

Open season doesn’t apply to active-duty service members, Tricare for Life or premium-based plans — Tricare Reserve Select, Tricare Retired Reserve and Tricare Young Adult. These premium-based plans can be purchased at any time during the year. But those in Tricare Young Adult with either the Prime or Select options can only change plans during open enrollment or a qualifying life event.

For those eligible for FEDVIP dental and vision plans: Most retirees and their family members are eligible for dental and vision coverage under the Federal Employees Dental and Vision Insurance Program, or FEDVIP. The deadline for enrolling in or changing FEDVIP coverage is Dec. 9.

Families of active duty, National Guard and reserve service members — as well as Guardsmen and reservists who aren’t on active duty — are eligible for the Tricare Dental Program, which requires separate enrollment.

Those in the military community must be enrolled in a Tricare health plan to be eligible for FEDVIP vision coverage. Those eligible include active duty family members, retirees and their eligible family members and Selected Reserve members and their families.

For military members with expenses for child or adult day care: This is the second year the Uniformed Service Member Dependent Care Flexible Spending Account is available to active duty members, as well as members of the Active Guard Reserve on Title 10 orders. The last day to enroll is Dec. 9. The flexible spending account helps defray the cost of child care and other dependent care by providing tax savings. The Federal Flexible Spending Account Program, known as FSAFEDS, is sponsored by the Office of Personnel Management.

Recognizing this individuality, we as elected officials try to smooth out the highs and lows that impact veterans and service members and assess the potential unintended consequences of our legislative initiatives.

It’s these “unintended consequences” that have become a recurring theme of the Veterans and Military Advisory Council, or VMAC, that I established to help inform me on the issues facing veterans, military service members and their families. The VMAC is an ad hoc and evolving group of elected officials, veterans, concerned citizens and veteran advocates from Northern Virginia (Fairfax, Loudoun, Fauquier, and Prince William Counties) that meets quarterly to discuss state and federal issues affecting veterans and determine how we can affect positive change.

At our most recent meeting, we turned our attention to an inconsistency between the Affordable Care Act, or ACA, and Tricare’s treatment of dependent children.

Nationally, the ACA prohibits insurance companies from denying coverage or charging higher rates based on preexisting conditions. In Virginia, Medicaid expansion, finally enacted in 2019, has provided health care access to approximately 500,000 Virginians who previously did not have coverage. The ACA also made a significant step forward in ensuring that young adults have access to health insurance during their transition from teenagers to adult independence.

One of the most widely recognized provisions of the ACA is the requirement that health care plans allow dependent children to remain on their parents’ health insurance until they turn 26. This provision has provided millions of young Americans with a safety net, including my two daughters, allowing them to focus on their education or early professional careers without the additional burden of securing their own, and potentially expensive, health insurance.

Surprisingly, this protection is not extended equally to all American families, particularly those who serve in our military.

Under current regulations, military service members who rely on Tricare for their health care face a different reality. Once a dependent child turns 21, they are no longer eligible for coverage under Tricare Prime unless they are enrolled in a university, in which case coverage can be extended, but only until age 23.

After this, the only option available to them is Tricare Young Adult, which requires premiums and has a deductible. This option is not only more expensive, but it is also more administratively burdensome. The result is a situation where the children of those who have dedicated their lives to serving and protecting our country are left with higher costs compared to their civilian counterparts.

For many military families, the additional premiums and deductibles required under Tricare Young Adult are not just a financial inconvenience — they are a significant burden. This is especially true when compared to the no-cost or low-cost coverage their dependents enjoyed under Tricare Prime.

The disparity is glaring: While civilian children can stay on their parents’ health insurance until age 26 without additional costs, military families — who often endure frequent relocations, deployments and other unique stressors — must face a higher financial burden for their children’s health care during this critical, transitional time in their lives.

The solution to this problem is both simple and just: We must encourage our congressional delegations across the nation to extend the same protections to military families that we afford to civilian families under the ACA. Specifically, dependent children of military service members should be allowed to remain on their parents’ Tricare plan until they turn 26, without the need to transition to a more costly health care plan like Tricare Young Adult.

This simple reform would not only alleviate the financial burden on military families but also ensure that the children of service members have the same opportunities for stability and success as other young Americans. It is a matter of fairness, of ensuring that those who serve our nation are not disadvantaged simply because of their service. From a legislative perspective, this should be considered “low hanging fruit” to correct an unintended consequence.

Del. David Reid has represented the 28th District in the Virginia House of Delegates since 2017. He has served for five years as co-chair of the General Assembly’s Military and Veterans Caucus (GAMVC) and is the vice chair of the House Transportation Committee. He served 23 years in the U.S. Navy Reserve as an intelligence officer, where he was awarded the prestigious Navy and Marine Corps Commendation Medal on three occasions, and retired as a commander.

The Tricare open season runs through Dec. 10. Some Tricare beneficiaries are also eligible for the Federal Employees Dental and Vision Insurance Program, or FEDVIP. That program’s open season ends on Dec. 9. It’s also the time to enroll in the dependent care flexible spending program now offered to active-duty service members.

Be aware of some changes, such as increases in some costs, as you decide what plan is best for you. A new contractor, TriWest Healthcare Alliance, is taking over for the Tricare West Region on Jan. 1. The current East Region contractor, Humana Military, remains the same.

Check the online Humana provider directory or the TriWest provider directory to see if your health care providers are in the network.

Tricare open season applies to those enrolled in or eligible for Tricare Prime or Tricare Select. During this period, enrolled beneficiaries can make changes to their health coverage — such as switching from Tricare Prime to Tricare Select, or moving from individual to family enrollment. If you’re eligible for a Tricare plan but aren’t enrolled, now is the time to do it. Otherwise, you’ll have to wait until a qualifying life event, such as the birth or adoption of a child, marriage, divorce, moving or changes to other health insurance.

Any changes you make during open season will take effect Jan. 1.

During this time, eligible Tricare beneficiaries who want to stay in their current plan can do so if they’re still eligible.

But all beneficiaries who are in the Tricare West Region should contact the new contractor, TriWest, before the start of the new contracts on Jan. 1, to make sure their contact information is up to date, and to transfer their payment information if they pay enrollment fees or premiums by credit card or bank transfer.

The new West Region includes 26 states, as beneficiaries in six states have been transferred to that region from the East Region under the new contracts. Those six states are Arkansas, Illinois, Louisiana, Oklahoma, Texas and Wisconsin.

Open season doesn’t apply to active-duty service members, or to Tricare for Life, or to the premium-based plans — Tricare Reserve Select, Tricare Retired Reserve and Tricare Young Adult. These premium-based plans can be purchased at any time during the year. But those in Tricare Young Adult with either the Prime or Select options can only change plans during open enrollment or a qualifying life event.

To enroll in a plan, or to make changes, eligible beneficiaries can either call their regional contractor, or download an enrollment form and mail it to their 2025 regional contractor. Remember, if you live in the U.S. you won’t be able to use the Beneficiary Web Enrollment self-service portal this year to make changes.

Call Humana Military for the East Region at 800-444-5445.

For the West Region, call TriWest at 888-874-9378.

The plans:

Tricare Prime is a health maintenance organization-style plan in which you get most of your care from a primary care manager, with referrals required for specialty care. There is no deductible. Active-duty service members, their family members and transitional survivors don’t pay enrollment fees or out-of-pocket costs for covered services, unless they get non-emergency care without a referral, use non-network providers without authorization, or use a pharmacy other than a military pharmacy. Retirees, their families and all others pay enrollment fees and out-of-pocket costs for covered services except for preventive care.

Tricare Select is a preferred provider organization-style plan in which you choose your Tricare-authorized provider and don’t have to get referrals for most services. There are deductibles, co-payments and cost-shares.

Cost increases

The costs for the Tricare pharmacy benefit will stay the same through 2025.

Generally, those who have been paying out-of-pocket for healthcare under Tricare in 2024 will pay extra in 2025, according to fee schedules just released by the Defense Health Agency. For those who make co-payments for covered services such as primary care visits, specialty care outpatient visits and emergency room visits, some co-pays will go up by $1 to $3 a visit.

Individual active-duty service members don’t have out-of-pocket costs. Their family members may have costs, depending on the Tricare health plan they’re enrolled in, their sponsor’s pay grade and when the sponsor entered active duty, the type of care they get, and where they get it.

There are no costs for covered preventive care visits.

Those who pay annual enrollment fees will also see increases. For example, retirees who entered the military before 2018 will pay $744 to enroll their family in Tricare Prime, an increase of $18 from $726 in 2024.

Annual deductibles will increase for some, which means the families will pay more out of pocket before Tricare kicks in. For example, active duty families in Tricare Select whose service member is E4 and below and entered the military on or after Jan. 1, 2018, will pay $128 out of pocket before Tricare kicks in, an increase of $3 compared to 2024.

By law, there are differences in some costs based on when the sponsor entered the military. Those who entered before Jan. 1, 2018, are part of Group A, while those who entered on or after Jan. 1, 2018, are part of Group B.

Costs for premium-based plans

These costs, set by the Defense Health Agency, have continued to rise over the years. The largest increase is in the Tricare Young Adult Prime option, with a 14% increase in monthly premiums. Those premiums increase by $90, from $637 to $727 a month. This “will put the plan out of reach for most young adults and their families,” said Eileen Huck, government relations senior deputy director for the National Military Family Association.

“The good news is that the cost of Tricare Young Adult Select is going up by a much smaller amount,” she said. The Tricare Young Adult Select option premium increases by 8%, from $311 a month to $337. The Tricare Young Adult Prime and Select plans are available for purchase by qualified former dependent children up to age 26. “We still think that young adults should be able to retain their Tricare coverage up to age 26 at no additional cost,” she said.

The Tricare Young Adult program must be at no cost to the government, under the rules set by Congress when it was implemented in 2013. So, the full cost of the program’s premiums is reflected in the fees charged to families. Defense officials look at the health care expenditures for the program for the previous year and calculate the costs.

The monthly premiums for Tricare Reserve Select and Tricare Retired Reserve are also increasing. For example, they’re increasing by 4% for service members in the Tricare Reserve Select program for member only, and 7% for member and family in the Reserve Select program. Those in the Tricare Retired Reserve program will pay an extra 8% in monthly premiums.

Monthly premiums for Tricare Reserve Select for member only are $53.80, up 4% from $51.95 in 2024. For member and family, cost is $274.48, up 7% from $256.87 a month in 2024.

For Tricare Retired Reserve, member only, monthly premiums are $631.26, up 8% from $585.24 in 2024. Member and family, cost is $1,513.04, up 8% from $1,406.22 in 2024.

Dental

Families of active duty, National Guard and reserve service members — as well as Guardsmen and reservists who aren’t on active duty — are eligible for the Tricare Dental Program, which requires separate enrollment. Premiums for the dental program decreased slightly in November, and remain the same until Feb. 28, 2025.

Most retirees and their family members are eligible for dental coverage under the Federal Employees Dental and Vision Insurance Program, or FEDVIP, which is administered by the Office of Personnel Management and also requires separate enrollment. For 2025, the Federal Employees Dental and Vision Insurance Program (FEDVIP) has twelve dental carriers.

Visit www.benefeds.com to enroll in FEDVIP and to get more information.

Vision

Those in the military community must be enrolled in a Tricare health plan to be eligible for FEDVIP vision coverage. Those eligible include active duty family members, retirees and their eligible family members, and Selected Reserve members and their families.

For 2025, FEDVIP has five vision carriers.

Visit www.benefeds.com to enroll in FEDVIP and to get more information.

Dependent care flexible spending

This is the second year military families can sign up for the new Dependent Care Flexible Spending Account, which allows families to set aside money before taxes for dependent care expenses. Families sign up for this benefit through the Federal Flexible Spending Account Program (FSAFEDS) during the federal benefits open season, which is now through Dec. 9.

These accounts help defray the cost of child care and other dependent care by providing tax savings. For help in determining whether to set up an account, and how much money to set aside, officials advise troops to take advantage of the Defense Department’s free counseling and advice from personal financial management counselors at many military installations, and tax counselors available all year through DoD’s Military OneSource. FSAFEDS also offers free benefits counseling.

Defense officials will later offer a health care flexible spending account, also through FSAFEDS, with a specific enrollment period in 2025.

Officials advise those who were affected to call the DMDC/DEERS Support office at 800-538-9552 to confirm their eligibility.

The problem, which was fixed Sunday after about 48 hours, affected retirees and family members whose service was tied to the Coast Guard, National Oceanic Atmospheric Administration and the Public Health Service, according to Defense Health Agency, or DHA, officials.

On Friday, DHA posted a note on their Tricare website advising people who had lost Tricare eligibility to contact their regional Tricare contractor for assistance if they had trouble getting health care before the situation was resolved.

Officials attributed the hiccup to a data transfer, and the Defense Manpower Data Center notified DHA officials that some records were missing from a file sent by the Coast Guard, according to DHA.

There were no other impacts from the incident, officials said.

DHA and their regional contractors have been transferring beneficiary enrollment information in DEERS in preparation for new Tricare contracts that start Jan. 1.

DHA earlier announced a global enrollment freeze from Oct. 25 to Oct. 27, requiring beneficiaries within the United States to call their regional Tricare contractor to update their information or make health plan changes.

And through Dec. 31, those who live in the U.S. must call their regional contractors to make health plan changes, including during open season, which starts Nov. 11. Beneficiaries won’t be able to update health plans online in milConnect by way of the Beneficiary Web Enrollment system through the end of the year.

Enrolled beneficiaries living in one of the 26 states in the new Tricare West Region, including the six states moving from the East to the West Region, must provide their payment information to the new West Region contractor, TriWest Healthcare Alliance, before Jan. 1.

If you don’t provide your payment information to TriWest by then, you may be involuntarily disenrolled from Tricare, according to Tricare officials. This applies only to those who currently pay by electronic funds transfer, debit card or credit card. If you pay by military allotment, that allotment will automatically transfer, officials said.

You can provide your payment information now through Tricare.mil/west or by downloading the Tricare automatic payment authorization form and mailing it to TriWest. Beneficiaries don’t have to wait until open season to do this.

Effective Jan. 1, Arkansas, Illinois, Louisiana, Oklahoma, Texas and Wisconsin will join the new West Region. About 1.1 million beneficiaries live in those six states.

Enrolled beneficiaries living in either the East or West Region who don’t want to change their current Tricare plan don’t need to re-enroll during open season, which runs from Nov. 11 through Dec. 10.

During open season, enrolled beneficiaries have the ability to change their plan if, for example, they decide to move from Tricare Select to Tricare Prime. This year, because of Tricare’s current online limitations, you will have to make those changes by contacting your Tricare regional contractor by phone at their call center. Any changes made during open season take effect Jan. 1.

Open season is the only time you can change your plan, except for a qualifying life event such as the birth or adoption of a child, marriage, divorce or retirement from active duty. Eligible beneficiaries can also enroll in Tricare during this time.

If you need to know whether your health care provider is staying in the network before making a decision about open season, you can check the contractors’ provider directories. Humana Military will continue as the East Region Tricare contractor; Humana and TriWest will publish their online provider directories by Nov. 2, according to the Defense Health Agency.

Tricare officials will publish information about Tricare rate changes in the coming weeks.

For those eligible for the Federal Employees Dental and Vision Insurance Program, or FEDVIP, open season is one day shorter, running from Nov. 11 through Dec. 9. That time frame also applies to service members who want to enroll in the dependent care flexible spending accounts and the new health care flexible spending accounts, which are administered by the Federal Flexible Spending Account Program, or FSAFEDS.

Tricare open season applies to those enrolled in or eligible for the following plans:

• Tricare Prime
• U.S. Family Health Plan
• Tricare Prime Remote
• Tricare Prime Overseas
• Tricare Prime Remote Overseas
• Tricare Select
• Tricare Select Overseas

Open season doesn’t apply to active duty service members or those with Tricare for Life coverage, which is automatic for those with Medicare Part A and Part B.

It also doesn’t apply to those enrolled in Tricare premium-based plans — Tricare Reserve Select, Tricare Retired Reserve and Tricare Young Adult — which can be purchased any time of the year. Still, those enrolled in those plans and who are living in a state moving to the West Region contract may still need to provide their payment information to TriWest at Tricare.mil/west by Jan. 1.

Tricare Prime is a health maintenance organization-style plan in which you get most of your care from a primary care manager, with referrals required for specialty care. There are no deductibles. Active duty service members, their family members and transitional survivors don’t pay enrollment fees or out-of-pocket costs for covered services. Retirees, their families and all others pay enrollment fees and out-of-pocket costs for covered services except for preventive care.

Tricare Select is a preferred provider organization-style plan in which you choose your Tricare-authorized provider and don’t have to get referrals for most services. There are deductibles, copayments and cost-shares.

Military community, take note: Defense health officials recently announced some limitations to online options for Tricare beneficiaries making changes to their health plans, starting with a global enrollment freeze that will affect any Tricare plan from Oct. 25-27.

During those three days, Tricare beneficiaries won’t be able to update their information or make changes to their plans, including overseas and dental plans.

The Oct. 25-27 outage is scheduled to allow the Defense Health Agency and its partners to transfer beneficiary enrollment information to the regional contractors, DHA officials said in an announcement Monday.

Additionally, after that freeze ends, Tricare beneficiaries won’t be able to make online health plan updates in milConnect through Beneficiary Web Enrollment beginning Oct. 28 through Dec. 31. Instead, beneficiaries will need to contact their regional Tricare contractor by phone to do things like change their primary care manager, update their plan due to a qualifying life event or change their plan during Tricare open season, which runs Nov. 11 through Dec. 10.

Those not currently enrolled in a Tricare plan can still enroll in one online between Oct. 28 and Dec. 31 through milConnect.

Tricare beneficiaries who live overseas can continue to use milConnect between Oct. 28 and Dec. 31. However, those transferring from the U.S. to an overseas location will need to contact International SOS.

Officials advise beneficiaries to check their information in the Defense Enrollment Eligibility Reporting System as soon as possible.

At Humana Military, officials acknowledged they expect the call volume to increase for the East Region during these last months of the year. Their contact center has been working throughout the year to staff and train “a robust level of employees to manage the elevated demands that we expect as a result of open season” and the transition to the new contract happening at the same time, officials told Military Times. “During this time, we encourage Tricare East Region beneficiaries to call on Wednesdays, Thursdays or Fridays as we anticipate shorter wait times on those days of the week.”

The current West Region contractor, Health Net Federal Services, is staffed appropriately to handle the extra calls between Oct. 28 and Dec. 31, officials told Military Times. They’ll follow their established process for accepting enrollment changes outside of the Beneficiary Web Enrollment.

Officials with TriWest Healthcare Alliance, which takes over the West Region contract Jan. 1, told Military Times they are “well prepared” to open their contact center on Nov. 11 to support beneficiaries during open season. DHA has conducted a validation of their operational readiness, and their staff is trained to handle customer inquiries, they said.

The temporary online limitations come ahead of Tricare’s new regional contracts, which begin Jan. 1.

Those who want to make changes effective from Oct. 28 through Dec. 31 should call their current regional contractor. Humana Military, which covers the East Region, is at 800-444-5445. The current West Region contractor, Health Net Federal Services, is at 844-866-9378; TriWest Healthcare Alliance will take over as the new West Region contractor effective Jan. 1.

Those who want to make changes effective Jan. 1 and beyond, including Tricare open season:

• East Region: Call Humana Military at 800-444-5445.
• West Region, which adds Arkansas, Illinois, Louisiana, Oklahoma, Texas and Wisconsin effective Jan. 1: Call TriWest Healthcare Alliance at 888-874-9378. Their call center will open the first day of Tricare open season on Nov. 11.
• Overseas: Update information in the Defense Enrollment Eligibility Reporting System or contact International SOS.

11:59 p.m. Eastern Time tonight, Dec. 11, is the deadline for service members to enroll in the new Dependent Care Flexible Spending Account. It’s also the sign-up deadline for those eligible for dental and vision coverage under the Federal Employees Dental and Vision Insurance Program, or FEDVIP. Most retirees and their families are eligible for dental and vision coverage under FEDVIP. Families of currently serving members are eligible for the vision coverage under FEDVIP. These currently serving families are eligible for the Tricare Dental Program, which requires separate enrollment.

11:59 p.m. Eastern Time tomorrow, Dec. 12 is the deadline for enrolling in or making changes to your Tricare plan. If you don’t want to make changes, you don’t have to take any action.

The new Dependent Care Flexible Spending Account is available to active duty members, as well as members of the Active Guard Reserve on Title 10 orders. The flexible spending account helps defray the cost of child care and other dependent care by providing tax savings. It’s part of the Federal Flexible Spending Account Program, known as FSAFEDS, which is sponsored by the Office of Personnel Management.

Families can contribute as little as $100, and as much as $5,000 over the year to this account. Eligible expenses include child or adult day care, preschool, summer day camps, and before- or after-school programs.

Open enrollment ends at midnight on Monday, meaning federal employees, retirees and some military service members won’t have another chance to change their benefits until next year. Now is the time to review your coverage, weigh competing plans and make adjustments for the plan year ahead.

Very few employees elect to change their coverage each year despite the fact that most plans likely changed in some way, whether premiums went up, benefits narrowed or new perks were added. Experts interviewed by Federal Times said it’s worth at least scanning through your plan brochure to see what’s new.

Selections made during this annual period will affect coverage for twelve months beginning on Jan. 1, 2024.

In all, more than 8 million people are covered by the program each year, including U.S. Postal Service workers who won’t be covered by their own unique program until 2025.

Federal Times has been tracking major policy changes affecting plans this year to help you navigate options and save time.

2024 premium increases

Let’s start with your wallet.

The average federal employee can expect to pay 7.7% more on insurance premiums next year. It’s customary for this to fluctuate, as costs are evaluated annually based on several factors, including the availability of new medical technology, inflation, prescription drug prices and demand for care.

Your premium is a guaranteed expense, so figure out exactly how yours is changing.

Of the more than 150 plan options available in 2024, eight had no change in their premiums, according to Kevin Moss, a benefits expert at Consumers’ Checkbook. Premiums got cheaper for 31 plans.

In 68 plans, the premium increased, but by less than 7.7%. About a third of plans, or 47 of them, increased above the average.

Program-wide changes

There are about a dozen plan options leaving the federal government’s health insurance program in 2024. One of the largest is Humana, though its departure will affect fewer than 10,000 subscribers, according to the Office of Personnel Management.

Here’s a complete list of which plans are leaving the program or dropping coverage for certain areas.

There are also two new plans in 2024 that weren’t available last year: Compass Rose Standard and Sentara Health in northern Virginia.

Remember that if your carrier is dropping you from coverage, you’ll need to select a different plan, or else you’ll be auto-enrolled in the lowest cost plan as determined by OPM.

Vision and dental

While medical costs may soar for some FEHB enrollees, vision and dental premiums will change little in the year ahead.

The average premium increase is 1.4% for dental plans and 1.1% for vision.

For benefits highlights under the FEDVIP program, click here.

Expanded options for IVF, infertility

A major theme of coverage in recent years has been diagnosis and treatment of infertility. The issue is that some plans have very narrowly granted coverage for artificial reproductive health care, which requires some kind of medical intervention to conceive a baby.

This year, employees should still expect to pay a potentially large share of their associated costs out-of-pocket, though all carriers are being required to cover artificial insemination drugs and drugs for in vitro fertilization for three cycles per year.

See which specific carriers are expanding ART coverage next year.

FEHB and Medicare coordination

This is a significant change for next year to be aware of, said Moss.

Almost half of all carriers offer plan options that provide additional benefits and incentives for those under Medicare Part B, the optional portion that covers doctor visits, outpatient services, durable medical equipment and preventatives.

For next year, Part B is going up by about $10 a month.

“About 70% of federal retirees enroll in Part B, which means paying two premiums and in essence two duplicative insurance programs,” according to Consumers’ Checkbook.

It’s worth it, experts said, for retirees who join Part B and get access to FEHB Medicare Advantage plans that can reimburse Part B premiums or waive out-of-pocket medical expenses outside of prescription drugs.

Medicare Advantage plans can also open up Part D coverage to assist with drug costs. Part D is another voluntary benefit for beneficiaries of Medicare provided by a private plan.

“We were getting some notice from OPM in the spring that the Part D reforms were something that were really big,” Moss said. “They wanted retirees to benefit from this. And really what it’s also doing is pushing more of the FEHB costs onto the Medicare program.”

A total of 39 plans will offer Medicare Advantage or Medicare Part D plans that automatically coordinate with FEHB coverage.

Most prescription drug plans will also auto-enroll you if you have Medicare Parts A and B or just Part A, Moss said. However, you can choose to opt-out.

Medicare information is found in Section 9 of each FEHB plan brochure.

Gender-affirming care

A priority that was rolled over from last year, gender-affirming care, was updated to include a reduction in the number of required evaluation letters for initiation of treatment, medical necessity of facial gender-affirming surgery and hormone therapy.

Specific coverage can be found in Sections 5(b) and 5(f) of plan brochures.

Obesity treatment

Just this month, the Food and Drug Administration approved another weight-loss drug option alongside existing medications like Ozempic, Wegovy and Mounjaro.

As the landscape for treatments broadens, OPM said it expects carriers to regularly update their coverage of obesity drugs as they become approved.

In its letter to carriers in January, OPM directed carriers to “have adequate coverage of FDA approved anti-obesity medications on the formulary.”

This year, carriers have new coverage requirements for these drugs and for screening and prevention efforts.

Mental health

Another continued effort this year, mental health coverage by FEHB plans must adhere to clinical recommendations to screen youth and teens for major depressive disorder and anxiety.

OPM also encouraged carriers to support the use of telehealth in improving provider networks.

I’m ready to enroll. What’s next?

OPM has instructions for how to choose your benefits at this link.

Plus, check out these tips from experts on how to streamline your decision-making.

Military personnel, Tricare open enrollment

If you’re a military service member and have questions about your Tricare health benefits or your premium costs, check out MilitaryTimes.com coverage here.

Changes made during open season will take effect Jan. 1.

For those eligible for Tricare: Tricare is the health care program for service members, retirees and their families worldwide. If you want to make changes in your plan, such as moving from Tricare Prime to Tricare Select, or vice versa, the deadline for doing so is Dec. 12. For information about enrolling in or changing plans, visit the Tricare Open Season page. If you’re already enrolled in a Tricare plan and don’t want to make changes, you don’t have to take any action. But you should still check to see if there are changes in Tricare costs that could affect you.

For military members with expenses for child or adult day care: A new benefit, the Dependent Care Flexible Spending Account, is available to active duty members, as well as members of the Active Guard Reserve on Title 10 orders. The last day to enroll is Dec. 11, one day shorter than Tricare open season. The flexible spending account, announced by Department of Defense officials earlier this year, helps defray the cost of child care and other dependent care by providing tax savings. The Federal Flexible Spending Account Program, known as FSAFEDS, is sponsored by the Office of Personnel Management.

Families can contribute as little as $100, and as much as $5,000 over the year to this account. Eligible expenses include child or adult day care, preschool, summer day camps, and before- or after-school programs. A $5,000 yearly contribution works out to about $417 a month from military pay. That amount is deducted from pay before taxes, so this reduces the amount of total income subject to taxes. Thus, a family with $60,000 in income who contributes $5,000 to their account would only be taxed on $55,000. You’ll submit eligible expenses for reimbursement. Information about the process for doing that, including an app, is available on the FSAFEDS website.

Military families should review their expected child care costs carefully to determine how much to set aside in an account if they enroll in the program. Any amount left over in their account by the end of the grace period in 2025 will be forfeited. Troops and spouses are encouraged to take advantage of the Defense Department’s free counseling and advice from personal financial management counselors at many military installations, and tax counselors available all year through Military One Source. FSAFEDS also offers free benefits counseling.

For those eligible for FEDVIP dental and vision plans: Most retirees and their family members are eligible for dental and vision coverage under the Federal Employees Dental and Vision Insurance Program, or FEDVIP. The deadline for enrolling in or changing FEDVIP coverage is Dec. 11, also one day shorter than the Tricare open season.

Families of active duty, National Guard and reserve service members — as well as Guardsmen and reservists who aren’t on active duty — are eligible for the Tricare Dental Program, which requires separate enrollment.

Those in the military community must be enrolled in a Tricare health plan to be eligible for FEDVIP vision coverage. Those eligible include active duty family members, retirees and their eligible family members, and Selected Reserve members and their families.

Visit BENEFDS for more information about dental and vision coverage, and to enroll in or change plans.