As the new year approaches, it’s wise to evaluate your family’s health care benefit. Understanding Tricare changes in 2025 is essential for military families and retirees. This post helps you understand these changes, so you can make informed decisions about your health care.
Staying informed on Tricare changes in 2025 is particularly important. It affects your access to care, costs, and available benefits. From new regional contracts to updates in childbirth support and dental coverage, changes are on the horizon for Tricare health plans.
Table of Contents:
Understanding Tricare Changes in 2025
Several significant adjustments are coming to Tricare in 2025. These impact beneficiaries in the U.S., so read on to discover how these changes could affect you and your family members. Prepare for a smooth transition into the new calendar year.
New Regional Contracts and You
Perhaps the biggest change coming in 2025 is the introduction of new regional contracts for Tricare. This primarily affects those living in the United States. Six states—Arkansas, Illinois, Louisiana, Oklahoma, Texas, and Wisconsin—are shifting from the East Region to the West Region. This impacts available network providers and how you’ll get care.
This shift also introduces a new regional contractor, TriWest Healthcare Alliance. If you are a service member or a family member residing in one of these six states and enrolled in Tricare Prime, you should verify whether your current primary care manager (PCM) will remain in the Tricare network. If your PCM is leaving, you’ll need to choose a new one. If you’re on Tricare Select, understand that the Tricare regions shifting may lead to changes in plan costs and coverage. With Tricare Select being a self-managed preferred provider option health plan, understanding the available network providers is especially important.
For those with authorized referrals spanning the change on January 1st, 2025, don’t worry. If you are already enrolled in a TRICARE Prime plan and have an existing referral, you may not need a new referral to see a specialist within that six-month period. Stay up-to-date, make informed choices, and maintain optimal healthcare for you and your loved ones.
Childbirth and Breastfeeding Support Gets an Upgrade
The TRICARE Childbirth and Breastfeeding Support Demonstration (CBSD) is expanding in 2025. This demonstration provides support services to those with Tricare Prime, Prime Remote, or Tricare Select. The expansion now includes overseas locations and has new rules regarding the required certifications for labor doulas to participate in the CBSD.
If you’re expecting or planning to be, get familiar with the updated TRICARE Maternity Care Brochure. This program will now also cover TRICARE beneficiaries overseas. These expanded services are an important care benefit for active duty and retired service members with families.
Navigating the New Dental Contract
Changes are coming to the TRICARE Dental Program (TDP) as well. Though United Concordia will still manage the TDP, there will be premium rate changes starting in March 2025. These updates impact the TDP for active duty family members, young adult family members, and retired service members and their family members.
Check your patient portal regularly for details regarding annual deductible, enrollment fees, and other Tricare news. So, keep an eye out for new rate information. Stay tuned for updates about Tricare open season later in 2024 for changes starting January 2025. It is during open season that service members can evaluate different health plan options. You will choose from options like Tricare Prime, Tricare Select, Tricare Reserve Select, Tricare Retired Reserve, and Tricare Young Adult based on their family’s health care needs.
Drive Time Standard Waiver: A Simpler Process
Tricare Prime beneficiaries living over 30 minutes (but under 100 miles) from a military hospital or clinic can easily stay with their present primary care manager (PCM) without needing any waivers. If this applies to you, you will get a letter from Tricare explaining your options.
If you’re happy with your current PCM, you can do nothing and maintain your current coverage. This eliminates any potentially daunting administrative steps. This simplified process benefits those with established care and wishing to avoid changing health care providers.
If you do want to make a change, there is information on how to proceed. This gives families with Tricare Prime more control and convenience during Tricare open season.
Staying Informed
To stay up to date about additional details on Tricare changes in 2025, some good places to look include:
- TRICARE News.
- Military Health System News.
- Defense Health Agency News.
Subscribing to their email alerts ensures you’re getting accurate and up-to-date info. Be sure to utilize the official website to access credible information during open season as open season is a time when scams are most prevalent. Verify you are using the .mil website.
Conclusion
Tricare changes in 2025 bring important shifts in how beneficiaries, especially those in the U.S., access care and cover costs. These changes also introduce a new regional contractor. They are updating plan costs and introducing changes to open season enrollment processes and timelines, so ensure you make informed decisions before open season ends in December. Be prepared to verify information using a valid form of military ID or an official government credit card when logging into your patient portal.
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Familiarize yourself with the adjustments to regional contracts, childbirth support, dental programs, and the drive time waiver. Subscribe to email updates and bookmark the Tricare Newsroom and TRICARE news releases for the latest news. If you have coverage under the Continued Health Care Benefit Program, pay special attention to updates related to your coverage, as these might change with the updated benefits. Changes will occur beginning January 1st, 2025. Keep in mind open season will also impact those with family health plans through Humana Military.
Tricare changes in 2025 don’t need to feel overwhelming. This knowledge helps you smoothly transition into next year’s health care benefit landscape. You can secure the right coverage and benefits for you and your family. Be sure to consider your family’s specific needs when considering your options among available health plans and family health plans.
