Changing Your Medical Plan

Tip: You might want to print this topic before you begin.

Overview

Sponsors and spouses can initiate a medical plan change for themselves and their family members. Dependents over the age of 18 can initiate a medical plan change for themselves only.

You can change the medical plan for a beneficiary who is currently enrolled in a TRICARE Select or TRICARE Prime/Remote plan, and is eligible for a different plan based on their status and location. The beneficiary’s address must be accurate and in the same region as their enrollment.

You can change a plan from TRICARE Prime or Remote to TRICARE Select or from TRICARE Select to TRICARE Prime or Remote.

When you change from a Prime or Remote plan to a Select plan, you do not need to select a PCM.
When you change from a Select plan to a Prime or Remote plan, you do need to select a PCM.
If you are a retiree who is enrolling family members in different plans (Prime and Select), be aware that you must perform a separate enrollment process for each plan.

If you meet the criteria, you can change your plan either during open enrollment, or if you experience a QLE. The end date of your current enrollment must be later than the start date of the plan you are requesting.

If you begin a plan change during open enrollment, the effective date for the new plan will be set to January 1 of the next calendar year.
If you are changing a plan because of a QLE, the start date will be set to the effective date of the QLE, and can be up to 90 days in the past and 90 days in the future.

The prior enrollment will be terminated one day prior to the effective date of the new plan. You will also be required to accept an Access to Care Waiver.

Before you begin, gather any information you need to update family member addresses, email, or other contact information, and the credit card or EFT information you might need to process payment information.

Note that the system times out after 15 minutes of inactivity.

Steps

On the Family Members page, click the Medical Enrollments tab to ensure that the Start Plan Change button is visible. If the button is not shown, or if it is disabled, you cannot change your plan.
Under the Family Members list, click Start Plan Change.
On the Enroll in TRICARE - Select Enrolling Family Members page (Step 1 of 5), select one (1) or more family members to enroll in TRICARE medical benefits.
Click Continue.
Select a reason for the plan change.
- If it is during the open enrollment period, the page shows the Annual Open Season option.
- If you are changing your plan because of a Qualifying Life Event, select a QLE, the Effective date, and any other required information.
Click Continue.
On the Enroll in TRICARE - Address Verification page, verify the addresses for each family member whose plan you want to change.
- If a family member elected to receive their benefit change correspondence by email on the Update Address Information page, the corresponding checkbox is selected.
- If you need to change an address, click Cancel, then click Update Contact Info under the Contact Info tab. If necessary, the system will prompt you to transfer an enrollment to the correct region.
- If available, you can check if you are eligible for a TRICARE Prime Remote plan by entering the sponsor's current work zip code in the Sponsor Work Zip section of this page, or on the Update Address Information page. If the Zip code qualifies for TRICARE Prime Remote and the family meets all other qualifying conditions, family members can be enrolled in a TRICARE Prime Remote plan.
Click Continue.
On the Acknowledgements page, select all of the checkboxes to acknowledge your responsibilities.
- You must waive access standards to enroll online. Click the access standards link to open a new tab or window and learn about TRICARE Prime distance and drive time standards.
- If you do not want to waive access standards, you can click the paper form link to download a paper form from a new tab or window, and mail it to your contractor.
- The Select a Country for Medical Care drop-down list is displayed for eligible beneficiaries who have an OCONUS address (including APO/FPO/DPO).
Click Continue.
On the Enroll in TRICARE - Select Plan page (Step 2 of 5), select a plan for the first family member listed under Enrolling Family Member(s).The page shows one (1) plan the family member can change to, and its default start date.
Click Continue.
You might see the Command Sponsored for Prime Plans page. If so, read the instructions, and select the Family member is command sponsored checkbox, if appropriate.
Click Continue.
- The following pages can vary depending on the selections for each family member.Beneficiaries changing to a Select plan do not choose a PCM.Beneficiaries changing to a Prime or Remote plan must choose a PCM.
If you see the Enroll in TRICARE – Verify Selected Plan page, verify that the information is correct. Click Continue. If more family members are in the list, select a plan for the next family member in the list.
- A check mark indicates that a family member is complete.
- Follow the various steps to change plans for family members until you have completed all family members in your list.
Click Continue. If you have finished, go to step 27, Enrollment Review. Otherwise, some plan choices require selecting a Provider Type, as in the next step.
On the Enroll in TRICARE - Select Provider Type page (Step 2 of 5), select a provider type.
- The provider type options change depending on the status and location of the beneficiary and the selected plan. Fill in any fields that display after you select a provider type.
- The following message displays for enrollees that are eligible for a TRICARE Remote Plan overseas: "For TRICARE Prime Remote Plans, you can submit your enrollment using the Civilian provider type."
Click Continue. Some plans require selecting a PCM, as in the next steps. Otherwise, go to step 27, Enrollment Review.
On the Enroll in TRICARE - Search for a PCM page (Step 2 of 5), enter search criteria to search for a PCM for the family member listed under Enrolling Family Member(s). Family members with a check mark next to their name have been completed.
- Select a search option and fill in the required fields, such as Zip Code, City and State, or Place of Care.
- If available, click Provider Directory to search for a specific provider in a new tab or window.
- In the Optional Search Filters section, you can filter the results by Specialty, Gender, or by entering the PCM’s last name.
Click Search.
On the Enroll in TRICARE - Assign a PCM page (Step 2 of 5), select a PCM.If your provider is not shown, you can click the paper form link to open the TRICARE site in a new tab or window, where you can select a plan and download an East or West Enrollment Form to mail to your contractor.
Click Continue.
On the Enroll in TRICARE - Confirm PCM Changes page (Step 2 of 5), verify the selected provider information. Click Continue.Some plans require premium payments, as in the next steps. Otherwise go to step 27, Enrollment Review.
- If you are changing the plan for more than one (1) family member, the Select Plan page displays again.
- Select a plan for the next family member in the list. A check mark means that a family member is completed.
- If available, you can select the checkbox to apply this PCM to another family beneficiary.
- Repeat the process for all family members in the list.
On the Enroll in TRICARE - Premiums page, read the instructions and fill in the required information for the initial and recurring premium payments.
- To enroll online, the initial payment must be made by credit card.
- If you would like to pay by check, click Enrollment Form PDF at the bottom of the page to print the enrollment form and mail it in along with your payment.
- At the bottom of the page, select a recurring payment option. If you select EFT, another section displays where you can enter the appropriate financial information.
Click Continue.
On the Enroll in TRICARE - Confirm Premium Payment Information page, verify your payment details and recurring payment selection. Click Continue.
On the Enrollment Review page (Step 4 of 5), verify the selected enrollment options for each family member you are enrolling.
- To generate a PDF document with enrollment details, click Enrollment Form PDF.
- Click Submit to save your enrollment information.
On the Enroll in TRICARE - Confirmation page (Step 5 of 5), read about receiving your enrollment confirmation correspondence and the date that enrollees can start using the new plan. Click Home to return to the Family Members page.