When Army spouse Ashley Ashcraft first approached her husband about TRICARE’s Open Season — where beneficiaries have roughly one month from mid-November to mid-December to switch health plans for the upcoming year — he was hesitant.
“It’s free if we stay with TRICARE Prime,” he pointed out. “Why should we switch plans to TRICARE Select and have co-pays and deductibles?”
But a health scare with one of the Ashcrafts’ children demonstrated the need for more flexibility in their TRICARE plan.
After hearing about Open Season from other military families, they researched and found that switching from TRICARE Prime to TRICARE Select would allow them to book appointments for most primary and specialty care with any TRICARE-authorized providers without referrals. Pre-authorization from a member’s regional provider might be necessary in certain services.
And though some out-of-pocket costs vary depending on the sponsor’s military status, the couple realized Select’s pros outweighed its costs for them.
“We saw that if we switched over to Select, we wouldn’t have the wait times and could see the best doctors in the area without getting told who to see,” Ashcraft said. “That became worth it.”
Their decision became even firmer when they had a daughter diagnosed with Down syndrome and heart issues in 2023.
Open Season, which began in 2018, gives beneficiaries “maximum flexibility” so they can reevaluate every year and make health plan changes based on their family needs, according to Zelly Zim, a health system specialist with Policy and Programs at TRICARE.
“That’s the most important part,” Zim said.
Since its onset, the annual Open Season window usually sees “anywhere from 10[,000] to 20,000” beneficiaries switch plans, according to Zim. There could be any number of reasons why a beneficiary might consider switching, she said, including someone’s location and access to military hospitals and clinics, changes in military status or a desire for flexibility in picking providers.
“What type of access does your family need for care? Do you want to be going through a Primary Care Provider? Are you wanting to see a specialist?” she said. “There are a lot of families throughout their career who found that one plan or the other makes more sense.”
Zim said that looking at out-of-pockets costs, how healthy someone is in a given year or during that phase helps determine if a beneficiary should consider making changes during Open Season.
There’s something unique about this year’s Open Season, too: some TRICARE beneficiaries in the Atlanta, Georgia, and Tampa, Florida, areas can enroll in the TRICARE Prime Demo by CareSource Military & Veterans for expanded care opportunities.
“The goal is to give our beneficiaries an additional option,” Zim said.
And though she and her husband are stationed at Fort Bragg in North Carolina, Ashcraft is grateful for Open Season in its entirety.
“It’s great when everything is free, but if your current TRICARE plan isn’t adequate, it’s not worth it,” she said. “We have seen some of the best doctors in the whole country for what our daughter needs without the red tape because of being able to switch from Prime to Select — what a gift!”
Zim recommended that all military-connected families first check which plans they are eligible for. Also, beneficiaries should ensure all information is up-to-date with the Defense Enrollment Eligibility Reporting System (DEERS), especially with any recent births, adoptions or marriages.
Open Season applies for those who already have, or qualify for, TRICARE Prime, U.S. Family Health Plan or TRICARE Select. Those interested can find the best plan for them at TRICARE’s online plan finder at https://tricare.mil/Plans.
This year’s TRICARE Open Season runs from Nov. 10 to Dec. 9.
