What TriCare and FEHB Users Need to Know About Recent Policy Changes Affecting Families

Key Takeaways:

1. TRICARE and FEHB policies have undergone significant updates in 2025, impacting coverage for military families and federal employees.

2. Understanding enrollment timelines, eligibility changes, and healthcare cost adjustments ensures your family stays covered and avoids unexpected expenses.

Navigating Healthcare for Federal and Military Families in 2025

Healthcare options like TRICARE and FEHB (Federal Employees Health Benefits) play a critical role in providing reliable coverage for military and federal families. Policy adjustments in 2025 introduce changes to enrollment rules, premiums, and benefits. Staying informed helps you make the right decisions for your family’s healthcare needs.

2025 Updates to TRICARE and FEHB Policies

• Also Read: Divorce and Your Federal Pension—What Happens When You Split Assets and How It Could Affect Your TSP
• Also Read: What Happens to Your Federal Benefits After Divorce? Here’s the Lowdown
• Also Read: The Best FEHB Plans for 2025: Which One Fits Your Lifestyle and Budget the Best?

Both TRICARE and FEHB experienced key changes this year. Here’s what you need to know:

Expanded Eligibility for TRICARE Beneficiaries

TRICARE now offers expanded eligibility for certain dependents. For example:

• Increased Age for Dependents: Dependents now remain eligible for coverage under specific TRICARE plans until age 26 without requiring full-time student status.

• Enhanced Coverage Options: Family members of active-duty service members have access to additional supplemental benefits.

FEHB Premium Adjustments

FEHB premiums increased by an average of 11.2% this year, with enrollees shouldering a 13.5% rise. Despite this, the government continues to cover approximately 70% of the total premium costs. Retirees, in particular, are seeing higher expenses due to these changes.

Enrollment Periods and Deadlines

Timely enrollment is critical to maintaining coverage and avoiding lapses. Here’s a quick refresher on key timelines:

TRICARE Enrollment

TRICARE enrollment occurs during the Open Season, which aligns with the federal calendar. The Open Season runs from mid-November through mid-December, giving you a six-week window to make changes or enroll in a plan.

FEHB Open Season

FEHB also uses the same Open Season timeline. This is the only period when you can switch plans, add dependents, or modify your coverage unless you experience a Qualifying Life Event (QLE) such as marriage, childbirth, or retirement.

Key Policy Changes to Be Aware Of

Coordination Between TRICARE and FEHB

If you’re eligible for both TRICARE and FEHB, you may now coordinate coverage more efficiently. TRICARE becomes the primary payer for active-duty families, while FEHB steps in as secondary coverage, reducing out-of-pocket costs. For retirees, this coordination allows greater flexibility in choosing plans tailored to your medical needs.

Medicare Integration for Retirees

TRICARE For Life (TFL) beneficiaries now face updated rules regarding Medicare enrollment. If you’re 65 or older, enrolling in Medicare Part B is mandatory to retain TFL coverage. FEHB retirees also benefit from Medicare coordination, helping to offset higher out-of-pocket expenses.

Rising Costs and How to Manage Them

Both TRICARE and FEHB have seen cost adjustments in premiums and deductibles this year. Here are the details:

TRICARE Cost Changes

TRICARE beneficiaries face higher enrollment fees, copayments, and prescription drug costs. These increases vary based on the type of TRICARE plan you select. Proactively budgeting for these costs ensures your family’s healthcare remains uninterrupted.

FEHB Premiums and Deductibles

FEHB premiums rose significantly, reflecting increased healthcare expenses nationwide. Deductibles and copayments also saw modest increases, making it more important than ever to review your plan’s details and compare options during Open Season.

Understanding Your Coverage Options

TRICARE Plan Choices

TRICARE offers multiple plans, including:

• Prime: Ideal for active-duty families seeking low out-of-pocket costs.

• Select: Offers flexibility to see non-network providers but at a higher cost.

• TRICARE For Life: Supplemental coverage for Medicare-eligible retirees.

Each plan caters to different needs, so carefully review the coverage details to determine the best fit for your family.

FEHB Plan Categories

FEHB includes a wide variety of plans, ranging from High-Deductible Health Plans (HDHPs) to traditional Preferred Provider Organizations (PPOs). Consider the following when choosing your FEHB plan:

• Network Coverage: Ensure your preferred doctors and specialists are in-network.

• Premiums and Copayments: Balance monthly costs with potential out-of-pocket expenses.

• Supplemental Benefits: Look for plans offering dental, vision, or wellness programs.

Tips for Maximizing Benefits

Review Plan Documents Thoroughly

Both TRICARE and FEHB provide detailed plan documents during Open Season. Take time to review these thoroughly, focusing on:

• Changes in Coverage: Check for adjustments to benefits or exclusions.

• Updated Costs: Confirm new premiums, copayments, and deductibles.

• Additional Benefits: Look for added services, such as telehealth or wellness incentives.

Use Online Tools

Many agencies offer online tools to help you compare plans. For example, FEHB’s comparison tool allows you to evaluate premiums, coverage options, and networks side-by-side. TRICARE’s online resources also simplify enrollment and benefit management.

Managing Healthcare for Retirees

If you’re a federal or military retiree, understanding how TRICARE and FEHB integrate with Medicare is essential. Here’s what you need to know:

• Medicare Part B Requirement: TRICARE For Life requires Part B enrollment to maintain coverage.

• FEHB Coordination: FEHB works well with Medicare, offering secondary coverage to reduce your overall costs.

• Prescription Drug Benefits: Both programs now include expanded options for managing medication expenses.

Protecting Your Family’s Health

TRICARE’s Family-Focused Benefits

TRICARE continues to prioritize family health, offering benefits like:

• Mental Health Services: Expanded access to counseling and therapy.

• Maternity Care: Comprehensive coverage for prenatal, delivery, and postpartum services.

• Pediatric Services: Preventive care, immunizations, and specialty care for children.

FEHB Family Coverage Options

FEHB provides robust options for family coverage, including:

• Self Plus One Plans: Cost-effective coverage for you and one eligible family member.

• Family Plans: Broad coverage for larger families, including dependents up to age 26.

Avoiding Common Pitfalls

Missing Enrollment Deadlines

Missing Open Season deadlines can result in lapses in coverage. Mark your calendar and set reminders to ensure timely enrollment.

Overlooking Plan Changes

Failure to review plan changes could leave you with unexpected costs or reduced benefits. Always read your plan’s Annual Notice of Changes (ANOC) to stay informed.

Staying Ahead of Future Changes

Healthcare policies evolve regularly, and staying proactive ensures you’re prepared for whatever comes next. Here are some tips:

• Monitor Official Updates: Subscribe to newsletters from TRICARE or OPM for timely information.

• Seek Professional Advice: Consult with a benefits advisor or HR representative to clarify questions about your coverage.

• Engage with Communities: Join online forums or local groups to share experiences and gain insights from fellow beneficiaries.

Ensuring Your Family’s Coverage in 2025 and Beyond

Navigating healthcare in 2025 requires a thorough understanding of TRICARE and FEHB’s policy changes. By staying informed about enrollment timelines, rising costs, and plan options, you can make confident decisions that protect your family’s health and financial well-being.