Jeffrey Wade
The annual open season in mid-November through mid-December is when most enrollment changes occur in the Federal Employees Health Benefits program and Postal Service Health Benefits program. Outside of Open Season, you can enroll in the FEHB Program, change your enrollment, or cancel coverage only in connection with certain events called qualifying life events (QLEs). QLEs include marriage, birth or adoption of a child, acquisition of a foster child, legal separation, divorce, or death of a spouse or dependent. You usually have 60 days from the life event to enroll in a new plan. If you are enrolled, you may change plans, options, type of enrollment, or premium conversion status. TRICARE Open Season lets you change your healthcare plan for the next year. Changes made during this time start on Jan. 1 of the next year.
| Characteristics | Values |
|---|---|
| When is open season? | Mid-November to mid-December |
| Who can change their insurance during open season? | Those with TRICARE Prime, US Family Health Plan, or TRICARE Select |
| Who cannot change their insurance during open season? | Active-duty service members |
| What can you do during open season? | Enroll, change your enrollment, change to Self Only or cancel coverage |
| What are the Qualifying Life Events (QLEs) that permit enrollment or change in enrollment? | Marriage, birth or adoption of a child, acquisition of a foster child, legal separation, divorce, or death of a spouse or dependent |
| What is the deadline to report changes during open season? | 60 days from the life event |
| How can you change your insurance during open season? | Online, by phone, by mail or fax |
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What You'll Learn
Understanding qualifying life events
Changes to Your Existing Coverage
One of the most common QLEs is losing your health insurance or expecting to lose it soon. This could be due to a termination or change in your employment status, a cessation of your employer's contribution, or a change in your eligibility for government contributions. Additionally, if your health plan area changes or your coverage is no longer available in your new location, it qualifies as a QLE.
Household Changes
Gaining or losing a dependent through birth, adoption, marriage, or divorce is considered a QLE. If you or any member of your household loses their existing coverage, it qualifies as a household change. Other events, such as the death of a family member who previously provided health insurance coverage, may also be considered a QLE.
Changes in Residence
Relocating to a new zip code, county, or state that changes your health plan area is a QLE. Moving can impact your insurance options, and you may need to consider new plans offered in your new location. Remember that changes in residence also include moving to a new home within the same area, as it may still affect your insurance coverage.
It is important to note that you typically have a limited time frame, often 60 days, before or after a QLE to enroll in or change your insurance plan. Reporting changes promptly ensures that you receive the appropriate savings for your plan and avoids any gaps in coverage. Additionally, you may be required to provide documentation to confirm the qualifying life event, such as birth certificates, marriage licenses, or proof of address changes.
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$17.99
Enrolling in a new plan
Online
If you are eligible, you can enrol in a new plan online through the Beneficiary Web Enrollment portal in milConnect.
By Phone
Call your regional contractor or designated provider to enrol in a new plan. The contact information for the East and West Regions can be found in the "How can I change my health care plan?" section of the relevant website.
By Mail or Fax
Download and complete the region-specific form for the plan you wish to enrol in. Then, send it to your regional contractor or designated provider.
In-Person
You may also be able to enrol in person at a designated location. Contact your insurance provider to find out if this is an option.
It is important to note that open season does not apply to active-duty service members or premium-based plans. If you are not currently enrolled in a plan, you can enrol at any time throughout the year. Additionally, outside of the open season, you can still enrol in or change your plan if you experience a qualifying life event, such as marriage, the birth of a child, or a change in income.
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Changing your plan type
If you want to change your insurance plan type during open season, you can do so by enrolling in a new plan. The open season for Federal Employees Health Benefits and Postal Service Health Benefits programs is usually mid-November through mid-December. During this time, you can change your plan type, options, type of enrollment, or premium conversion status.
If you are enrolled in a TRICARE plan, the open season dates may differ. For example, the TRICARE Open Season for 2024 was November 11–December 10. During this period, you could change your healthcare plan for the following year, starting on January 1.
Outside of the open season, you can still change your insurance plan type, but only under certain circumstances. A significant factor that permits changes outside of the open season is a qualifying life event (QLE). A QLE refers to specific changes in your life, such as marriage, divorce, the birth or adoption of a child, or retirement from active duty. These events may make different insurance plan types available to you and your family members.
To change your plan type, you can use various methods, depending on your insurance provider. Some common methods include online portals, phone calls to your regional contractor or designated provider, or mail/fax submissions of region-specific forms.
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Cancelling your insurance
If you have group health insurance through your employer, you generally cannot cancel your policy at any time. To cancel your employer's healthcare plan outside of the Open Enrollment Period, you must experience a qualifying life event (QLE) or a special enrollment period (SEP). A QLE could include returning to pay status after a leave of absence, an increase in pay, or moving outside of your HMO's enrollment area. If you have recently started a new job that offers health coverage, lost your coverage, moved, got married, had a baby, or experienced a life change, you may qualify for an SEP.
If you are cancelling a plan purchased on a public health exchange, you can typically cancel by logging into your account and terminating the plan's coverage. If you need help, you can call the platform's customer service team. If you are cancelling a plan from a private exchange, you can contact your insurance company or broker directly.
It is important to note that once you cancel your coverage, you might have to wait for the next Open Enrollment Period to enroll in a new plan.
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Switching to a different provider
Switching to a different insurance provider during the open season can be done in several ways. The process depends on the type of insurance and the provider. Here is a general guide on how to switch:
Understanding Open Season
The open season is an annual period when individuals can make changes to their insurance plans. This period typically occurs in mid-November through mid-December, with changes taking effect on January 1st of the following year. During the open season, individuals can enroll in new plans, change their existing plans, or cancel their coverage.
Research and Compare Insurance Providers
Before switching providers, it is essential to research and compare different insurance companies. Evaluate factors such as coverage options, provider networks, prescription drug coverage, customer service, and pricing. Consider your specific healthcare needs and priorities when making your decision.
Choose Your Desired Plan and Provider
Once you have compared different insurance providers, select the plan that best suits your needs. Consider factors such as the type of coverage, deductible amounts, co-pays, and whether your preferred healthcare providers are in-network with the new insurance plan.
Enroll in the New Plan
After choosing your desired plan, initiate the enrollment process with the new insurance provider. You can typically enroll online, by phone, or through a paper application. Provide the necessary personal and health information, and ensure you understand the terms and conditions of the new plan.
Cancel Your Previous Insurance (If Necessary)
If you decide to switch to a different insurance provider, you may need to cancel your current coverage. Contact your current insurance company and follow their cancellation process. Be mindful of potential consequences, such as losing certain benefits or facing a waiting period before your new coverage takes effect.
Confirm Your New Coverage
Once you have enrolled in the new plan, confirm the effective date of your new coverage. Ensure that you have received confirmation from the new insurance provider and understand the terms and conditions of your new policy. Review any documentation provided and clarify any questions or concerns with the insurance company.
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Frequently asked questions
Open season is the annual period when most enrollment changes in the Federal Employees Health Benefits program and Postal Service Health Benefits program occur.
Open season usually takes place from mid-November to mid-December.
Open season applies to those with TRICARE Prime, US Family Health Plan, or TRICARE Select. It does not apply to active-duty service members or premium-based plans.
You can change your insurance during open season by contacting OPM at (888) 767-6738 or going online to www.opm.gov/healthcare-insurance/healthcare.
If you miss open season, you can still make changes to your insurance outside of open season if you have a qualifying life event (QLE), such as marriage, divorce, the birth or adoption of a child, or a change in income. You usually have 60 days from the life event to enroll in a new plan.
