The 20^th of the Month Rule

What is the 20^th of the Month Rule?

The 20^th of the Month rule is used to determine the date your TRICARE Prime coverage begins.

Once TriWest receives a completed enrollment form (with fees when applicable) through the mail, fax or at a TRICARE Service Center, it is date-stamped. The date stamp will determine the enrollment date, not the date that the beneficiary signs or submits the form.

Please note the 20^th of the Month rule does not apply to following new enrollments with the conditions noted below:

• Newborn, Adoptees and Pre-Adoptees enrollment
  • Application must be received and date-stamped prior to 60 days from the date of birth
• Active Duty to Retired
  • Application must be received prior to the retirement eligibility date
• Sponsor to Sponsor changes
  • Application must be received with 30 days of the eligibility date for the new sponsor

If the form is date-stamped on or before the 20^th of the month, your Prime coverage will be effective on the 1^st of the following month. For example, if TriWest receives an enrollment form date-stamped on January 16, the Prime effective date is February 1.

If the form is date-stamped after the 20^th of the month, your Prime coverage is effective on the 1^st of the month after next. For example, if TriWest receives an enrollment form date-stamped on January 21, the Prime effective date is March 1.

Do I Need to Re-enroll Annually Before the 20^th?

No. If you are already enrolled in TRICARE Prime and you remain eligible for Prime coverage, you do not need to re-enroll unless your sponsor’s status changes.