Tricare Help

Son graduated college, but still has dependent ID card – can he use it?

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My son just graduated college at the age of 22. Because he was given a new Dependent’s ID card when he turned 21 and furnished a letter of attendance from his university, the date of expiration on the card is his 23rd birthday, which is about nine months away. As he is not employed yet, he continues to be my dependent; he lives with me and I provide more than 50 percent of his living expenses, as well as his health care under my Tricare For Life. Must he be converted from Tricare Standard to Tricare Young Adult immediately, or by the time he turns 23 and presumably has a job? Can he continue to use the Dependents ID card for other purposes such as access to military facilities, MWR and Space A, until the card expires, even if he must go onto TYA immediately? And what if he does get a job, but it doesn’t have a health care plan?

Officially, Tricare coverage and military ID card privileges for dependent children beyond age 21 are contingent upon two things – that the dependent child is in full-time student status, and that the sponsor is providing more than half the child’s financial support. You may be fulfilling the latter requirement at the moment, but your son obviously is no longer a full-time student. As such, he is no longer legally entitled to an ID card or health coverage under your TFL.

The odds of the military bureaucracy catching onto that in the nine months until your son’s current ID card expires are impossible for me to say. But if it does, you could be liable for fraud. The proper route to take would be to inform the Defense Enrollment Eligibility Reporting System of your son’s change in status and enroll him in TYA now. You can do that by visiting the ID Card/DEERS office of any military installation or by calling the main DEERS support office toll-free at 1-800-538-9552.

Your son would lose TYA eligibility if he becomes employed before age 26. At that point, unfortunately, he would be on his own, even if his employer did not offer health insurance.

Son not attending college; can I keep him covered under Tricare?

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I am a retired Navy and I have Tricare for Life. My son is turning 18 this summer. He is graduating high school but doesn’t plan to go to college. How can I keep him covered?

Your son may stay under ordinary Tricare (Prime or Standard) until he turns 21, as long as he remains unmarried and you continue to provide more than half of his financial support. If he is a full-time college student at the time he turns 21, he could stay under ordinary Tricare until age 23. If not, his only other option would be Tricare Young Adult, under which he could stay covered until he reaches age 26. However, Tricare Young Adult requires payment of monthly premiums.

Can daughter be covered under ex-wife’s sponsorship?

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My husband and I divorced four and a half years ago after 30 years of marriage. Because of that, my coverage is now under my own Social Security number. Our daughter was dropped from my husband’s Tricare policy last year when she turned 21. Since the new health care coverage means she can be covered until 26 years of age, whose plan can she be covered under? Can she be added as a dependent on his plan or mine?

Eligibility for Tricare Young Adult is based on the status of the sponsor. The list of eligible sponsors includes:

  • Active duty service members
  • Retired service members
  • Activated Guard/Reserve members
  • Non-activated Guard/Reserve members using Tricare Reserve Select
  • Retired Guard/Reserve members using Tricare Retired Reserve

Unfortunately, the list of eligible sponsors does not include former spouses entitled to Tricare benefits under their own Social Security number by virtue of the “20/20/20” rule. As such, your daughter is eligible for TYA only under the sponsorship of your retired ex-husband, assuming your daughter is properly registered in the Defense Enrollment Eligibility Reporting System as his dependent.

My dependent is turning 21 – but what if they join the military?

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Can a person who is about to turn 21 and hasn’t attended a higher education institution for a year — but is joining the armed forces — still continue be a beneficiary on their sponsor’s Tricare?

Dependent children become ineligible for ordinary Tricare when they reach age 21 unless they are enrolled full-time in college. Full-time college students may remain in ordinary Tricare under a parent’s sponsorship until age 23. However, in both cases, dependent children may remain on Tricare under a parent’s sponsorship until they reach age 26 under a relatively new program called Tricare Young Adult, as long as they are unmarried and do not have access to any other health care coverage (such as through an employer). Be advised that Tricare Young Adult requires payment of monthly premiums, and the premiums are not cheap.

Of course, dependent children become eligible for full military health care benefits in their own right the moment they begin active duty.

Will I lose my coverage if I get married?

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I am 20 years old, go to school full time, and am a stay-at-home mom. I am covered under my father’s Tricare Prime coverage and am planning on getting married soon. My boyfriend’s work does not offer insurance, though, and I have been having a lot of medical problems lately. I am worried I will no longer be covered after we marry. How does that work?

Children of Tricare beneficiaries remain eligible for Tricare only as long as they remain single. Marriage will end your eligibility for Tricare, regardless of whether or not your fiancé has his own health insurance.

If you stay single for now, you may remain covered by Tricare until your 21st birthday, or your 23rd birthday if you continue to be a full-time college student until then and you remain dependent on your Tricare sponsor for more than half of your financial support.

At age 23 — again, if you stay single — you would be eligible for a relatively new program called Tricare Young Adult, which requires payment of monthly premiums. You could remain in that program until your 26th birthday.

Can disabled children keep care after I retire?

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I am active duty and will be retiring in about a year. I have two disabled children, ages 20 and 17. I have been told that they will be eligible for Tricare even after I retire. Is this true? If so, what should I be doing now to ensure continuity of care?

Children of Tricare-eligible beneficiaries generally are eligible for Tricare coverage until age 21, or until age 23 if they are full-time college students. This is true regardless of whether the sponsor is active-duty or retired. After that, children can be covered under a relatively new program called Tricare Young Adult until age 26. However, Tricare Young Adult requires payment of monthly premiums.

Since your children are disabled, there may be special considerations in your case. Disabled dependent children may remain eligible for Tricare beyond the normal age limits, depending on the nature and severity of their disabilities.

As you get closer to retirement, you should contact the Defense Enrollment Eligibility Reporting System support office. DEERS is the Defense Department’s eligibility portal for Tricare. Let them know of your imminent change in status and ask for guidance. You can reach that office toll-free at 1-800-538-9552.

Do I still pay for family’s Prime coverage once I move to TFL?

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When I turn 65 and become eligible for Tricare for Life and Medicare, will I continue to make Tricare Prime premium payments for my younger wife and family?

Yes, when you transition to Tricare For Life, your family may stay under Tricare Prime, and you would continue to pay the Prime annual enrollment fee and network co-payments.

Your wife may stay in Prime until she also turns 65 and transitions into Tricare for Life. Your dependent children may stay in Prime until they reach age 21, or age 23 if they are full-time college students. At that time, they may transition into a relatively new program called Tricare Young Adult, which carries its own separate premiums, and stay in that program until they reach age 26 as long as they remain unmarried and have no other health care coverage, such as through an employer of their own.

Do Tricare benefits kick in at age 60 or 65?

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You have said that retired reservists can begin receiving Tricare benefits at age 60. When I retired I was informed that the health benefits are free when you are eligible for Medicare at age 65. Which is correct?

Both statements are correct; you’re talking about two different things. When retirement-qualified reservists reach age 60, they become eligible for military health care benefits in the form of Tricare Prime or Tricare Standard. Tricare Prime charges an annual enrollment fee of $230 for an individual and $460 for a family for those enrolled before Oct. 1, 2011, and $260 for an individual and $520 for families for those enrolled after that date. Prime has no annual deductibles. Tricare Standard does not charge an annual enrollment fee, but retirees must pay annual deductibles of $150 for an individual and $300 for a family.

When retirees reach age 65 and become eligible for Medicare, they transition to the program known as Tricare for Life. At the moment, TFL charges no enrollment fees or deductibles, but the program does require retirees to have Medicare Part B, which carries a premium of about $100 a month.
Retirees also pay some out-of-pocket costs for prescription drugs under all Tricare programs.

Why won’t Tricare talk to me about daughter’s claim?

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My daughter attends college in another state. She is 20 and still covered by my Tricare. She called me recently because she was having trouble with a claim, but when I called Tricare to try to straighten it out, they refused to help me, saying the Privacy Act wouldn’t allow them to talk to me about my own daughter. I tried to explain she was my dependent, even gave them my Social Security number to prove I was who I said I was, but they wouldn’t listen to reason. Who can I talk to at Tricare to make sure other parents don’t go through this?

You may not like this answer, but for purposes of the Privacy Act, your daughter became an adult when she turned 18. She, alone, has the authority to grant someone else access to her Tricare claims and other personal information. That’s easy to arrange, however: She needs to give you a signed and dated written authorization. If she agrees, contact your Tricare Service Center to learn how to proceed.

If it ever becomes necessary to file an appeal of a denied Tricare claim, and if your daughter wants you to deal with the matter on her behalf, she must provide with the appeal a signed and dated statement appointing you as her representative on the appeal.

Just found out Dad isn’t signed up for Part B; what now?

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My father, an Army retiree, turned 65 in April and has not yet enrolled in Medicare Part B. Are there any penalties for late enrollment? He was recently hospitalized, and I need to know the quickest, and easiest way to help him do this right away so as his insurance doesn’t deny all the bills that he recently had.

If a Tricare-eligible retiree or retiree family member becomes legally entitled to free Medicare Part A, federal law requires that he must be enrolled also in Medicare Part B at that same time. Failure to be enrolled also in Part B results in the immediate loss of Tricare eligibility until the beneficiary has Medicare Part B in force.

Your father should immediately contact the Social Security Administration at 1-800-772-1213 for guidance to enroll in Medicare Part B.

The legal provision to which I refer is part of the law that governs Tricare eligibility. It does not apply to active duty family members or to civilians.

Without delay, your father also needs to contact the Defense Enrollment Eligibility Reporting System, better known as DEERS, at 1-800-538-9552 for an official determination of his Tricare eligibility.

If your father is not enrolled in Part B, it is most likely that his Tricare eligibility was automatically terminated on the first day of the month when he turned 65.

It is unlikely that he can get retroactive coverage for care he received while he was ineligible, but DEERS can give you an official answer.