Tricare Help

Late husband’s out-of-wedlock child still gets Tricare – is this legal?

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My husband passed away in 1999. He was medically retired and his death was service-connected. He had a child out of wedlock in 1994, and before his death, a court awarded the natural mother sole legal care and custody. He and the mother also both agreed that child support would be eliminated at that time. Today, the child is 18 years old and is receiving Tricare coverage. Is this legal? If not, what can I do to get him off of DEERS?

Tricare makes fairly generous provisions for surviving family members of active-duty and retired military personnel who pass away. Spouses and children of service members who die on active duty or in retirement remain eligible for Tricare – the spouses for life unless they remarry, the children until they reach age 21, or 23 if they are full-time college students.

Since your husband and the mother of the child were never married, the mother is not eligible for Tricare. But the child is, and will remain so for another three years, or another five years if he is a full-time college student at the time he turns 21.

Girlfriend is pregnant – will Tricare cover baby?

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I am an active-duty sailor. I recently found out that my Japanese girlfriend is three weeks pregnant. Will the Navy pay for the pregnancy? Will I be able to enroll the child in Tricare?

Tricare cannot cover any pre-natal care for your girlfriend – or any other health care, up to and including the birth itself – unless and until you marry her. As the child of an active-duty member, however, the baby will be automatically covered under Tricare Prime from the moment of birth until 60 days later. This is a sort of grace period while the parents get settled after the birth. If you want to keep the child covered under Tricare Prime after those 60 days, you must properly enroll the child in the Defense Eligibility Enrollment System, the Defense Department’s eligibility portal for Tricare, and formally enroll the child in Tricare Prime before those 60 days are up.

If you don’t enroll the child in Tricare Prime before it reaches 61 days of age, then the child will automatically be covered under Tricare Standard at that point.

You should contact DEERS to get information on what documentation you will need to register the child in that database. You can do that by visiting the ID Card/DEERS office on any military installation or by calling the main DEERS support office toll-free at 1-800-538-9552.

Responsible for brother’s new baby; how can I prove child is eligible for Tricare?

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I’m the sister of an active duty service member. My brother is married but has been separated from his wife for two years, living in separate states. They are currently going through the divorce, but it has not been finalized. Now my brother has a baby on the way with another lady. He is deploying and has given me full power of attorney while he is gone and has asked me to enroll the child in DEERS/Tricare once it is here. He knows the child is his, but what documentation will I need to prove that this child is eligible for benefits?

Your brother can get all the information he needs by visiting the ID Card/DEERS office on any military installation or by calling the main DEERS support office toll-free at 1-800-538-9552.

If he won’t be able to do that before he deploys, you will not be able to get onto a military installation without a military ID card, so you would have to call the main DEERS support office.

However, none of this can be done until the baby is born.

Also, you and your brother should be aware that one of the requirements for a child to be considered a legal dependent of a service member is that the service member must provide more than half of the child’s financial support. The DEERS office can talk to you about that as well.

Can married soldier’s child born out of wedlock still be covered?

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I am an active-duty soldier and I’m currently married. I’ve been separated from my wife for almost two years, and I just had a child with someone else. Can I enroll my child in Tricare even though he was born out of wedlock?

Yes. In such situations, the marital status is irrelevant; all that matters is that it is your biological child. However, for a child to be considered a legal dependent for Tricare purposes, the military sponsor — you — must be providing more than half the child’s financial support.

Also, the child must be properly registered in the Defense Enrollment Eligibility Reporting System (DEERS), the Defense Department’s eligibility portal for Tricare. You can do that by visiting the ID Card/ DEERS office of any military installation of by calling the main DEERS support office toll-free at 1-800-538-9552.

DEERS is the ultimate decision-making authority on Tricare eligibility questions.

Having baby with Army retiree, but he’s technically married to someone else

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I am having a baby with a medically retired Army veteran. He is married, but not to me. His wife left him while he was still active duty, and he hasn’t seen or spoken to her in four years. With his income, he cannot afford a divorce, and she will not file for one because she still receives benefits for being married to him. I am unsure of my options; how can I help our son get the benefits he deserves?

Unless you are married to the Army retiree, you cannot obtain any military/Tricare health coverage for yourself. However, once your son is born, he will be fully eligible for Tricare under the father’s status as a military retiree, as long as the baby is properly registered in the Defense Enrollment Eligibility Reporting System, which is the Defense Department’s portal for determining eligibility for various military benefits, including health care.

The baby’s Tricare options will be Tricare Prime, the military’s version of an HMO, which is available in some areas, or Tricare Standard, the military’s version of a fee-for-service plan. There are differences between the plans; Prime requires payment of an annual enrollment fee, and specialty care and referrals are coordinated through a primary care manager. Standard allows a much broader choice of health care providers and has no primary care managers or annual enrollment fee, but it requires payment of deductibles and cost-shares; out-of-pocket costs under Standard generally are higher than under Prime.

Again, the most important initial consideration is to get the baby registered in DEERS and obtain a uniformed services dependent ID card for him. Without that, the baby is not eligible for Tricare coverage.

You may contact the ID Card/DEERS office of any sizable military installation — find the one nearest you here — or you may call the main DEERS support office toll-free at 1-800-538-9552.

Just discovered I am baby’s father; how can I get the child covered quickly?

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Through DNA testing, I recently discovered that a 7-month-old girl is my daughter. It will take up to three months to get the birth certificate changed to show I am the father because DEERS will not take the DNA results as proof. The Voluntary Acknowledgement of Paternity also can only happen with the corrected birth certificate. How do I get my daughter medical coverage in the meantime? I am not married to the mother.

I’m afraid you can’t get Tricare coverage for your child under your sponsorship until DEERS has the proper documentation and your child is properly registered in the DEERS database. I’m sorry I don’t have better news.

Will Tricare cover delivery of soldier’s baby?

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I am having a baby with a soldier. We are not married. Will Tricare cover the delivery? My insurance through my employer was terminated in my seventh month and I can’t get coverage from another insurance company.

Unless you are married to the soldier, you are not eligible for any health care under Tricare, to include maternity care, delivery of the baby and any necessary post-natal care. The child, however, will be covered from the moment of birth as the military dependent of the soldier.

There is a possibility, though a slim one, that the local military hospital at the installation where your soldier is stationed would agree to handle the birth, depending on the facility’s staffing and patient load. Contact the patient administration office at the hospital to inquire about this.

You can confirm the Tricare eligibility status of you and your baby by calling the Defense Enrollment Eligibility Reporting System support office at toll-free 1-800-538-9552. DEERS is the Defense Department’s eligibility portal for Tricare.

Pregnant girlfriend still legally married to another soldier

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My girlfriend is still legally married to another soldier, although they have been separated for two years. We just found out she is pregnant. If she can’t get the divorce before the birth of the child, will I be able to enroll my child in Tricare under my sponsorship? The mother is not military.

You would have to establish legal paternity of the child as his or her biological parent, but assuming you can do that, the answer to your question is yes, you can enroll the child in Tricare under your sponsorship even if the mother is not legally divorced and you and she are not married at the time of the birth. Please note, however, that mother and child would not be eligible for any prenatal maternity care as long as you are not married; Tricare coverage would begin only for the child once he or she is born. You should call the Defense Enrollment Eligibility Reporting System (DEERS) support office at 1-800-538-9552 for more guidance. That office is the main gateway on issues regarding Tricare eligibility.

Will Tricare cover my maternity care?

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My soldier ex-boyfriend and I had a baby out of wedlock in July. Both my son and I have Medicaid, which will bill my ex for the maternity care once DNA proves he is the father. Can he send those bills to Tricare and have them pay?

Your maternity care cannot be covered by be Tricare because the child, not the mother (the one who gets the maternity care) is the one with Tricare coverage. Thus, the child’s medical care will be covered by Tricare, but not the mother’s.

To confirm Tricare eligibility in that case, please call the Defense Enrollment Eligibility Reporting System at 1-800-538-9552.

Pregnant and engaged; how soon can I get benefits?

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I am the girlfriend of a soldier, and I am 10 weeks pregnant. We have every intention on getting married, but I want to know if there is a time limit in which we need to wed in order for our unborn child, and me, to receive military benefits.

You will become eligible for Tricare, including maternity care, on the day you are legally married to the baby’s father. You cannot use Tricare, however, until you are legally married and your husband has contacted his Personnel Section to register you for the program. That takes only a few days.

If the baby is born before you are married, the child’s Tricare coverage will begin on the day he is born. There are some administrative requirements to be met before that, but you can get detailed official information about the Tricare eligibility of a child born out of wedlock by calling the DEERS Support Office, toll-free, at 1-800-538-9552. Be prepared to take notes.