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.

If sponsor no longer provides child support, is child still eligible for Tricare?

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My husband’s daughter is 19 and a full-time college student. He no longer provides more than half of her support — child support ended when she turned 18) — but his ex-wife is insisting that the daughter still be covered under Tricare, since still a full-time student. Doesn’t my husband have an obligation to update DEERS to let them know that she is no longer his “dependent”? Once that happens, she will become ineligible for Tricare, is that correct?

The military sponsor has the primary responsibility of updating and maintaining correct information on himself and his dependents in the DEERS database.

A very specific requirement of Tricare eligibility for dependent children is that they remain dependent on their military sponsors for more than half of their financial support. In the scenario you describe, it does not seem that your husband is providing more than half of his daughter’s financial support. If that is the case, then yes, she would be ineligible for continued Tricare coverage under your husband’s sponsorship even though she is a full-time college student.

Can graduate students keep Tricare?

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I am enrolled as a full-time student in college and am covered under Tricare. I will graduate this spring but I will be enrolling in medical school during the summer. Will I still be covered as a full-time student under Tricare until I am 23, or is the full-time student eligibility only applicable to undergraduates?

Whether your eligibility will continue depends on your enrollment status with your university, not the program you are in.

If you are officially enrolled in a full-time student status, your Tricare eligibility will continue until you marry, graduate and leave school, or reach your 23rd birthday, whichever comes first.

For an official reply to your question, please call the DEERS Support Office, toll-free, at 1-800-538-9552.

What is the cutoff age for retirees’ children?

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What is the cutoff age for a military retiree’s children to obtain a military ID card if he or she is enrolled in an accredited school? 
By federal law at this time, the Tricare eligibility of a child who is enrolled as a full-time student at an accredited university, college, or trade school ends at marriage, graduation, termination of full-time status for any reason, or by reaching age 23, whichever occurs first.
For an official response, this question, and all others regarding Tricare eligibility should be referred to the DEERS Support Office by calling, toll-free, 1-800-538-9552.  I suggest you call that office for confirmation of the above.  Tricare Help cannot provide official responses regarding any Tricare matter.
DEERS is a federal agency.  All information is confidential and protected by the Privacy Act.

Covered by dad’s Tricare – and I’m pregnant

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Q. My dad is retired and has Tricare Prime health insurance. I’m 20 years old and attending college, and I just found out I’m pregnant. Will the birth be covered under my parents’ insurance? And will the child be covered?

You need to call the Defense Enrollment Eligibility Reporting System (DEERS), toll-free, at 1-800-538-9552, to make sure your Dad properly enrolled you in Tricare, and you (because you are over 17 and an adult for Tricare legal purposes) have kept your military ID card and DEERS registration up-to-date.

If you are unmarried, Tricare eligibility will usually continue (by law) until  midnight on the day before your 21st birthday.  However, for as long as you are enrolled as a full-time student in good standing at an accredited university, your Tricare eligibility can be continued until midnight of the day before your 23rd birthday.  Eligibility beyond age 21 is not automatic.  You must make special arrangements.  Ask DEERS for help.

So, first, call DEERS.  If DEERS does not report that you are eligible for Tricare, ask what you need to do to re-establish your Tricare eligibility.  While talking with DEERS, make sure all your other information is correct and up-to-date.  Check the expiration date of your ID card.  If it is within 90 days or so of expiring, ask DEERS how to renew it.

To use Tricare, your DEERS record and ID card both must be up-to-date.  DEERS will help you with instructions for anything you need to do.  Talk with DEERS about extending your eligibility after age 21.  Get them to explain the matter of your full-time student status.  Such as, if you drop out of school for a semester to have the baby, you will not be covered by Tricare during that time because you will not be a full-time student.  Make sure you talk with DEERS about that situation and understand it thoroughly.

At any time when DEERS reports that you are eligible for Tricare, you are entitled to full Tricare benefits, including all maternity care.  If DEERS says you are not eligible at any time, Tricare cannot pay for any medical care you get when DEERS does not say you are eligible.

You are eligible for Tricare because of your father’s military service.  That benefit, however, does not extend to his grandchildren.  The fact that you, the mother, are Tricare-eligible, does not make your baby eligible.

If the baby’s father is an active duty service member, or a military retiree, the baby can be made eligible, even if you are not married to him.  Ask DEERS about it if that’s the case.

Be sure that you know what Tricare plan you are covered by. If you are enrolled in Tricare Standard, you may get care under Tricare anyplace in the world.  If you are enrolled in Tricare Prime, you may use only certain doctors and hospitals.  They are most likely only in the area where your father lives.

You have to make some decisions about where you will get all your maternity care and which Tricare plan to be enrolled in.  If Tricare Prime is available where you live, you can have your Prime membership transferred, if that is the area where you will get your medical care.

You cannot easily get your prenatal care in one Prime service area and deliver in a different Prime service area.  You can get your prenatal care in Prime area A and deliver in Prime area B only if you time it right and get your membership transferred in time.  That is hard to do when you are in labor.  Especially on a weekend or at 2 a.m. on Tuesday.  Don’t count on being able to do it.

If you are enrolled in Tricare Prime, I suggest that you call your Tricare Prime Service Center and have a long talk with them to make sure you understand Tricare Prime’s rules about which providers you may use.  You can incur a lot of unnecessary expense if you do not follow Prime’s rules exactly.

Also, changing doctors in mid-pregnancy may be a problem.  It isn’t easy to find a doctor who will accept you as a new maternity patient after your first trimester.

I’m sure your Dad or Mom will want to be involved, and Dad will want to help you to resolve all your Tricare issues.  Tricare, however, is not allowed to talk with him about your medical care unless you send Tricare a signed and dated letter with which you authorize them to talk with Dad and Mom (by name) or whomever you wish to authorize.  Otherwise, Tricare cannot talk with another person about you.  That is Privacy Act stuff.  There is no getting around that law, not even for your Tricare sponsor.

If you have thought of having an abortion, Tricare is not allowed by federal law to cover it unless your life would be in danger if the pregnancy were to continue.  That is a pretty powerful restriction and hard to prove.

You have a lot of things to learn and arrangements to make, and not a lot of time to do it,  especially the decision about your maternity care doctor.