Q. My active-duty husband and I have been married less than two months, and I have not had a chance to enroll in DEERS. He will take leave at the end of this month so we can that all taken care of. However, I’ve been very sick the last week and have missed a lot of work. I’m not getting any better and am not sure what is wrong. I am wondering, if I go to the ER, will Tricare reimburse me for the cost later, after I am enrolled, or will we be stuck with what could be a very high medical bill?
A. Tricare will not pay for any care received for family members who are not enrolled in DEERS, the Defense Department’s eligibility portal for Tricare. You cannot have obtained a military dependent ID card if you are not yet enrolled in DEERS, and you need to show that ID card when you seek medical care under Tricare.
As the military sponsor for your family, it is your husband’s responsibility to properly register you in DEERS and get you a Defense Department ID card. This is not a laborious or time-consuming process. He can square you away by visiting the ID Card/DEERS office on any military installation. You can get more information by calling the main DEERS support office in California at toll-free 800-538-9552.
I just had a baby by a solider. He told me that in order for our son to be covered by his military benefits, paternity needs to be established by DNA because we are not married. Is that true?
If the soldier acknowledges the baby as his and has put his name on the birth certificate as the father, then no paternity testing is required.
You can get all the information you need to make the baby eligible for Tricare and other military benefits by contacting the Defense Enrollment Eligibility Reporting System (DEERS). Your soldier can do this 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.
My mother got CHAMPUS through her second husband. He died in the 1990s, and she became eligible for Tricare as his widow. A few years later she got Medicare, and they canceled her military insurance. An officer friend thinks Tricare was wrong to cancel her insurance. Could she still be eligible?
It sounds like your mother turned 65, became entitled to Medicare, and thus, lost her Tricare eligibility prior to October 1, 2001, when Congress created Tricare for Life.
The best way for her to find out if she is still eligible is to call the Defense Enrollment Eligibility Reporting Service at 1-800-538-9552. They can explain to her exactly how the Tricare eligibility rules apply in her case.
You have said a former spouse must be married to the same uniformed service sponsor for at least 20 years during which the sponsor accrued military retirement credits. In other words, the sponsor’s active duty and the marriage must have overlapped by at least 20 years. But in another instance, you’ve also said that a spouse’s coverage is not affected by the death of the sponsor, and that the duration of the marriage is not a factor. I have been seeing a lady who is divorced from a military retiree and has Tricare for Life coverage under his name. I am also a military retiree with TFL. I have been told that if we married and I died before her, she already would have lost Tricare benefits through her ex-spouse, and also from me, since we would not have been married for 20 years. Can you advise?
The two situations you cite in your letter involve two distinct sets of circumstances. One situation involves a former spouse, the other involves a current spouse whose retiree sponsor dies.
The so-called “20/20/20 rule” comes into play in divorce cases involving military retirees. A former spouse may retain Tricare benefits after divorce if the marriage lasted 20 years, the military member served on active duty for at least 20 years, and the marriage and active-duty service overlapped for at least 20 years. A former spouse who meets those criteria may retain Tricare coverage for the rest of her life, under one significant condition: she does not remarry. If she remarries, she loses Tricare eligibility under her former husband’s sponsorship. Once lost, it can never be restored under the retiree sponsor’s name, even if the former spouse’s second marriage ends in divorce or death.
The other situation you cited involves a spouse whose military retiree sponsor dies before her. In this case, the 20-year rule does not apply, for the simple reason that they were not divorced. A spouse covered by Tricare whose retiree sponsor dies before her remains eligible for Tricare for the rest of her life, regardless of how long the marriage lasted — again, unless she remarries. If she does, she loses Tricare eligibility for good under that sponsor’s name.
How this applies to your specific situation: If you and your lady friend marry, she would indeed lose eligibility under her divorced husband’s Tricare for Life sponsorship. However, if you were to properly register her in the Defense Enrollment Eligibility Reporting System (DEERS) as your wife, she would then become eligible for Tricare for Life coverage under your sponsorship. If you die before her, but are still married at the time of your death, she would remain eligible for Tricare under your sponsorship. Regardless of how long you had been married, the 20-year rule would not apply if the marriage was still intact at the time of your death. But again, she would lose her coverage under your sponsorship if she were to remarry again.
If you and your lady friend do marry, your first step should be to contact the DEERS support office toll-free at 1-800-538-9552 to get started on registering her for Tricare coverage.
My friend and his wife are legally separated, but she is not cooperating with divorce. How can he get her off his DEERS?
Tricare eligibility for spouses generally ends only when a divorce is final — and in some cases, it doesn’t end even then. If a service member serves at least 20 years in uniform, is married for at least 20 years, and the marriage and military service overlap for at least 20 years, a former spouse may retain Tricare eligibility after divorce, unless and until he or she remarries. This is known as the “20/20/20” rule.
The ultimate authority on eligibility questions such as yours is DEERS. I would suggest your friend call the DEERS support office toll-free at 1-800-538-9552 to see what his options are.
Is there a way to find out if a person is covered under a Tricare policy?
For information about Tricare eligibility, please call the DEERS Support Office, toll-free, at 1-800-538-9552.
Privacy Act provisions may prevent your learning about the Tricare eligibility of anyone except those who are Tricare eligibile under your sponsorship.
I am retired Air Force and I just got married. I want to enroll my wife in the Defense Enrollment Eligibility Reporting System so she can be covered under my Tricare Prime, since we live near a military hospital that accepts military retirees for care. How long after enrollment in DEERS will my wife need to wait for benefits?
Your wife’s Tricare coverage became effective on the same day as you were married. For her to use Tricare, however, you must enroll her in DEERS and get her a military ID card. She can use Tricare as soon as her DEERS registration is complete. See your personnel section for help to do those things.
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.
I have a friend who is going through a divorce. He is retired from the Air Force, and in the divorce papers, his estranged wife is requiring that he keep her and her child (who is not his biological child) on Tricare for an additional year. Can she sue him if Tricare drops her?
As a lawyer friend of mine says, “Anybody can sue somebody for anything. Finding a lawyer willing to take the case, and/or winning the case, are entirely different matters.”
The legal requirements for Tricare eligibility are established by federal law. I cannot give legal advice, but I can suggest the best place to start an inquiry about the legal requirements for Tricare eligibility is by calling the DEERS Support Office, toll-free, at 1-800-538-9552.
DEERS cannot give legal advice, but it can advise inquirers about the provisions of federal law concerning Tricare eligibility. Even lawyers should begin any inquiries about Tricare eligibility at that office.
My husband is a disabled Army vet and he cannot seem to tell me what Tricare is or if he can get it. I understand it is some kind of insurance. Could we be eligible for it?
There are two programs for which you might be eligible.
You wrote that your husband is a disabled vet. Depending on his disability rating from the Veterans Affairs Department, you may be eligible for care through the VA. If his rating is “100 percent, permanent and total,” he may qualify for free VA medical care for the rest of his life, and his wife and unmarried children under age 18 would be entitled to the program called CHAMPVA.
Alternatively, if your husband is entitled to receive retired pay, he and his family may be entitled to Tricare.
For official information regarding your husband’s Tricare eligibility, he should call the DEERS Support Office, toll-free, at 1-800-538-9552. He must call, himself. Due to provisions of the Privacy Act, that information cannot be given to another person.
Another source of public information regarding Tricare eligibility is at the official Tricare website.