Tricare Help

I changed my name; how do I tell Tricare?

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I got married a few months ago and I switched my last name to my wife’s. How can I switch my last name in Tricare? I am enrolling my wife in DEERS next month.

You need to call the DEERS Support Office at 1-800-538-9552.

Personnel at that office will tell you all you need to know, exactly what you need to do, and the way to do it. They will walk you through every step and answer all your questions regarding Tricare eligibility. Be prepared to take notes. DEERS deals with eligibility only and cannot answer any questions about the Tricare program, its benefits, its claims, or its payments. You must contact your Regional Tricare Service Office for official information about any of those things.

Can girlfriend and baby be covered by Tricare?

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My girlfriend and I recently had a baby. We are not married, but she is my beneficiary. Can I put her on Tricare Reserve Select with my daughter?

The requirements for Tricare eligibility are established by federal law and regulation. Because you are not legally married to the mother, she cannot become eligible for Tricare. That means her maternity care cannot be covered by Tricare.

The child’s situation is a different matter entirely. As your biological child, your baby daughter can be covered retroactively to the moment of birth.

To provide Tricare coverage for your daughter, there are certain actions you must take. To learn exactly what you must do, and for guidance in doing them, please call the DEERS Support Office, toll-free, at 1-800-538-9552. Be prepared to take notes of what you must do and how to do it. DEERS and your Personnel Office will walk you through the entire process.

Can fiancee keep seeing same doctors when we get married?

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I am an active-duty sailor and I am getting married in February. My fiancee has bipolar disorder. She is concerned about being able to keep her same doctors and counselor/therapist when we are married and what hoops we may have to jump through with Tricare to make it work. How can I help her ensure she keeps her current doctors?

Tricare is a federal program, but it has a rule in common with most commercial health insurance companies and policies: In order for Tricare to help pay for medical services, the provider of care must be registered with Tricare and be authorized to be paid by Tricare for covered services rendered to Tricare beneficiaries.

Your bride will become legally entitled to Tricare the moment she is married to you., For her to use Tricare, however, you must register her in DEERS and apply for her military ID card. Your Personnel Section will help you do that.

Tricare has no limits or restrictions on its coverage of pre-existing conditions. Mental health care, including pharmacy services, is a Tricare benefit, subject to existing rules regarding the medical necessity and appropriateness of care for the particular patient’s diagnosis, symptoms, and medical history.

Seamless continuity with your wife’s same providers may be a problem for two reasons:

One is the perennial element of military service in that you are subject to periodic transfer to a new location, perhaps across the world. You have little or no control over that element of military service.

The other is whether your wife’s providers are, or are willing to become, Tricare-authorized providers, as I discussed above. A section of the official website was designed especially to inform providers of care about Tricare and its rules regarding providers. Your wife should make her doctors aware of the web site and its provider section, but the decision of whether to become Tricare authorized providers is voluntary and entirely in their hands.

What if estranged husband tries to stop us from getting ID cards?

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My estranged husband of 26 years is retired Army and has been extremely hostile since I left our abusive relationship. In the two and a half years we have been separated, he has disobeyed every court order issued for child support and disclosure of income and assets. Now my daughter and I need new military ID cards, which we need to prove our coverage under Tricare — our only health insurance. Although I have been told that a hostile spouse cannot terminate Tricare while we are married, he will undoubtedly refuse to process the paperwork necessary for the new ID cards. How can I get the new ID cards without his cooperation?

Once you divorce your husband, your and your daughter’s Tricare eligibility will be separate issues.

Your daughter is automatically eligible for Tricare because her father is a retired uniformed service member. To use Tricare, she must be registered in DEERS and be issued her ID card. Only the uniformed services or the Defense Department can do either of those things for her. Her father’s permission, approval, or assistance, however, are not required.

You may need official help to register her in DEERS and to get her ID card if her father will not cooperate. All you need to do is call the DEERS Support Office, toll-free, at 1-800-538-9552. DEERS deals with eligibility issues only.

Your letter implies that you will still be eligible for Tricare after your divorce because of the 26-year duration of your marriage. DEERS can help you with that, too. If you meet the requirements as a former spouse, you are legally eligible for Tricare, and DEERS will help you get registered and get a proper ID card.

Your former husband does not have the power or the authority to prevent you from using Tricare. He cannot control your access to care and has no rights to know whether you file Tricare claims or anything about your medical care. That is all confidential.

However, the court may grant your former husband the right to information about his daughter’s claims and medical care. That is something to discuss with your attorney if you have one.

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.

Can sister be covered under my husband’s Tricare?

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I have a sister who is going to be moving in with me. She is on Social Security disability and Medicare. My husband is retired Navy. Can he add her to his Tricare as a dependant?

Tricare eligibility is established by federal law for certain categories of people. Brothers, sisters, parents or other family members do not meet the legal requirements for Tricare eligibility.

If you live near a uniformed service facility with a hospital or clinic, it is possible that your husband can arrange for your sister to get some, or even all, of her medical care and pharmacy services there. He should contact the Patient Administration Office or the Executive Officer at the facility for more information about that.

For your sister to have access to any military benefits, there are some administrative actions your husband would have to take to establish her as his legal dependent. His Personnel Office can help make those arrangements, including her registration in DEERS.

For confirmation of my reply, above, and for official answers to any and all questions about Tricare eligibility, please call the Defense Enrollment Eligibility Reporting System Support Office at 1-800-538-9552. DEERS deals with eligibility issues only.

Can Marine’s parents, brother buy Tricare coverage?

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My son is taking a medical retirement from the Marines. I am his father and will be unemployed and uninsured soon due to a company closing. Is it possible for me, his mother and brother to buy coverage through him with Tricare?

Although it functions in many of the same ways, Tricare is not a health insurance policy or an insurance company. It is a federal health benefits program created by law with the sole purpose of paying part of the costs of civilian medical care for the spouse and eligible children of active-duty service personnel, retired personnel and their eligible family members, surviving family members of deceased active duty and retired personnel, and a few others.

The parents, siblings, or other family members apart from the service member’s spouse and children are not eligible for Tricare. They cannot purchase eligibility or coverage by the program.

You can get official confirmation of the above, and a complete description and explanation of Tricare eligibility, by calling the DEERS Support Office, toll-free, at 1-800-538-9552.

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Son is an airman; can I get Tricare?

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My son is in the Air Force, stationed at Hickam Air Force Base, Hawaii. He applied to have me as a secondary dependent (I am his mother) and it was approved in June. I went to MacDill Air Force Base, Fla., a few weeks ago to get my military ID and to find out about medical care. They told me I couldn’t see a doctor there, but if I saw a civilian doctor and he ordered tests, they could do them on base. I’m sure there is some way for me to get some medical care. Can I join Tricare? Can I go to another military medical facility?

By law, a service member’s parents are not eligible for Tricare. That is true even if the parent is totally dependent on the service member. You can get official confirmation of the above by calling the Defense Enrollment Eligibility Reporting System at 1-800-538-9552.

Dependent parents may be authorized medical services, at varying levels of care, at a military hospital. Depending on the situation at the particular hospital, a parent may get total care there, limited services or no services. The parent has no legal right to care at the military hospital. If granted, it is a matter of courtesy only.

Apparently, that was your experience in that, although you cannot see a military doctor at your hospital, it can provide certain laboratory services for you when ordered by your civilian physician.

The primary consideration for whether a dependent parent can get care is usually the availability of space, personnel, and/or the technical capacity of that hospital to provide the care the parent needs.

The primary mission of military hospitals, by law, is to provide care for active duty military personnel. That must always be the hospital’s primary concern.

The decision to grant or deny a dependent parent’s access to care at the military hospital rests entirely with its Commanding Officer. That decision is based on his or her professional opinion, after consideration of the hospital’s primary mission.

You may want to approach the hospital’s Patient Administration Office or Executive Officer about your concerns.

Can family get Tricare once I move in with fiance?

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I plan on marrying a retired Coast Guard pilot next year, but my children and I have since moved in and combined our families into one unit. Can my two kids and I join Tricare prior to the marriage while living with him?

No; you’ll have to get married first. You and your children will become Tricare-eligible on the day you marry. Your husband, however, will have to register the family with the Coast Guard and DEERS, and get uniformed service ID cards for you before you can use Tricare. Save all your medical bills until he gets that done.

He should call the DEERS Support Office, toll-free, at 1-800-538-9552, if he needs guidance. His Personnel Section can help him with it immediately if nearby; or, he can try a reserve unit with a personnel shop.

Why can’t I ‘turn off’ daughter’s Tricare eligibility?

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Q. I am retired and my daughter is 18 years old. We are estranged through divorce. She has medical insurance in Ohio, but her claims are being denied because she is eligible for (but not enrolled in) Tricare. How can I make her ineligible for Tricare so she can move on to other insurance? There has to be a mechanism to turn this off.

By federal law, free Tricare benefits flow directly to the beneficiary as a result of the military sponsor’s service. The sponsor does not have the authority to cancel or otherwise affect her Tricare eligibility. Her use of Tricare would not involve you in any way.

If your daughter is unmarried and meets all eligibility requirements, and if she were properly registered in DEERS and with your service, Tricare Standard would act as a free supplement to any commercial insurance, paying all, or most, of what that policy does not pay, such as its deductibles and copayments. Tricare is always last payer to all other health insurance.

Please contact the Defense Enrollment Eligibility Reporting System (DEERS) for an official response to your question, and guidance regarding possible actions, at 1-800-538-9552. DEERS is a federal agency under the auspices of the Defense Department.