I am a National Guard retiree, age 60, and I’m currently receiving retirement pay. Will my spouse be eligible for Tricare Prime, Standard or Extra when I die?
Your spouse would remain eligible for the same Tricare options and costs that are in effect for her now. When she reaches age 65 and becomes entitled to Medicare, she would transition into Tricare for Life.
However, one large condition is attached to maintaining her Tricare eligibility after your death: She must not remarry. If she does, her Tricare eligibility would cease, and it could never be restored under your sponsorship, even if the second marriage ended in death or divorce.
When I turn 65 and become eligible for Tricare for Life and Medicare, will I continue to make premium payments for Tricare Prime coverage for my younger spouse and family?
Yes, when you transition to Tricare For Life, your family may stay under Tricare Prime, and you will 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 (age 23 if 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).
I am a retired airman with Tricare Prime for myself and my family. Our 6-year-old grandson, our daughter’s son, also lives with us, and we we have been awarded “joint conservatorship” of him, to include primary residency and health care responsibilities. How can we enroll him in our Tricare family plan? Despite the fact that our grandson has lived with us for most of his life and we are responsible for all aspects of his care and well-being, he was denied DEERS enrollment under my sponsorship.
Tricare eligibility is established by federal law; Tricare has no authority to make eligibility determinations. By law, only the services may determine whether a particular individual meets the legal criteria for Tricare eligibility, to register an eligible person in DEERS, and to issue an appropriate uniformed service identification card.
The law is not very flexible when it comes to covering grandchildren. There are only two ways for the child to be covered by Tricare:
If no one at DEERS explained these details to you, you can confirm the above by calling the DEERS support office, toll-free, at 1-800-538-9552.
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.
My 22-year-old son is a junior in college. In some places I read that he will lose his Tricare eligibility on his 23rd birthday, but elsewhere I read he can be covered until age 26. Which is it?
If your son remains a full-time student, he can indeed continue under your regular Tricare coverage until he reaches his 23rd birthday. At that time, he may transition into a relatively new program called Tricare Young Adult and stay in that program until his 26th birthday, as long as he remains unmarried and has no other health care coverage options, such as through an employer.
However, Tricare Young Adult requires payment of monthly premiums. Currently, those premiums are $201 per month for Tricare Prime or $176 a month for Tricare Standard.
My 82-year-old mother is a recent legal immigrant to the U.S. She lives with us and is our dependent. How can I get her signed up for Tricare?
Dependent parents and parents-in-law are not eligible for Tricare. Under certain circumstances, however, the uniformed services may determine a parent or parent-in-law to be the dependent of an active duty member or retiree. In those circumstances, the parent or in-law may be allowed to use a military treatment facility, subject to the availability of space, personnel, and technical capacity.
You must apply with your service for your mother to be designated, legally, as your dependent. Then you may apply with your MTF for her to be allowed to use its facilities. Ask whether she can be eligible for Tricare Plus, which will give her the same access rights to free MTF care as are enjoyed by Tricare Prime members. She will not have Tricare Prime health care coverage, but the medical care she will get will be just as good.
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.
I have a sister-in-law who is 18 and is about to move to our duty station to live with us to attend college. Can my husband, who is active-duty military, claim her as a dependent if she is a full-time student?
No, I’m sorry, but a dependent sister-in-law cannot become eligible for Tricare. You can confirm that fact by calling the DEERS Support Office, toll-free, at 1-800-538-9552.
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.