Tricare Help

Can ex-wife keep Tricare?

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I joined the Navy in 1972, married in 1974, and retired in 1992. My wife and I got divorced this year. She has no work-related insurance and has not remarried. Will she be eligible for full medical benefits?

MYhe requirements for continued Tricare coverage for former spouses after divorce is one of the most clearly delineated aspects of Tricare policy. It’s defined by the so-called “20/20/20 rule”:

1. The service member must have accrued at least 20 years of service creditable toward military retirement.

2. The marriage must have lasted at lest 20 years.

3. The marriage and the member’s military service must have overlapped by at least 20 years.

If all three requirements are met, the former spouse can maintain Tricare eligibility under her own Social Security number for life, as long as she does not remarry. If she does remarry, her Tricare eligibility ends and cannot be restored even if the subsequent marriage ends in death or divorce.

In your case, it appears that you and your ex-wife meet the first two requirements, but not the third; your service and the marriage overlapped by only 18 years.

However, there is a lesser known corollary known as the “20/20/15 rule” under which the first two requirements above remain the same, and the overlap between service and marriage was at least 15 years. In that situation, a former spouse is entitled to one year of continued Tricare coverage, starting on the date of the divorce decree.
Based on the information you provided, your ex-wife appears to qualify for that one year of extended coverage.

How long can I keep Tricare after divorce?

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I will soon be divorced from my retired military spouse. Until what age will I be able to continue my Tricare coverage? I read recently that my coverage extends only until age 62, short of Medicare eligibility at age 65.

For former military spouse to remain eligible for continued Tricare coverage after divorce, they must meet the three criteria of the “20/20/20 rule”:

1. The service member must have at least 20 years of service creditable toward military retirement purposes.

2. The marriage must have lasted at least 20 years.

3. The member’s service and the marriage must have overlapped by at least 20 years.

If you meet those criteria as a former spouse, then you remain Tricare-eligible for life, as long as you meet one large condition — you do not remarry. If you do, your Tricare eligibility connection to your retired military spouse is ended and cannot be restored even if your subsequent marriage ended in death or divorce.
Assuming you did not remarry, until age 65 you would be eligible for Tricare Prime or Tricare Standard. At age 65, you would transition into Tricare for Life, with Medicare as first payer and Tricare Standard as second payer.

Married for 18 of husband’s years of service; what coverage would I have if we divorced?

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I have been married 27 years, and my husband was active duty for 24 years. We were married for 18 of his 24 years of service. I know I don’t fall under the 20/20/20 rule, so I need to know what coverage I am entitled to. Also, what sort of coverage, if any, is my husband responsible for in case of divorce?

As you note, you don’t meet the requirements of the 20/20/20 rule for continued lifetime Tricare coverage after divorce. However, there is a corollary known as the 20/20/15 rule. If the service member served at least 20 years on active duty, the marriage lasted at least 20 years, and the marriage and the member’s service overlapped by at least 15 years, then a former spouse is entitled to one year of Tricare coverage starting on the date the divorce becomes final. That seems to fit your situation.

As to what your husband would be reponsible for after divorce, that’s up to the divorce court. A judge conceivably could order him to pay some or all of the costs of commercial health insurance for you as part of the divorce settlement; however, a state court judge could not order that you remain covered under Tricare longer than the one year you would be entitled to under the federal law by which Tricare operates. The question of your post-divorce health care costs likely would be taken into consideration as part of a broader arrangement regarding alimony and/or division of your husband’s military retirement pay.

If spouse gets surgery just after divorce is finalized, will I have to pay for it?

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I am finalizing a divorce and just waiting for the judge to sign off on the final decree. My ex-wife has a surgery scheduled – already approved by Tricare – that may fall after the divorce has been finalized. Will Tricare still cover this surgery even if it falls after the official date we are divorced, and if it is not covered, can I be charged for the operation?

If you have at least 20 years of active duty, have been married for at least 20 years, and the marriage and your service overlapped by at least 20 years, your spouse can remain eligible for Tricare after the divorce indefinitely, as long as she does not remarry. If you don’t meet the requirements of this “20/20/20″ rule, your spouse will lose her Tricare coverage on the day your divorce becomes final. Tricare has approved the operation based on the fact that your spouse is your legal dependent, or was at that time. If the operation occurs after the divorce becomes final, you almost certainly would be charged for it once Tricare denies the claim for payment.

Can I make sure ex-wife didn’t put another man’s baby on my Tricare?

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My ex-wife became pregnant by another man during our divorce. We are divorced now, but we were married when she had the baby. I know she was entitled to Tricare benefits during the divorce proceedings, but how can I find out if she put another man’s baby on my Tricare?

The child would have to be listed as a dependent on your file in the Defense Enrollment Eligibility Reporting System, the Defense Department’s eligibility portal for Tricare. It is extremely unlikely that your wife/ex-wife could have done that without your knowledge, but you can check the status of your DEERS information by visiting the ID Card/DEERS office of any military installation or by calling the main DEERS support office at 800-538-9552.

Can soldier ensure wife’s baby — which isn’t his — does not get coverage?

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I am an attorney representing a soldier pro bono in a divorce proceeding. The soldier’s wife is now pregnant with a child that is not his. She is receiving all of her medical care through Tricare. Upon the birth of the child, how can the soldier ensure that his Tricare benefits are not being used to pay for the hospital stay or other expenses for a child who is not his dependent? The divorce will not be finalized at this point.

The only way the child could possibly use Tricare benefits is if the service member proactively registered the child in the Defense Enrollment Eligibility Reporting System (DEERS), the Defense Department’s eligibility portal for Tricare. For the child to qualify as a dependent, the service member would have to be contributing more than half of the child’s financial support.

DEERS registration does not happen automatically; registering family members in DEERS is the responsibility of the military sponsor — the service member.

As long as the couple is married, the spouse will continue to be covered by Tricare, to include maternity care and the birth of the child. After birth, children normally are covered automatically for up to 60 days under Tricare Prime, the military’s version of an HMO. It is during that 60-day period that the military sponsor normally would register the child in DEERS and decide whether to formally enroll the child in Tricare Prime for the long term, or let the temporary Prime coverage lapse and cover the child under Tricare Standard, the military’s version of a fee-for-service plan.

In this case, if the divorce is not finalized when the baby arrives and the military sponsor is providing more than half of the child’s financial support for some period of time until the divorce is finalized, then the military sponsor could register the child in DEERS and for Tricare coverage in that interim, even though it is not his biological child. However, once the divorce is finalized, the ex-wife will lose Tricare eligibility, as will the child, unless the military sponsor legally adopts the child or enters into some form of shared custody arrangement — which does not sound likely in this case. To close that loophole, the military sponsor would simply need to contact DEERS to have the ex-wife and the child removed from his file in the database.

Does ex-wife really need military IDs for young children to get care?

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My fiancé’s ex-wife is demanding we get military IDs for their kids, who have Tricare under him. She lost her benefits after the divorce, but insists that she cannot get medical care for the kids without military IDs. The kids are 4 and 6 years old. We were under the impression they would not need IDs until the age 10, and feel like she is using it as an excuse to get on base and reap the benefits (commissary, childcare, etc.). Does she need military ID for them in order to take them to appointments?

You are correct, dependent children normally do not receive ID cards before age 10. However, there are some situations in which ID cards may be issued earlier, including family situations like yours, where the biological parents are divorced and share custody, and one of the parents is not eligible for Tricare. The ultimate arbiter of whether children younger than 10 should be issued ID cards is the Defense Enrollment Eligibility Reporting System (DEERS), the Defense Department’s eligibility portal for Tricare. Your husband should contact DEERS for more information. He 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.

Pregnant, but baby isn’t estranged husband’s; am I covered?

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My husband walked out more than six months ago and I haven’t seen or heard from him since. Our divorce is pending, but not yet final, and I know I am still covered by Tricare until the divorce is final. Now, I have just found out I am pregnant, and he is not the father. Am I still eligible for maternity care? Will a paternity test be required? Will he have access to the medical records? Our divorce will definitely be final several months before the due date.

As long as a spouse is legally married to an active-duty service member or military retiree, the spouse is eligible for Tricare coverage, assuming they are properly registered in the Defense Enrollment Eligibility Reporting System.

In your specific case, if your divorce will indeed be finalized prior to the birth of the child, the paternity of the child is irrelevant because you will be seeking only pre-natal and maternity care for yourself during your remaining period of Tricare eligibility.

Your question about whether your husband will have access to your medical records is a legal issue outside the scope of our Tricare Help column. I believe normal privacy laws would apply, but you would have to verify that with a lawyer.

You can check your DEERS status by visiting the ID Card/DEERS office of any military installation or by calling the main DEERS support office at 1-800-538-9552.

Can mom’s military husband take her benefits before divorce?

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My mother has been married to a military man for the past six years, but now they are separating and may file for divorce. She is currently covered by his military benefits, but this man may try to take her medical, dental, and life insurance away from her. Can he legally do that before they are divorced?

The short answer is no. While they remain legally married and your mother is legally a military spouse, she remains eligible for Tricare medical and dental coverage, as long as she is properly registered in the Defense Enrollment Eligibility Reporting System, the Defense Department’s eligibility portal for Tricare. She can check her DEERS status 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.

However, Tricare medical and dental coverage is not completely free; Tricare Prime, for example, the military’s version of an HMO, requires payment of annual enrollment fees, while Tricare Standard, the military’s version of a fee-for-service plan, carries various co-pays and cost-shares. Dental coverage for active-duty family members also is not free; it requires payment of monthly premiums. If your mother’s husband is paying those costs now, your mother may have to assume those costs.

For more information about her medical care, your mother should contact the Tricare managed-care contractor for the Tricare region in which she lives. Contact information for all Tricare regions is here.

She should also call the Tricare contractor for the active-duty family member dental program, which is MetLife, to further discuss that coverage. MetLife’s Tricare-related toll-free customer service line is 1-855-638-8372, and the associated website is here.

Servicemembers’ Group Life Insurance is a completely different matter. Service members retain complete control over that benefit and can designate anyone they choose to receive the payout should the member die while on active duty. Service members also can change their SGLI beneficiary designations at any time.

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.