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Tricare Help: Post-DOMA, can new spouse get Tricare?

Jul. 18, 2013 - 06:15PM   |  
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Q. I am an Air Force Reserve retiree. At age 60, I went on Tricare Prime and, at 65, I started on Medicare with Tricare for Life as my supplemental insurance. As of the recent Supreme Court decision striking down the Defense of Marriage Act, I will now be able to marry my life partner of 22 years.

Once we have our marriage certificate, and I register her under the Defense Enrollment Eligibility Reporting System, I understand that she will be able to start receiving all the benefits of a military spouse. She is younger than I am and will not be eligible for Medicare for several years. Will my new spouse also be eligible for Tricare for Life until she reaches the age of 65? I understand that I will have to pay the Tricare for Life annual enrollment fee for her and network co-payments.

A. Your spouse will not be eligible for Tricare for Life until she reaches age 65 and enrolls in Medicare Parts A and B. There is one exception to that rule: If she is entitled to Medicare before age 65 due to disability, she can be covered under Tricare for Life earlier than age 65.

Assuming that is not the case for her, her options until then will be Tricare Prime or Tricare Standard. When she reaches age 65, she will transition into Tricare for Life, with Medicare as her first payer and Tricare Standard as her backup second payer.

Tricare for Life requires no annual enrollment fees; the only payment required is the monthly Medicare Part B premiums, currently about $100 a month for most beneficiaries, plus applicable co-pays and cost shares for care.

Tricare Prime requires an annual enrollment fee; if you and your spouse choose that plan for her, you would pay the individual, not the family, enrollment fee.

If you cover your spouse under Tricare Standard only, there is no enrollment fee, just applicable cost-shares and deductibles.

Q. My son’s dad is in the military. I was told by his new girlfriend that my son has insurance through the military. How do I find out if he does or not? I don’t want to get into trouble if I go with another insurance.

A. The easiest way would be to talk to the father, but from what you say in your email, you don’t seem to be in communication with him.

The only other avenue of information would be the Defense Enrollment Eligibility Reporting System, the Defense Department’s eligibility portal for Tricare. Dependent children of military sponsors must be registered in the DEERS database to use Tricare health care benefits.

Privacy concerns may preclude DEERS from giving you complete — or even any — information, but as the child’s mother, you may be able to at least verify that your son is registered in DEERS. Call 800-538-9552.

Write to Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or tricarehelp@military times.com. In email, include the word “Tricare” in the subject line and do not attach files. Get Tricare advice any time at www.militarytimes.com/tricarehelp.

Answers by RallyPoint

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