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Tricare Help: Family members must enroll, pay for dental care

May. 9, 2014 - 06:00AM   |  
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Q. I’m the pregnant spouse of an active-duty soldier who is separating in July. We’re on Tricare Prime. I really need some dental work, but the military clinic tells me the military doesn’t do dental care for spouses. I’d ask my husband, but he’s away right now in training and is not allowed to contact anyone. I haven’t had any dental care since we’ve been married. What can I do?

A. Family members of active-duty personnel generally cannot receive free dental care directly from military treatment facilities; they must enroll in the voluntary Tricare Dental Plan and pay monthly premiums to see private-sector dentists. Complete information on that plan can be found here: www.tricare.mil/Dental/TDP.aspx.

There are a number of steps that must be taken to enroll in that program and have your eligibility confirmed. Since your husband is separating in about three months, you have a limited window to get your foot in the door. And your eligibility would end on the last day of the month in which your husband separates.

Q. I am a “gray area” retiree. When I turn 60, what are my Tricare options? And what will the cost be for me and my wife?

A. When you begin receiving military retirement benefits, you and your wife will be eligible for all normal Tricare options open to military retirees. The main options are Tricare Prime, the military’s version of an HMO, which requires enrollment, payment of annual premiums and coordination of care through a primary care manager; and Tricare Standard, the military’s version of a fee-for-service plan, which requires no enrollment or primary care managers but tends to carry slightly higher out-of-pocket costs than Prime.

Complete information on all Tricare options, including costs, is here: www.tricare.mil/welcome/plans.aspx.

Once you reach age 65 and become eligible for Medicare, you will transition into the Tricare plan called Tricare for Life, under which Medicare acts as first payer and Tricare Standard acts as a backup second payer, if necessary. Your wife would make the same transition when she turns 65 and becomes eligible for Medicare.

Q. How does Tricare define “full-time student”? My daughter joined the Navy, was released a year and a half later and is back at home. I have re-enrolled her in the Defense Enrollment Eligibility Reporting System under my sponsorship. She will be 21 very soon, but I’m told if she is a full-time student, she can stay on Tricare.

A. That’s correct. Once dependent children “age out” of ordinary Tricare at 21, they can remain covered until age 23 if they are full-time college students, are not married, and their sponsors contribute more than half their financial support.

Tricare itself doesn’t make full-time student designations; the schools do that. You would have to ask the registrar or admissions office of your daughter’s school for a letter certifying that she is a full-time student, then provide a copy to DEERS.

After age 23, the only remaining Tricare option for dependent children is a relatively new program called Tricare Young Adult, which requires enrollment and payment of monthly premiums. Coverage under TYA may last up to age 26.

Write to tricarehelp@militarytimes.com. Include the word “Tricare” in the subject line and do not attach files.

Answers by RallyPoint

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