Advertisement

You will be redirected to the page you want to view in  seconds.

Tricare Help: The many shades of Tricare eligibility

Aug. 20, 2014 - 01:30PM   |  

Q. Our daughter is 16 and is considering living at a deaf ranch (she is deaf) to finish her high school years. If she doesn’t live at home, will she still be eligible for Tricare?

A. Assuming your daughter’s military sponsor remains eligible for Tricare, and assuming she remains unmarried, then the answer is yes. As long as she remains a legal military dependent and single, she remains eligible for Tricare.

Dependent children normally “age out” of ordinary Tricare at age 21, or age 23 if they are full-time college students.

After that, they may enroll in Tricare Young Adult, which requires payment of monthly premiums. Dependent children exhaust all their Tricare options when they reach age 26.

Q. I’m a 65-year-old retiree who uses Tricare for Life. My spouse of 45 years has recently retired from her civilian job. She is 63. Her medical coverage with her current carrier is about to end. Does she have to purchase another plan, or can she use Tricare Standard as her major coverage until she turns 65?

A. As the spouse of a military retiree, your wife is fully eligible for Tricare coverage. For the next couple of years, she can use either Tricare Prime, the military’s version of a private-sector HMO, which requires enrollment and payment of annual premiums, or Tricare Standard, the military’s version of a private-sector fee-for-service plan, which does not require enrollment and charges no premiums.

At age 65, she will transition into Tricare for Life, as you have, and use Medicare as her primary coverage and Tricare Standard as her backup secondary coverage.

To use her Tricare benefits, your wife must be properly enrolled in the Defense Enrollment Eligibility Reporting System under your sponsorship. You can engage DEERS by visiting the ID Card/DEERS office on any military installation or by calling the main DEERS support office in California toll-free at 800-538-9552.

Q. My nephew lives with our family, and my wife and I have legal custody of him. Can we enroll him in Tricare under my sponsorship?

A. Tricare rules state that in order for a child to be considered a dependent of a military sponsor for Tricare purposes, the child must be either the biological offspring of the sponsor and his or her spouse; the biological child of the spouse, i.e., the military sponsor’s stepchild by marriage; or legally adopted by the military sponsor. Under those rules, legal custody is not enough to establish Tricare eligibility for a child.

That said, there are some outside advocates who insist the law governing Tricare can be interpreted in such a way that legal custody is, in fact, sufficient to qualify an individual for Tricare eligibility in situations such as yours.

Tricare itself does not make these kinds of eligibility determinations; only the military services may do that. The mechanism they use is DEERS.

Write to Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or tricarehelp@militarytimes.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

Join trending discussions in the military's #1 professional community. See what members like yourself have to say from across the DoD.

More In Pay & Benefits

Start your day with a roundup of top defense news.

VA Home Loan
Rates

Search By:

Product Options:
Zip Code:

News for your in-box

Sign up now for free Military Times E-Reports. Choose from Money and Education. Subscribers: log in for premium e-newsletters.


This Week's Marine Corps Times

This Week's Marine Corps Times

Best federal contractors
The companies hiring the most veterans now

Subscribe for Print or Digital delivery today!

Classifieds
MilitaryTimes Green Trusted Classifieds Looking to buy, sell and connect on Military Times?
Browse expanded listings across hundreds of military installations.
Faces of valorHonoring those who fought and died in Operations Iraqi Freedom and Enduring Freedom.
hall of valorThe Hall of Valor is a searchable database of valor award citations collected by Doug Sterner, a Vietnam veteran and Military Times contributing editor, and by Military Times staff.
Woman who cried rape
(3 replies)
   Last Post: TJMAC77SP
        May 3, 2014 1:32 PM
   Last Post: garhkal
        May 1, 2014 5:03 PM
Cliven Bundy
(45 replies)
   Last Post: Chief_KO
        Apr 26, 2014 9:49 AM
Handbooks

All you need to know about your military benefits.

Benefits handbook

Guard & Reserve All you need to know about the Guard & Reserve.

guard and reserve handbook