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Tricare Help: Will children be covered by fiance's Tricare?

Sep. 6, 2012 - 05:25PM   |   Last Updated: Sep. 6, 2012 - 05:25PM  |  
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Q. My fiance is on active duty in the Army National Guard and will be deployed in the fall. We would like to get married before then. I have two children who are not his biological children. Will his Tricare cover them immediately when we get married or does he have to legally adopt them?

A. Stepchildren do not have to be adopted to be fully covered by Tricare. As long as the active-duty military sponsor and the parent of the stepchildren are married, the stepchildren are covered.

However, if the marriage ends in divorce, the stepchildren lose Tricare eligibility on the date the divorce decree is final. The only way the children can remain eligible for Tricare in that scenario is if they were legally adopted before the divorce.

Keep in mind that all of the above applies only as long as your fiance remains on active duty. When in a drilling status, National Guard and reserve members can use Tricare only through a relatively new program called Tricare Reserve Select, under which beneficiaries must pay monthly premiums.

Your fiance should notify his service's personnel office as well as the Defense Enrollment Eligibility Reporting System support office to get your children registered for Tricare eligibility. You can call DEERS at 800-538-9552.

Q. Is there an easy and sure way to determine whether Tricare has paid its portion of a medical bill, other than getting a second bill from the medical service provider?

A. Tricare should send you an explanation of benefits form for all claims. EOBs are itemized statements detailing exactly how much Tricare paid for specific services on each claim. If you are not getting those forms, you should talk to the contractor in your Tricare region; find your point of contact at www.tricare.mil/contacts.

Q. 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?

A. 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 turns 65 and transitions into Tricare for Life. Your dependent children may stay in Prime until they reach age 21 (23 for full-time college students). At that time, they may transition into Tricare Young Adult, which carries separate premiums, and stay in that program until they reach age 26 — as long as they remain unmarried and have no other health coverage, such as through an employer of their own.

Find more information on TYA at www.tricare.mil/tya.

Write to Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or tricarehelp@militarytimes.com">tricarehelp@militarytimes.com. In email, include the word "Tricare" in the subject line and do not attach files. Get Tricare advice anytime at http://www.militarytimes.com/tricarehelp">www.militarytimes.com/tricarehelp.

Answers by RallyPoint

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