Can disabled adult son get Tricare and dental coverage?
February 3rd, 2012 | TriCare Help | Posted by Military Times
I am a retired, 100 percent disabled Navy officer. I have a 41-year-old son who is disabled and receives SSDI from Social Security. Does he qualify for Tricare and dental coverage?
To begin an inquiry concerning the possibility of your disabled son’s Tricare eligibility, please call the DEERS Support Office, toll-free at 1-800-538-9552.
If your son is determined to be entitled to Tricare, and if he is enrolled in free Medicare Part A, and in Medicare Part B, he will be entitled to the Tricare program called Tricare for Life. To use TFL, he must be properly registered in DEERS.
Under TFL, Medicare Parts A and B becomes the beneficiary’s primary health insurance, and Tricare Standard, as second payer, acts as a free Medicare supplement. The TFL beneficiary, thus, has coverage by two, full-service, stand-alone health “insurance” plans. The second plan, Tricare Standard, is provided without additional cost.
Under TFL, the vast majority of the beneficiary’s medical expenses will be paid in full by the combined coverage of Medicare plus Tricare. The only cost for Tricare for Life coverage is the monthly premium for Medicare Part B. That is somewhat more than $100 per month in 2012.
Tricare does not have a dental benefit. It does, however, provide for enrollment in a commercial dental insurance plan available to Tricare beneficiaries at group rates. There is a plan for active-duty personnel and their Tricare-eligible family members, and there is a similar plan for retirees and their families. You can get more information about the Tricare Retiree Dental Plan here.
Tricare after a divorce: Even lawyers should start with DEERS
February 1st, 2012 | TriCare Help | Posted by Military Times
I have a friend who is going through a divorce. He is retired from the Air Force, and in the divorce papers, his estranged wife is requiring that he keep her and her child (who is not his biological child) on Tricare for an additional year. Can she sue him if Tricare drops her?
As a lawyer friend of mine says, “Anybody can sue somebody for anything. Finding a lawyer willing to take the case, and/or winning the case, are entirely different matters.”
The legal requirements for Tricare eligibility are established by federal law. I cannot give legal advice, but I can suggest the best place to start an inquiry about the legal requirements for Tricare eligibility is by calling the DEERS Support Office, toll-free, at 1-800-538-9552.
DEERS cannot give legal advice, but it can advise inquirers about the provisions of federal law concerning Tricare eligibility. Even lawyers should begin any inquiries about Tricare eligibility at that office.
How do we know if we’re eligible?
January 30th, 2012 | TriCare Help | Posted by Military Times
My husband is a disabled Army vet and he cannot seem to tell me what Tricare is or if he can get it. I understand it is some kind of insurance. Could we be eligible for it?
There are two programs for which you might be eligible.
You wrote that your husband is a disabled vet. Depending on his disability rating from the Veterans Affairs Department, you may be eligible for care through the VA. If his rating is “100 percent, permanent and total,” he may qualify for free VA medical care for the rest of his life, and his wife and unmarried children under age 18 would be entitled to the program called CHAMPVA.
Alternatively, if your husband is entitled to receive retired pay, he and his family may be entitled to Tricare.
For official information regarding your husband’s Tricare eligibility, he should call the DEERS Support Office, toll-free, at 1-800-538-9552. He must call, himself. Due to provisions of the Privacy Act, that information cannot be given to another person.
Another source of public information regarding Tricare eligibility is at the official Tricare website.
I’m diabetic; when I get married, can I get Tricare right away?
January 27th, 2012 | TriCare Help | Posted by Military Times
My fiancé is active-duty military. I am a diabetic and am on the insulin pump, and I have been told that once I get married and go on Tricare, my care will not be what I’m used to. I have seen the same doctor for 17 years, and I heard Tricare won’t let me pick my doctor. I have also been told I may have to give up my insulin pump and go back to shots. Can you confirm or explain any of that? Also, when we get married, my parents will drop me from their insurance. Do I have to wait for an open enrollment date for Tricare, or is there a way that coverage can start right away?
First of all, if medically necessary and appropriate for the diagnosis, symptoms, and history of the particular beneficiary, an insulin pump can be covered by Tricare.
A problem could arise, however, in your choice of providers. Tricare is not an insurance policy; it is a federal health benefits program. Tricare requires that you receive all civilian medical care from Tricare-authorized providers only. Tricare may not pay for any medical services you receive from an unauthorized provider.
In your case, to retain your same providers, it would be necessary for them to be willing to become Tricare-authorized providers. They can learn how to do that here.
There is no open enrollment period for Tricare. You will become legally entitled to Tricare at the moment you are married. To use Tricare, however, your military sponsor (your husband) must contact his personnel office to register you in the Defense Enrollment Eligibility Reporting System and secure for you a uniformed service identification card. Your coverage will be retroactive to the moment of your marriage.
Do we still need Tricare Prime Plus under Tricare for Life?
January 25th, 2012 | TriCare Help | Posted by Military Times
My wife and I just qualified for Medicare and Tricare for Life. We were both enrolled in Tricare Prime. We are also enrolled in Tricare Prime Plus at a military treatment facility. Do we need to continue paying the annual enrollment fee to use Tricare Prime Plus?
If a person is enrolled in Tricare Prime when they become eligible for Medicare and Tricare for Life, his or her Prime enrollment is terminated. On the effective date of Medicare coverage, it is automatically changed to Tricare Standard, which becomes a free supplement to Medicare. The person is no longer eligible for Tricare Prime. He no longer has priority access to free care at a military hospital, and any Tricare Prime enrollment fees paid in advance are lost; they cannot be refunded.
I changed my name; how do I tell Tricare?
January 23rd, 2012 | TriCare Help | Posted by Military Times
I got married a few months ago and I switched my last name to my wife’s. How can I switch my last name in Tricare? I am enrolling my wife in DEERS next month.
You need to call the DEERS Support Office at 1-800-538-9552.
Personnel at that office will tell you all you need to know, exactly what you need to do, and the way to do it. They will walk you through every step and answer all your questions regarding Tricare eligibility. Be prepared to take notes. DEERS deals with eligibility only and cannot answer any questions about the Tricare program, its benefits, its claims, or its payments. You must contact your Regional Tricare Service Office for official information about any of those things.
If I divorce wife, will she lose all Tricare coverage?
January 18th, 2012 | TriCare Help | Posted by Military Times
My dependent spouse had a massive stroke and presently lives in a nursing home. She has been approved for Medicaid with Tricare being primary and Medicaid as secondary. We have been married for over 20 years and I have over 18 years active duty. If I file for a divorce and it is granted, are there any Tricare benefits she would be eligible for, or would she be dropped from Tricare altogether?
The requirements for Tricare eligibility are established by federal law and regulation. The information in your letter appears to indicate that your wife will lose all her Tricare eligibility immediately on the date the divorce is final.
To retain Tricare eligibility following divorce, a former spouse must have been married to the same uniformed service sponsor for at least 20 years during which time the sponsor earned retirement credits. That is, the sponsor’s active duty service and the marriage must have been concurrent for at least 20 years. Your letter does not report that.
For an official response to your question about your wife’s Tricare eligibility following divorce, please contact the DEERS Support Office, toll-free, at 1-800-538-9552.
Would I still have Tricare for Life after husband’s death?
January 16th, 2012 | TriCare Help | Posted by Military Times
I have been married to a retired Army man for six years. He has Tricare for Life, and since I have a DEERS ID card and Medicare parts A and B I know I am eligible for it too. If my husband dies before me, will I still be eligible for TFL, or would I have to be married to him for 20 years?
Your husband’s death would have no effect on your Tricare or Tricare for Life eligibility if he should predecease you. The duration of the marriage is not a factor.
The only exception would be if you remarry. In that case, you would immediately lose all Tricare eligibility under his sponsorship. That eligibility could not be restored even if the second marriage were terminated by divorce or the death of your second husband.
Please confirm the above by calling the DEERS Support Office, toll-free, at 1-800-538-9552.
Can girlfriend and baby be covered by Tricare?
January 13th, 2012 | TriCare Help | Posted by Military Times
My girlfriend and I recently had a baby. We are not married, but she is my beneficiary. Can I put her on Tricare Reserve Select with my daughter?
The requirements for Tricare eligibility are established by federal law and regulation. Because you are not legally married to the mother, she cannot become eligible for Tricare. That means her maternity care cannot be covered by Tricare.
The child’s situation is a different matter entirely. As your biological child, your baby daughter can be covered retroactively to the moment of birth.
To provide Tricare coverage for your daughter, there are certain actions you must take. To learn exactly what you must do, and for guidance in doing them, please call the DEERS Support Office, toll-free, at 1-800-538-9552. Be prepared to take notes of what you must do and how to do it. DEERS and your Personnel Office will walk you through the entire process.
Can fiancee keep seeing same doctors when we get married?
January 11th, 2012 | TriCare Help | Posted by Military Times
I am an active-duty sailor and I am getting married in February. My fiancee has bipolar disorder. She is concerned about being able to keep her same doctors and counselor/therapist when we are married and what hoops we may have to jump through with Tricare to make it work. How can I help her ensure she keeps her current doctors?
Tricare is a federal program, but it has a rule in common with most commercial health insurance companies and policies: In order for Tricare to help pay for medical services, the provider of care must be registered with Tricare and be authorized to be paid by Tricare for covered services rendered to Tricare beneficiaries.
Your bride will become legally entitled to Tricare the moment she is married to you., For her to use Tricare, however, you must register her in DEERS and apply for her military ID card. Your Personnel Section will help you do that.
Tricare has no limits or restrictions on its coverage of pre-existing conditions. Mental health care, including pharmacy services, is a Tricare benefit, subject to existing rules regarding the medical necessity and appropriateness of care for the particular patient’s diagnosis, symptoms, and medical history.
Seamless continuity with your wife’s same providers may be a problem for two reasons:
One is the perennial element of military service in that you are subject to periodic transfer to a new location, perhaps across the world. You have little or no control over that element of military service.
The other is whether your wife’s providers are, or are willing to become, Tricare-authorized providers, as I discussed above. A section of the official website was designed especially to inform providers of care about Tricare and its rules regarding providers. Your wife should make her doctors aware of the web site and its provider section, but the decision of whether to become Tricare authorized providers is voluntary and entirely in their hands.