Am I eligible for TFL under late ex-husband’s sponsorship?
March 26th, 2012 | TriCare Help | Posted by Military Times
I am the ex-wife of a career airman who is now deceased. We were married in 1953 and divorced in 1974. He enlisted in the Air Force in early 1947 and retired in late 1971. He remarried after our divorce. I remained single for years, but also eventually remarried, in 2003. I am now on Medicare Parts A and B. Am I entitled to any Tricare for Life benefits, or any health care benefits at all?
To be eligible for Tricare as the former spouse of a military retiree, you must meet several criteria. First, you must have been married for at least 20 years. Second, at least 20 years of the marriage must have overlapped with the service member’s active-duty time. Your ex-husband’s service from 1947 to 1971 means even though you were married for more than 20 years total, only 18 of those years overlapped with his time on active duty.
However, even if your marriage had overlapped with at least 20 years of his active-duty career, you still wouldn’t qualify for Tricare benefits, for the simple reason that you remarried. Former military spouses who meet the 20-year criteria can access Tricare benefits only as long as they remain single. By remarrying, they forfeit all eligibility to Tricare health coverage. And once that happens, eligibility can never be restored, even if the former spouse’s second marriage ends in divorce or death.
I know divorce ends eligibility, but what about death?
February 23rd, 2012 | TriCare Help | Posted by Military Times
I have read that Tricare for Life will end for a spouse who divorces a sponsor. My question, is will my wife still have her eligibility if we are still married and I pass away?
If your wife is eligible for Tricare at the time, your death will have no effect on her eligibility. Unless she remarries, she can continue to have Tricare coverage for the rest of her life.
What happens to wife’s coverage if I die before 60?
February 17th, 2012 | TriCare Help | Posted by Military Times
I am a 57-year-old gray-area reservist. What will happen to my wife’s Tricare and Tricare for Life eligibility if I die before I am 60?
The death of the military sponsor has no effect on the Tricare or Tricare for Life eligibility of family members.
On your 60th birthday, you will become entitled to retired pay. If you submitted the required applications through your reserve component, you and your family will become eligible for Tricare.
If you die before that time, your eligible survivors will become Tricare beneficiaries on the day you would have turned 60, again contingent upon proper application through your reserve component.
If your widow remains unmarried, if her Defense Eligibility Enrollment Reporting System registration is up to date, and if she is enrolled in Part B of Medicare, she will become entitled to Tricare for Life when her Medicare entitlement begins at age 65.
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.
Does ex-wife lose eligibility if husband dies?
November 22nd, 2011 | TriCare Help | Posted by Military Times
If a woman divorced from a retired military member is now enrolled in Tricare under the 20-20-20 rule, does she remain eligible for Tricare if the sponsor dies?
Even if the sponsor dies, the former spouse’s Tricare eligibility will continue. The only thing that will end eligibility is if the former spouse remarries. You can confirm this by calling the DEERS at 1-800-538-9552.
When your other health insurance is under a different name
October 31st, 2011 | TriCare Help | Posted by Military Times
I work in the airline industry and can enroll in my employer’s insurance. I also have Tricare Standard as my secondary insurance — my husband is deceased. However, the Tricare coverage is under my married name, and everything with my employer is under my maiden name. Will this cause a problem when I try to file a claim with Tricare as my secondary insurance? I need to enroll in my employer’s insurance soon.
Your problem is a simple administrative issue requiring an explanatory letter. How quickly it gets resolved depends on who gets the letter and when.
Write to your Tricare claims processing office — the same place where you submit Tricare claims — and explain the situation. Make three or four extra copies. Send the letter to the claims processor now, and send another copy with the first claim you submit to Tricare as second payer.
If it doesn’t take, you will know in a few weeks after you submit your first claim to Tricare as second payer. If your claim is denied, it isn’t a disaster; you just need to file and appeal.
If Tricare simply writes asking for more information, no appeal is needed. Just reply immediately, explaining everything again, and include a copy of the letter Tricare sent you so they know what you’re talking about.
If Tricare denies the claim, then it’s time to file an appeal. The appeal must be in writing and state the specific matter in dispute: For example, “Tricare denied claim number X because I used two different names on the claims. I have attached an explanatory letter.”
Attach a copy of the explanatory letter with the appeal letter. Include also a copy of Tricare’s explanation of benefits showing the claim denial.
Send the appeal letter, the explanatory letter, and Tricare’s EOB showing the denial to the address of the Tricare office that denied the claim. It’s on the Tricare EOB. Be sure to answer all questions Tricare asks, if any. That should resolve the name problem.
If widow becomes pregnant, is maternity care covered?
August 3rd, 2011 | TriCare Help | Posted by Military Times
Q. My husband died on active duty in 2007. Our two sons and I use Tricare. I don’t plan on marrying for a couple of years, but what if I get pregnant? I know the baby, once born, wouldn’t be covered under Tricare, but would it cover my pregnancy, labor and delivery? Can I be penalized for it?
As the un-remarried widow of a deceased active duty uniformed service member, you are eligible for Tricare. Under present law, you will continue to be eligible for Tricare through your deceased sponsor for the reminder of your life, unless you marry again. If you remarry, your Tricare eligibility under that sponsorship will terminate at midnight of the day before your remarriage.
The above means that your maternity care can be covered by Tricare for as long as you remain eligible. There are no penalties of any kind. Your baby, however, will not be eligible for Tricare because he is not the child of your deceased sponsor.
In order for you and your present children to continue to use Tricare while you remain eligible, you must keep your DEERS registration and military identification cards up-to-date.
For official confirmation of the above, please call the DEERS Support Office, toll-free, at 1-800-538-9552.
What happens if my husband passes away?
April 26th, 2011 | TriCare Help | Posted by Military Times
Q. My husband retired from the Air Force in 1995 and immediately started another career with a firm with great benefits. As a result, we did not enroll in Tricare Prime and have used Tricare as our secondary insurance in only a handful of situations. Now he is losing his battle with cancer and will soon die. At that time, I will lose all my health benefits. Since I am only 60, I will not qualify for Medicare for several more years.
My question is: How do I enroll in Tricare Prime? Who should I contact and what documentation will I need?
As a widow, you will retain your eligibility for Tricare for the rest of your life unless you remarry. If you remarry, you will forever lose your eligibility under your present husband’s sponsorship, even if the second marriage ends by death or divorce.
From the present time until you become entitled to Medicare at age 65, you can be enrolled in either Tricare Standard or Tricare Prime. Tricare Prime is not available everywhere, however. It is usually available only within a 40-50 mile radius of a military hospital.
When you become entitled to Medicare at age 65, you will become eligible for Tricare for Life. Tricare for Life, or TFL, is a Tricare plan that combines the full benefits of Medicare Part A and Part B with the full benefits of Tricare Standard. Tricare Standard will act as a free Medicare supplement for the rest of your life. Tricare for Life members are not eligible for Tricare Prime. They must be enrolled in Tricare Standard as their companion to Medicare under Tricare for Life.
In the meantime, for official information about Tricare eligibility for widows, and for guidance about becoming enrolled in Tricare Standard or Tricare Prime, please call the DEERS Support Office, toll-free, at 1-800-538-9552.
What will happen to my coverage after husband dies?
January 7th, 2011 | TriCare Help | Posted by Military Times
Q. My husband retired from the Navy in 1992. He is now 80 years old and uses Tricare as secondary coverage for Medicare. I am still working at age 51. We have been married since 1988. Will I remain a military dependent after my husband is no longer alive? If so, will I be eligible for Tricare when I reach Social Security Retirement age?
Unless you remarry, your husband’s death will have no effect on your Tricare eligibility. If you remarry, your Tricare eligibility under your present husband’s sponsorship will terminate immediately. If the second marriage ends in divorce or death, eligibility under your present husband cannot be restored regardless of circumstances.
You can ensure that you are properly registered and eligible for Tricare at this time by calling the Defense Enrollment Eligibility Reporting System (DEERS), toll-free, at 1-800-538-9552. If there is a problem, ask DEERS how to fix it. It is your responsibility to keep your DEERS record and military identification card up-to-date.
If you become entitled to free Medicare Part A at age 65 and enroll in Medicare Part B, you will become eligible for Tricare for Life, or TFL for short. Under TFL you will have full benefits of Medicare Parts A and B as your primary coverage and Tricare Standard as a free Medicare supplement for all medical services that are covered by both Medicare and be Tricare. The vast majority of your Medicare claims will be of that type.
Under TFL, if you receive a medical service that is covered by Tricare but is not covered by Medicare, Tricare will process a claim for that item as if it were your only health insurance. In that case, all Tricare claims processing rules will apply including the Tricare cost share and, if applicable on that claim, the Tricare deductible.
Some people become eligible for free Medicare Part A before they are 65 under a Social Security plan for disabled persons. If they enroll in Part B, they become eligible for TFL just as if they were 65. Call the Social Security Administration about Social Security disability benefits. Social Security cannot give you official information about Tricare or Tricare for Life.
For more information about Tricare Plans, including TFL, please go the official Tricare website. You will also find contact information for your Regional Tricare Office at that site.
Without pension, can my wife still get Tricare?
December 15th, 2009 | TriCare Help | Posted by Military Times
Q. I retired from the Army National Guard. I am drawing a pension from my former employer as well as from the Army. I elected survivor benefits from my employer but not from the Army. If I predecease my wife, is she entitled to Tricare for Life even though she will not be receiving an Army pension?
Your decision regarding military survivor benefits for your wife will have no effect on her Tricare or Tricare For Life coverage. Neither will your death have any effect — unless she were to remarry.
If your wife were to remarry, she would immediately and permanently lose all Tricare eligibility received as a result of your service. If her second marriage were to end by divorce or death, her Tricare benefits under your sponsorship can never be restored.
To confirm those facts officially, please call the DEERS Support Office, toll-free, at 1-800-538-9552.
DEERS is the place to call for answers to all Tricare eligibility questions, for help with resolving eligibility issues or problems, and for help to enroll a new spouse or child in Tricare.
DEERS cannot provide any information about the Tricare program, its benefits, or its claims. For that information, you must call your Tricare Service Center or search for the information in the official Tricare web site.
Tricare beneficiaries should contact DEERS at least once each year to confirm that all information in their DEERS record is correct and up-to-date. Any status changes — such as an address change, or changes in family members such as a newborn child, a child turning 21, a child who marries, or a family member who dies — should be reported to DEERS promptly.