Q. My dad, 88, and mom, 84, are covered by Medicare/Tricare for Life. Mom has had three strokes that have left her needing needs care 24/7. Dad doesn't want her to go to a skilled nursing facility, so we're trying to keep her at home as long as possible.
We use have gone to an in-home health service to offset some of the family caregiving. But it's becoming a financial burden for my father, as he pays out of pocket for these services. Does Tricare cover any in-home health services?
A. Yes, Tricare does cover home health care services — to a point.
Basic in-home care authorized under Tricare includes part-time and intermittent skilled nursing care; home health aide services; physical, speech and occupational therapy; and medical social services — in essence, the same in-home services covered under Medicare.
But obtaining prior authorization from Tricare is a must for in-home health care, and beneficiaries may be charged separately for certain types of equipment and medications required in connection with that care.
Bottom line, your dad quite likely does not have to cover all the expenses exclusively out of pocket. Get all the details from the Tricare for Life contractor, Wisconsin Physician Services, at 866-773-0404.
Q. My husband is retired from the military, and we have our two kids still living with us. My daughter is 20 and fresh out of school, with no job and no income or health plan of her own. My son is 19 and will also be out of school in a few months, and likely will be in a similar situation. Are they still considered dependents with full Tricare benefits?
A. Yes, both children are eligible for Tricare until they reach age 21 regardless of their employment or income status, with the somewhat large caveat that they must remain unmarried. They may stay covered under Tricare until age 23 if they are full-time college students at the time they turn 21.
What's more, upon reaching age 21 (or age 23 if full-time college students), your kids may well be eligible for extended coverage under the Tricare Young Adult program, although that option requires enrollment and payment of monthly premiums, and also requires that the child remains single. There are some other requirements as well. TYA coverage may last until age 26.
More details on Tricare for dependent children are here.
Specific information on Tricare Young Adult is here.
Email tricarehelp@militarytimes.com. Include the word "Tricare" in the subject line and do not attach files.
