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Tricare Help: Marrying a military dependent won't get you coverage

Jul. 21, 2010 - 06:58PM   |   Last Updated: Jul. 21, 2010 - 06:58PM  |  
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Answering your questions on Tricare.

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Answering your questions on Tricare.

Q. My fiancé is 22 and a full-time student. He has Tricare through his father's military service. If we marry, will I be covered by his Tricare health insurance under his father's sponsorship?

No. In fact, not only would you not be included in his Tricare coverage, but he would lose his Tricare eligibility. If a Tricare-eligible child marries, regardless of age or full-time student status, his Tricare coverage is terminated immediately under the federal law that governs the program.

Q. I understand the catastrophic cap is $3,000 for retiree families. How can I find out the balance in my account?

The balance in a family's catastrophic cap account is reported on the Explanation of Benefits every time a claim is processed for a family member. You can also call your Regional Tricare Service Center to get the balance.

Each time a claim is processed for a family member, any amount paid as a deductible or cost share is reported in the running total of the family's catastrophic cap account for that fiscal year.

When the total reaches $3,000 for a retiree family, or $1,000 for an active-duty family, Tricare will withhold nothing more from the amount it pays. For the rest of that fiscal year, Tricare will pay 100 percent of the amount it allows on each family member's claim.

At midnight Sept. 30, the end of the fiscal year, the amounts in all Tricare catastrophic cap accounts roll back to zero and begin to accumulate anew.

Q. When I get Medicare, do I have to do anything special to keep my Tricare pharmacy benefit? A friend told me that Medicare has a prescription drug plan that I must use instead of the Tricare plan. Is that true?

Medicare has a pharmacy plan called Medicare Part D, but people who enroll in the basic Medicare program, called Original Medicare, are not required to join it. Original Medicare consists of Medicare Part A and Part B only.

Medicare Part D is not recommended for Tricare for Life beneficiaries. The Pentagon's Office of Health Affairs has said Tricare beneficiaries are unlikely to benefit from it financially unless they are below the U.S. poverty line and qualify for financial aid on their Part B premiums.


Write to Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or"> In e-mail, include the word "Tricare" in the subject line and do not attach files. Get Tricare advice anytime">at our blog.

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