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Tricare Help: Will boyfriend's illness be covered after marriage?

Aug. 7, 2013 - 04:08PM   |  

Q. My boyfriend and I plan to wed. What’s holding us back is that I’m on active duty and he’s a civilian with a major illness. He’s on dialysis and on the waiting list for a kidney transplant. Will Tricare cover his medical care since it’s a pre-existing condition, or will he be required to maintain separate medical coverage?

A. Tricare places no restrictions on pre-existing conditions for newly eligible beneficiaries for any medical procedures or services that Tricare normally covers (basically anything that is “medically necessary”). Tricare covers dialysis, and it covers most organ transplants.

When you and your boyfriend marry, you’ll need to register him under your military sponsorship in the Defense Enrollment Eligibility Reporting System, the Defense Department’s eligibility portal for Tricare. Once that is done, he can use Tricare benefits. Visit the local ID Card/DEERS office on any military installation or call the main DEERS support office at 800-538-9552.

Q. I have been married for 15 years. My husband got out of the Navy two years ago after 17 years. I know I don’t have any health coverage, but what about our son? He is 13 years old, a minor.

A. Your son is not eligible for Tricare, either. The only way he could have remained eligible is if your husband had stayed in the service long enough to qualify for retirement benefits, including health care. That requires serving at least 20 years on active duty. If your husband got out with only 17 years, neither he, nor any of his family members, is eligible for Tricare.

Q. Does Tricare for Life cover chiropractic care?

A. Tricare does not cover chiropractic care under any program options. The only chiropractic care available anywhere in the military health care system is offered on a limited basis only to active-duty members who receive care in certain designated military treatment facilities.

Q. Does the Humana Medicare Advantage (PPO) health plan fulfill the requirement that to be eligible for Tricare one must have Medicare parts A and B?

A. Medicare Part C plans, also known as Medicare Advantage Plans, are offered by private companies that are approved by Medicare to provide Part A and B benefits. Beneficiaries enrolled in Part C plans still pay their Part B premiums to Medicare, so they remain eligible for Tricare for Life. Part C plans may charge additional premiums and other costs beyond the basic Part B monthly premium, but they also may offer coverage and services beyond that of regular Part B. Each beneficiary must carefully weigh the costs and benefits of a Part C plan for their own needs.■

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

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