Military Health, Tricare programs - Army Times

Tricare Help: What if my child needs coverage past 23?

Q. My daughter is in college and will soon turn 23 and lose her Tricare eligibility. She has excellent grades, but suffers from an obsessive-compulsive disorder, phobias and extreme anxiety. She has not been able to get and keep a job. Because of her need for ongoing mental health care, is there any way we can get her Tricare eligibility extended beyond her 23rd birthday?

A. The upper age limits for Tricare eligibility are set by federal law. However, the law has a provision that if a child becomes disabled prior to her 21st birthday and is incapable of self-support, Tricare eligibility can be extended indefinitely for as long as the inability to support herself endures.

If her disabling condition improves and she becomes capable of supporting herself, she’ll lose her Tricare eligibility — and then it can’t be restored, even if the condition recurs.

Call the Defense Enrollment Eligibility Reporting System Support Office, toll free at (800) 538-9552, for more information about your daughter’s rights. DEERS will tell you how to apply for an extension of her Tricare eligibility. However, her high marks in college may hurt her chance to qualify for extended coverage.

Q. I will soon turn 60 and be eligible for Tricare. I want to compare my employer’s plan with Tricare to see which one is best for me and my family. How do I do that?

A. Visit http://tricare.mil/mybenefit/home/overview/Plans? to download the handbook for each Tricare plan. If you want hard copies, call your Regional Tricare Service Center — visit http://tricare.mil/mybenefit/home/overview/Regions? for an overview and contact information — to request free handbooks for each plan.

Yours is not an either/or situation, though, because Tricare Standard works well as a free supplement to your employer’s plan. For no additional cost to you, Tricare Standard will pay much, or all, of the other plan’s deductibles and co-payments.

If you decide to withdraw from your employer’s plan, you may find a suitable replacement in Tricare Prime or the US Family Health Plan, if you live where those options are available. Neither is recommended as a supplement to other health insurance.

Write to James E. Hamby Jr. at Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or e-mail tricarehelp@atpco.com. In e-mail, include the word “Tricare” in the subject line.