JUNE 28, 2023 – Is your child a recent high school or college graduate? You might be wondering how this affects their TRICARE eligibility.
“Young adult family members’ TRICARE options depend on their age, student status, and a few other factors,” said Debra Fisher, TRICARE Health Plan policy and programs analyst at the Defense Health Agency. “It’s important to know what these options are so that you and your child can choose the health coverage that best fits their needs.”
Learn how young adult family members can use TRICARE.
Coverage Before Age 21 and During College
Adult children are eligible to continue in their existing TRICARE coverage until at least age 21. College students may be eligible to stay in their existing TRICARE plan until they graduate or turn age 23—whichever is sooner. They must be a full-time student at an approved institution of higher learning, and their sponsor must provide more than 50% of their financial support. Be sure to update their student status in the Defense Enrollment Eligibility Reporting System (DEERS). If you have questions about your child’s eligibility, contact your local ID card office.
Moving away for college is a TRICARE Qualifying Life Event. This means the college student and other family members may be eligible to change TRICARE health plans within 90 days of the move. Don’t forget to update your student’s address in DEERS. If they’re eligible for TRICARE Prime and TRICARE Select, some things to consider when choosing a plan are how far they are from home, their health needs, and costs. Visit Going to College to learn more.
TRICARE Young Adult Program
Most young adult children lose eligibility for regular TRICARE when they age out or graduate from college. However, they may qualify for TRICARE Young Adult (TYA) if they meet all of these criteria:
- Unmarried adult child of an eligible uniformed service sponsor
- At least age 21 (age 23 if a full-time student) but not yet age 26
- Ineligible to enroll in their own employer-sponsored health plan
- Ineligible for other TRICARE program coverage
- Not a member of the uniformed services
TYA coverage includes medical and pharmacy benefits, but it doesn’t include dental or vision benefits. How your child gets care with TYA depends on whether they enroll in TYA Prime or TYA Select. As outlined in the TRICARE Young Adult Program Fact Sheet, eligibility for these options is based on sponsor status and where the child lives. TYA has a monthly premium. Additional costs are based on whether they enroll TYA Prime or TYA Select, their sponsor’s status, and where they receive care. To learn more about these costs, check out the TRICARE Compare Costs Tool.
Unlike with TRICARE Prime and TRICARE Select plans, TRICARE Open Season doesn’t apply to TYA. Once children show as eligible for TYA in DEERS, they can purchase TYA coverage anytime. They can also end TYA coverage at any time. Certain changes in status, like turning age 26 or getting married, will also cause their TYA coverage to end.
Continued Health Care Benefit Program
Young adults may be eligible for temporary health coverage through the Continued Health Care Benefit Program (CHCBP) in either of these situations:
- They lose eligibility for regular TRICARE and they don’t qualify for TYA
- They lose eligibility for TYA
Adult children who choose to purchase CHCBP must do so within 60 days of losing TRICARE or TYA eligibility. CHCBP is a premium-based plan, with coverage and other costs similar to those of TRICARE Select. Check out the TRICARE Compare Costs Tool to learn more.
Other Coverage Options
Even if eligible for TYA or CHCBP, young adult children may have other health care coverage options. Search the Health Insurance Marketplace to find options that are in your family’s budget and meet your child’s needs. Your child may qualify for financial assistance for commercial health plans available through the Health Insurance Marketplace. They may also qualify for Medicaid coverage, depending on their status and the state they live in.
So before choosing a health plan, be sure to research all your options. If you’re a parent, involve your child in deciding which plan is right for them. If you have questions about your TRICARE plan options, talk to your TRICARE contractor.
Would you like the latest TRICARE news sent to you by email? Visit TRICARE Subscriptions, and create your personalized profile to get benefit updates, news, and more.
Courtesy Story
Defense Health Agency