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Tricare Help: Pregnant daughter must stay single to keep Tricare

May. 16, 2013 - 03:30PM   |  

Q. I am a retired Marine with Tricare Prime for myself and my family. My daughter, 19 and a full-time student, is pregnant by her boyfriend, also a full-time student. Am I correct that she can stay on my Tricare Prime only as long as she stays single? I am trying to talk her and her boyfriend out of getting married until after the child is born for this exact reason. My understanding is that the baby will not be covered by Tricare Prime after it is born, but if nothing else, my daughter can keep the insurance through her pregnancy and delivery if she stays single.

A. You are correct; your daughter remains eligible for Prime under your sponsorship only if she remains single and dependent upon you for more than half her support and does not have available health insurance in her own right, such as through an employer. Marriage would end her Tricare eligibility under your sponsorship.

You are also correct in that Tricare Prime will not cover the baby under your sponsorship once it is born. Tricare itself does not make such eligibility determinations; only the military services can do that.

The mechanism they use is the Defense Enrollment Eligibility Reporting System, basically the Defense Department’s eligibility portal for Tricare. For more information, call the main DEERS support office at 1-800-538-9552.

Q. I am an Army retiree who will turn 65 in July. I just enrolled in Medicare Part B so I can get Tricare for Life. How do I stop the Tricare Prime premiums from being taken out of my pension check starting in July? Does the system know I am enrolled in Medicare, and will the payments from my military pension stop when the Medicare premiums start being taken out of my Social Security check?

A. For beneficiaries transitioning from Tricare Prime to Tricare for Life, disenrollment from Prime is supposed to be automatic. If that does not happen, you should call DEERS and make sure the information in your file is up to date. You can reach the main DEERS support office at 1-800-538-9552.

To be fully eligible for Tricare for Life, you must be enrolled in Medicare Parts A and B and paying the Part B monthly premiums.

Assuming you are squared away with Medicare, there is nothing else you need to do. You will be covered by Medicare as your primary insurance and Tricare Standard as your free secondary backup coverage.

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 anytime at www.militarytimes.com/tricarehelp.

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