Tricare Help: What if I’m not eligible for Tricare, but I really need it? - Getting out, military health issues - Navy Times

Tricare Help: What if I’m not eligible for Tricare, but I really need it?

Answering your questions on Tricare.

Q. My husband is in the National Guard full time. We have been married 12 years, and I have been disabled for the past seven. My husband has now moved out and is living with another woman. My life depends on me keeping Tricare for Life; my medications are very expensive, and my attorney and I have found there is no other option for me but to keep Tricare. Without it I will die, and my husband knows this but isn’t willing to work with me. What can I do to get a waiver to keep my Tricare?

A. Tricare eligibility is a matter of federal law, not of merit or need. Tricare does not have the authority to declare a person eligible because of special needs or for compassionate reasons. Each individual must meet the requirements of law.

If there comes a time when you are no longer legally married to your military sponsor, you will immediately lose all eligibility for Tricare. An exception would be if you were married to the same military sponsor for at least 20 years, during which time your sponsor earned service points creditable for retirement. According to your letter, you do not meet that requirement.

For an official statement regarding your Tricare eligibility and the criteria you must meet to continue your eligibility after a divorce, contact the Defense Enrollment Eligibility Reporting System Support Office, toll-free, at 800-538-9552.

Social Security has a program for people who become disabled and are not capable of self-support. I suggest you contact the Social Security Administration, toll-free, at 800-772-1213 for more information.

As I’m sure your lawyer has advised you, you should contact your state’s social services office to learn what benefits, such as Medicaid, may be available for you.

Q. My spouse and I are both retired military, on Social Security, and we have Medicare Part B and Tricare for Life. For several years we have had a supplemental policy from United Health. But if we have TFL and Part B, do we really need the insurance from United?

A. No one but you can decide what health insurance coverage you need. What I can tell you is that Tricare for Life consists of full coverage of all the benefits of Medicare Part A and Part B, plus the full (and free) benefits of Tricare Standard as second payer.

Thus, with TFL you have full coverage by two full-service, stand-alone health insurance plans. Either of those plans, by itself, would provide adequate health insurance for an average person’s needs.

Only you can decide whether you need another health insurance plan in addition to TFL to feel secure in your coverage.

Write to Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or e-mail us. In email, do not attach files. Get Tricare advice anytime on our blog.