Tricare Help: Restoring child’s coverage after divorce - Getting out, military health issues - Navy Times

Tricare Help: Restoring child’s coverage after divorce

Q. My 18-year-old daughter is determined to marry a former soldier who is now a civilian. If the marriage ends in divorce or death before she is 21 and she returns home, can her Tricare eligibility under my sponsorship be restored?

A. I contacted the Defense Enrollment Eligibility Reporting System support office regarding your question, and officials there told me that your daughter’s Tricare eligibility can be restored until she turns 21 if you apply on her behalf. Her place of residence is not important.

You should discuss the matter with the DEERS support office, toll-free, at 800-538-9552, to be certain you understand what to do. DEERS will help with the details if you must do it by mail.

Q. After several of my claims were denied, I learned that my doctor was putting my Social Security number on the Tricare claim forms instead of my husband’s. Why doesn’t DEERS cross-reference the Social Security numbers of husbands and wives to prevent denials when such errors occur?

A. I agree that cross-referencing Social Security numbers in DEERS for spouses seems to be a practical remedy for your problem. I talked briefly with DEERS and with the Pentagon’s Office of Health Affairs about an answer to your question.

I was told it is a common error and that the only remedy is to refile the claim using the sponsor’s Social Security number instead of the patient’s. Obviously, this entails filing and processing a claim twice.

As this is a matter that only the technical folks at DEERS can resolve, knowing the reason won’t resolve the issue. Offhand, it sounds like millions of keystrokes for a marginal return that is easily remedied by more care when claims are filed.

It’s possible that cross-checking simply didn’t occur to the original DEERS planners. The system is old enough that its author may now be retired or deceased, and we will never know.

Q. My Tricare Prime benefit provides for an eye exam every two years. I am diabetic and have been advised to have my eyes examined yearly. Will Tricare cover that?

A. The Pentagon’s Office of Health Affairs tells me your yearly eye exam can be covered if your diagnosis of diabetes is reported when the claim is filed. If that diagnosis is not included with the claim, it will be denied.

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Write to Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or tricarehelp@militarytimes.com. In e-mail, include the word “Tricare” in the subject line and do not attach files.