With commencement season in full swing, students and their parents often have questions about TRICARE eligibility for young adults. It can be confusing, because TRICARE has a parity gap when it comes to young adult coverage.
Commercial plans are required by law to cover young adult dependents up to age 26, but TRICARE coverage ends at age 21 (or 23 if enrolled full-time in college).
MOAA continues to advocate for a parity fix to TRICARE young adult coverage. As families begin preparing for graduations and other milestones in their children’s lives, we remind lawmakers and DoD that military kids transitioning to adulthood lack the health care protections afforded to families covered by commercial health care plans.
[TAKE ACTION: Urge Your Elected Officials to Fix the TRICARE Young Adult Coverage Gap]
These same military kids deal with unique challenges and sacrifices as part of military life – moving every two to three years on average, switching schools and finding new friends, combating the stress and uncertainty associated with deployments and frequent family separations.
Click the above link to ask your lawmakers to co-sponsor the Health Care Fairness for Military Families Act, a bill that would fix this parity gap by extending TRICARE young adult coverage to age 26. In the meantime, it is important for uniformed services families to understand TRICARE coverage limitations for young adults. Here’s what you should know:
- Unmarried dependent children are eligible for TRICARE until age 21.
- These beneficiaries can extend TRICARE coverage until their 23rd birthday or graduation (whichever comes first) if enrolled full time in college. To extend TRICARE eligibility, you must provide proof of enrollment – contact an ID card office to see what documents are needed.
- Do you have a student going directly from undergrad to graduate school? Dependents under 23 generally are covered during the undergrad-to-grad school transition, with some exceptions -- if the student delays grad school beyond the summer break, for example. The sponsor must provide letters from the school registrar certifying 1) full-time enrollment before the break (you’ve probably already done this to maintain TRICARE coverage beyond the 21st birthday), and 2) acceptance or enrollment in the graduate program immediately after the break. If you run into problems with the ID card office or when requesting documentation from your university, please reference Table 4.4 on Page 86 of this regulation for details regarding ID cards for dependents.
- Do you have an unmarried adult child incapable of self-support because of a mental or physical incapacity that occurred while the child was your dependent? Your child may qualify as a secondary dependent with TRICARE eligibility beyond age 21. To find more information, please consult the Defense Finance and Accounting Service (DFAS) website and this Defense Manpower Data Center (DMDC) brochure.
[RELATED: Military Teen Survey: Despite Clear Struggles, Many Plan to Serve]
TRICARE does not make eligibility determinations. Any issues with eligibility status must be handled with the Defense Enrollment Eligibility Reporting System (DEERS) – typically at an ID Card Office – or the individual service branch. In the case of dependency determinations, please see the DMDC brochure for contact information.
MOAA recommends following up with your TRICARE contractor to confirm TRICARE enrollment after any DEERS status updates, but TRICARE cannot assist with eligibility issues.
When TRICARE eligibility ends, the young adult may be eligible to purchase TRICARE Young Adult (TYA), a premium-based plan for young adults up to age 26, or the Continued Health Care Benefit Program (CHCBP), a premium-based health plan providing continued health care coverage for 18 to 36 months after the loss of military health care benefits (including aging out of TYA).
Have you encountered challenges with young adult coverage? Please share your story at legis@moaa.org.
Have More Questions About Your Health Care Benefit?
MOAA's 2021-2022 TRICARE Guide answers some commonly asked questions.