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TRICARE Prime Handbook
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Life Events
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TRICARE Prime continues to provide health coverage for you and your family as you experience major life events. You will, however, need to take specific actions to make sure you remain eligible for TRICARE. With every life event listed in this section, the first step is to update your information in the Defense Enrollment Eligibility Reporting System (DEERS).
To update DEERS: |
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- Visit a uniformed services personnel office. Find one near you at http://www.dmdc.osd.mil/rsl.
- Call 1-800-538-9552.
- Fax address changes to DEERS at 1-831-655-8317.
- Mail the address change to:
The Defense Manpower
Data Center Support Office
Attn: COA
400 Gigling Road
Seaside, CA 93955-6771
- Update addresses electronically at www.tricare.mil/DEERS.
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Read the following sections to learn what to do when you get married, have a child, move, retire, and more. |
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Getting Married or Divorced
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Marriage |
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It’s extremely important for sponsors to register their new spouses in DEERS to ensure they are eligible for TRICARE. To register a new spouse in DEERS, the sponsor will need to provide a copy of your marriage certificate to the nearest uniformed services identification (ID) card-issuing facility. Once your spouse is registered in DEERS, he or she will receive a uniformed services ID card and will be eligible for TRICARE. When accessing care, your spouse will be asked to show his or her ID card.
Registration in DEERS is not the same as enrolling in TRICARE Prime. Once your spouse is registered in DEERS, he or she will need to enroll in TRICARE Prime, or he or she will be covered by TRICARE Standard and TRICARE Extra. For TRICARE Prime enrollment, download an enrollment application from Humana Military's Web site, visit a local TRICARE Service Center (TSC), or call Humana Military to request an enrollment application at 1-800-444-5445.
Your new spouse’s TRICARE Prime enrollment is effective based on the 20th-of-the-month rule. With the 20th-of-the-month rule, as long as Humana Military receives the completed enrollment application by the 20th of the month, coverage will begin on the first day of the next month. The application must be received by the 20th of the month, not postmarked by the 20th of the month. If the form is received after the 20th of the month, then coverage begins on the first day of the following month. See the Figure 5.1 to determine when TRICARE Prime coverage begins. |
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Enrollment Deadlines Figure 5.1
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Application Received
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Enrollment Start
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January 1-20
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February 1
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January 21-31
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March 1
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February 1-20
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March 1
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February 21-28
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April 1
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March 1-20
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April 1
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March 21-31
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May 1
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April 1-20
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May 1
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April 21-30
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June 1
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May 1-20
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June 1
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May 21-31
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July 1
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June 1-20
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July 1
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June 21-30
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August 1
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July 1-20
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August 1
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July 21-31
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September 1
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August 1-20
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September 1
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August 21-31
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October 1
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September 1-20
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October 1
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September 21-30
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November 1
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October 1-20
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November 1
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October 21-31
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December 1
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November 1-20
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December 1
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November 21-30
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January 1
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December 1-20
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January 1
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December 21-31
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February 1
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After Humana Military processes your application, your new spouse will receive a letter identifying his or her primary care manager (PCM) along with an enrollment card.
Note: If you are a retired service member and currently paying the individual enrollment fee, your enrollment fee will increase to the family plan rate when you enroll your new spouse in TRICARE Prime. |
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Divorced |
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Sponsors must update DEERS when there is a divorce. You, the sponsor, will need to provide a copy of the divorce decree. |
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Children |
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After a divorce, children (biological and adopted) remain eligible for TRICARE up to age 21 (or age 23 if enrolled in college full time and the sponsor provides at least 50 percent of the financial support) as long as their information is kept up to date in DEERS. Please contact DEERS to verify what documentation is needed to extend coverage.
While a child normally does not get his or her own uniformed services ID card until age 10, a child under age 10 should have an ID card when in custody of a parent or guardian who is not eligible for TRICARE benefits or who is not the custodial parent. Patient privacy may be a factor for divorced parents attempting to obtain information about received health care services. Contact Humana Military for assistance. Note: Children with a disability may remain eligible for TRICARE beyond the normal age limits. Please check with DEERS for eligibility criteria.
If children are living in a separate region with a former spouse, they may continue TRICARE Prime coverage using the split-enrollment feature. |
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Former Spouses |
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Certain former spouses are eligible for TRICARE coverage if the following requirements are met: |
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- Must not remarry (If a former spouse remarries, the loss of benefits remains applicable even if the remarriage ends in death or divorce.)
- Must not be covered by an employer-sponsored health plan
- Must not be the former spouse of a North Atlantic Treaty Organization (NATO) or “Partners for Peace” nation member
- Must meet the requirements of one of the three situations in Figure 5.2 . When a former spouse is eligible for TRICARE coverage, he or she must change their personal information in DEERS so that their name and Social Security number (SSN) is listed as the primary contact. The former spouse’s TRICARE eligibility will be shown in DEERS under his or her SSN.
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When a former spouse is eligible for TRICARE coverage, he or she must change their personal information in DEERS so that their name and Social Security number (SSN) is listed as the primary contact. The former spouse’s TRICARE eligibility will be shown in DEERS under his or her SSN. |
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