TRICARE Prime Handbook

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Life Events


Moving

TRICARE Prime coverage is portable—you can easily transfer your TRICARE Prime enrollment when you move within your TRICARE region or to a new TRICARE region. Follow these simple steps to ensure you have no break in coverage when you move.
  1. Do not disenroll from TRICARE Prime before you move to your new location.
  2. Once you arrive at your new location, update DEERS immediately.
  3. Select a new PCM or transfer your TRICARE Prime enrollment within 30 days of arriving at your new location.
If you move to another TRICARE Prime service area (PSA) in the same TRICARE region, contact your current regional contractor—you will only need to change your PCM. If you move to a TRICARE PSA in another TRICARE region, contact the new regional contractor to transfer your enrollment. The enrollment transfer is effective when your new enrollment application is received by your new regional contractor.
If you move to an area where TRICARE Prime is not available (same or new region):
  • Active duty service members: Transfer your enrollment to TRICARE Prime Remote (TPR) by submitting a new enrollment form. The enrollment transfer is effective when your regional contractor receives your form.
  • Active duty family members: If you live with your TPR-enrolled sponsor, your enrollment will transfer to TRICARE Prime Remote for Active Duty Family Members (TPRADFM). Your sponsor can include you on his or her enrollment form. Or, you can disenroll from TRICARE Prime and you are automatically covered by TRICARE Standard and TRICARE Extra as long as your DEERS information stays current.
  • Retired service members, their families, and all other TRICARE Prime enrollees: You must disenroll from TRICARE Prime and you are covered automatically by TRICARE Standard and TRICARE Extra as long as your DEERS information is current. If you do not disenroll, you will be utilizing the POS option.
Active duty service members and their families may transfer TRICARE Prime enrollment as often as needed. Retired service members, their family members, survivors, eligible former spouses, and others are limited to two enrollment transfers each enrollment year, as long as the second transfer is back to the original region of  enrollment.

If you are moving overseas, contact the appropriate overseas TAO in advance of the move to determine TRICARE Overseas Program (TOP) Prime eligibility requirements. Retirees and their family members are not eligible for any TOP Prime options. See Figure 5.4 on the previous page for TAO contact information.


Separating from the Service
If you are separating from the uniformed services, TRICARE coverage may or may not continue, depending on the circumstances of your separation. TRICARE offers transitional health care options—the Transitional Assistance Management Program (TAMP) and the Continued Health Care Benefit Program (CHCBP)—that provide temporary coverage until you have a new health plan.

Transitional Assistance Management Program
TAMP provides 180 days of transitional health care benefits to certain uniformed services members and their families, if the active duty sponsor is:
  1. Involuntarily separating from active duty under honorable conditions
  2. A member of the National Guard or Reserves separating from active duty for a period of more than 30 consecutive days in support of a contingency operation
  3. Separating from active duty following involuntary retention (stop-loss) in support of a contingency operation
  4. Separating from active duty following a voluntary agreement to stay on active duty for less than one year in support of a contingency operation
If you qualify for coverage under TAMP, you and your family will have 180 days of transitional health benefits after you separate. During this 180-day period, you may enroll in TRICARE Prime if you reside in a TRICARE PSA, or you will be covered under TRICARE Standard and TRICARE Extra. You and your family members will be covered as active duty family members, and copayments, cost-shares, deductibles, rules, and processes for these programs will apply.

Continued Health Care Benefit Program

CHCBP is a premium-based health care program administered by Humana Military Health Care Services, Inc. (Humana Military). CHCBP offers temporary transitional health coverage (18-36 months) after TRICARE eligibility ends. If you qualify, you can purchase CHCBP within 60 days of loss of eligibility for either regular TRICARE or TAMP coverage.

CHCBP acts as a bridge between military health benefits and your new civilian health plan. CHCBP
benefits are comparable to TRICARE Standard with the same benefits, providers, and program rules. The main difference is that you pay premiums to participate. For more information about CHCBP visit the
CHCBP Resources pages or call 1-800-444-5445.

Contact Humana Military or a beneficiary counseling and assistance coordinator (BCAC) to discuss your family’s eligibility for these programs. You also can visit TRICARE for more information.

TRICARE Reserve Select
Some members of the National Guard and Reserve may be eligible for TRICARE Reserve Select—a voluntary, premium-based health plan available for members who qualify when they separate from active duty. VisitTRICARE Reserve Select  for information about how to qualify for this program.


Retiring from Active Duty
When you retire from active duty, you and your eligible family members experience a “change in status,” and you will all receive new “retired” uniformed services ID card when DEERS is updated.

As a “retired service member” you will have new health care options. When on active duty, you were enrolled in either TRICARE Prime or TPR. After you retire, you can choose to re-enroll in TRICARE Prime, or you can use TRICARE Standard and TRICARE Extra. TPR is not available to retirees.

Here’s a quick glance at some of the changes in TRICARE when you retire:
  • If you re-enroll in TRICARE Prime:
  • You begin paying annual enrollment fees.
  • Network copayments/cost-shares will apply.
  • Your catastrophic cap increases.
  • Minor differences in covered services
  • Annual eye exams are no longer covered, but if you stay in TRICARE Prime, they are covered every two years.
  • Hearing aids are no longer covered.
  • If family members were using TRICARE Standard and TRICARE Extra before you retired, the cost-shares will now increase by five percent.
  • You must have Medicare Part B coverage for all Medicare-eligible family members to remain eligible for TRICARE.
Review the costs, including applicable TRICARE Prime enrollment fees, in the TRICARE: Summary of Beneficiary Costs flyer. You and your family members should look at your health care options together and determine which option best meets your needs after you retire. If you decide to re-enroll in TRICARE Prime, the 20th-of-the-month rule will apply for you and your family members. See Figure 5.1for enrollment deadlines.


Becoming Entitled to Medicare

When you or another family member become entitled to premium-free Medicare A—at age 65 or due to a disability or end-stage renal disease—TRICARE becomes the second payer after Medicare, if you have Medicare Part B coverage.

Medicare-eligible beneficiaries under age 65 have the option to continue enrollment in TRICARE Prime or use TRICARE For Life. If they remain enrolled in TRICARE Prime, annual enrollment fees are waived, if applicable.

Note: Active duty family members are not required to have Medicare Part B coverage to remain eligible for TRICARE. When the active duty sponsor retires, Medicare-eligible family members must have Medicare Part B or they lose eligibility for TRICARE.


Deceased Sponsor

When a sponsor dies, TRICARE coverage continues for eligible family members. Surviving spouses remain eligible for TRICARE as long as they do not remarry. If a surviving spouse remarries, he or she loses eligibility for TRICARE and cannot regain eligibility in the case of divorce or the death of the new spouse. Surviving children remain eligible for TRICARE until they turn age 21 (or 23 if enrolled in college full time and you, the parent, provide more than 50 percent of your child’s financial support). Note: Children with a disability may remain eligible for TRICARE beyond the normal age limits.

After the death of an active duty service member, all surviving family members continue to be treated as active duty dependents for three years. During this three-year “transitional survivor” period, all family members receive the same benefits at the same costs as active duty family members.

After three years, surviving spouses remain eligible for TRICARE Prime, Standard, and Extra at retired family member rates. TRICARE Prime enrollment fees will apply for surviving spouses who choose to enroll in TRICARE Prime after the three-year transitional survivor period. Surviving children remain eligible for TRICARE (TRICARE Prime, TPRADFM, TRICARE Standard, and TRICARE Extra) for three years after the date of the member’s death or up to age 21, whichever is longer. This age limit extends to age 23 if the surviving children were, at the time of the member’s death, dependent upon the former member for more than 50 percent of their financial support or if they were pursuing a full-time course of education in a secondary school or an institution of higher education. Note: The effective date of this benefit is retroactive to October 7, 2001.

Upon the death of a sponsor, you will receive a letter from DEERS telling you about your program options and how your benefits will eventually change. Contact Humana Military if you have any questions.


Loss of Eligibility

Upon loss of TRICARE eligibility, each family member will automatically receive a certificate of creditable coverage. The certificate of creditable coverage is a document that serves as evidence of prior health care coverage under TRICARE so that you cannot be excluded from a new health plan for pre-existing conditions. Examples of when certificates may be issued include:
  • Upon the sponsor’s separation from active duty, a certificate will be issued to the sponsor listing all eligible family members.
  • Upon the loss of eligibility for a dependent child (age 21, or 23 if a full-time student), a certificate will be issued to the dependent child.
  • Upon loss of coverage after divorce, a certificate will be issued to the former spouse, as soon as the information is updated in DEERS.
Certificates automatically reflect the most recent period of continuous coverage under TRICARE. Certificates issued upon request of a beneficiary will reflect each period of continuous coverage under TRICARE that ended within the 24 months prior to the date of loss of eligibility. Each certificate identifies the name of the sponsor or family member for whom it is issued, the dates TRICARE coverage began and ended, and the certificate issue date.

Send written requests for a certificate of creditable coverage to the Defense Manpower Data Center Support Office (DSO) at:

Defense Manpower Data Center
Support Office
Attn: Certificate of Creditable Coverage
400 Gigling Road
Seaside, CA 93955-6771

The request must include:
  • Sponsor’s name and SSN
  • Name of person for whom the certificate is requested
  • Reason for the request
  • Name and address to which the certificate should be sent
  • Requester’s signature
If you’re near an MTF while traveling, you can have a new prescription filled at any MTF pharmacy free of charge if the medication is on the MTF formulary and the pharmacy stocks the medication you need. All you’ll need is the written prescription and your uniformed services ID or Common Access Card. Refilling a prescription originally filled at another MTF is at the discretion of the MTF you are visiting.
Certificates cannot be requested by phone. If there is an urgent need for a certificate of creditable coverage, fax your request to the DSO at 1-831-655-8317 and/or request that DSO fax the certificate to a particular number.

Additional information is available at www.tricare.mil/certificate.

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Last Reviewed: July 11, 2008