Beneficiary Standard Handbook

If your active duty sponsor will soon retire, he or she will experience a “change in status” from active duty to retired. When your sponsor’s status is updated in DEERS, you will receive a new uniformed services ID card showing the new “retired” status. With the new “retired service member” status, your sponsor will have new health care options. Until they retire, they are enrolled in either TRICARE Prime or TRICARE Prime Remote. As retired service members, they can choose to re-enroll in TRICARE Prime, or they can use TRICARE Standard and TRICARE Extra.

Because your status also changes to that of a family member of a retired service member, the cost-shares and catastrophic cap for TRICARE Standard and TRICARE Extra will increase. There are also other program changes. Here’s a quick glance at some of the changes in TRICARE Standard and TRICARE Extra that you’ll experience when your active duty sponsor retires:
  

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When you or another family member becomes entitled to Medicare A—due to age, disability, or end-stage renal disease—TRICARE becomes the second payer after Medicare. To remain eligible for TRICARE, you must have Medicare Part B coverage (except for active duty family members). TRICARE beneficiaries that have Medicare Part A and Part B coverage are covered under TRICARE For Life (TFL).

If you are becoming entitled to Medicare due to age (65 and over), you will receive a letter from DEERS 90 days before your 65th birthday. The letter will tell you that your benefits are about to change, that you must have Medicare Part B coverage, and that you will begin using TFL. For additional details, contact Wisconsin Physicians Service at 1 (866) 773-0404 or visit the TRICARE Web site.

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TRICARE coverage continues for eligible family members whose sponsor dies—whether on active duty or if retired. Surviving spouses will remain eligible for TRICARE as long as they do not remarry. In the case of remarriage, surviving spouse status cannot be regained later, even if the surviving spouse later divorces or the new spouse dies.

Children remain eligible 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 be eligible for TRICARE beyond the normal limits.

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When an active duty sponsor dies, the surviving spouse remains eligible for TRICARE at the active duty family member rates for a three-year period, and the surviving children remain eligible for TRICARE at the active duty family member rates until age 21, or age 23 if enrolled full time in a post-secondary education program.  During this time, family members are referred to as “transitional survivors.”

During the transitional survivor period, you may enroll in TRICARE Prime, if available. If you choose not to enroll in TRICARE Prime, you will be covered automatically by TRICARE Standard and TRICARE Extra. If TRICARE Prime is not available, surviving spouses will be eligible to enroll in TRICARE Prime Remote for Active Duty Family Members for a three-year period, and surviving children are eligible to enroll until age 21 or 23. Your TRICARE coverage will continue uninterrupted as long as your information is correct in DEERS. At the end of the three-year transition, TRICARE eligibility continues for the surviving spouse at the retired family member rates. If the surviving spouse is enrolled in TRICARE Prime during the transitional survivor period and wants to continue coverage after three years, the spouse will need to submit a new enrollment application to Humana Military along with the appropriate enrollment fees.

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When a retired service member dies, family members remain eligible for TRICARE Standard and TRICARE Extra with no changes as long as information is kept up to date in DEERS. Surviving spouses will remain eligible for TRICARE as long as they do not remarry. In the case of remarriage, surviving spouse status cannot be regained later, even if the surviving spouse later divorces or the new spouse dies.

Children remain eligible up to age 21 (or to age 23 if the child is enrolled full time in college 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 limits.

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