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 cards when DEERS is updated.
As a retired service member, you and your family members will have new health care options, since TPR and TPRADFM are not available to retirees and their families. When on active duty, you were enrolled in either TRICARE Prime (if stationed in a non-remote area) or TPR. After you retire, you can choose to enroll in TRICARE Prime (if located in an area where TRICARE Prime is offered), or you can use TRICARE Standard and TRICARE Extra.
Note: If you stay at your current residence, you may be able enroll in TRICARE Prime if you waive your access standards. Contact Humana Military for details.
Here’s a quick glance at some of the changes in TRICARE when you retire:
If you enroll in TRICARE Prime:
You begin paying annual enrollment fees.
Network copayments/costshares will apply.
Your catastrophic cap increases.
Minor differences in covered services:
Annual eye exams are no longer covered, but if you enroll 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 enroll in TRICARE Prime, you must submit an enrollment application with the appropriate fees prior to your retirement start date to have continuous TRICARE Prime coverage. If you do not enroll in TRICARE Prime before your retirement date, the 20th-of-the-month rule will apply for you and your family members, and you are covered by TRICARE Standard and TRICARE Extra until your coverage begins. See Figure 6.1 for enrollment deadlines.
Medicare-eligible active duty family members under age 65 have the option to enroll in TPRADFM or use TRICARE For Life. 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.
