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 5.1 for 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.
Back to Top
|
