HMHS TRICARE Prime Remote Handbook - Getting Married or Divorced

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Getting Married or Divorced

Marriage

It is extremely important for active duty sponsors to register their new spouses in DEERS to ensure their spouses 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.

Registering in DEERS is not the same as enrolling in TPR/TPRADFM. Once your spouse is registered in DEERS, he or she will also need to enroll in TPRADFM or he or she will be covered by TRICARE Standard and TRICARE Extra.

For TPRADFM enrollment, download a TRICARE Prime Enrollment Application.

Figure 6.1 Enrollment Deadlines

Application Received	Enrollment Start	Application Received	Enrollment Start
January 1-20	February 1	July 1-20	August 1
January 21-31	March 1	July 21-31	September 1
February 1-20	March 1	August 1-20	September 1
February 21-28	April 1	August 21-31	October 1
March 1-20	April 1	September 1-20	October 1
March 21-31	May 1	September 21-30	November 1
April 1-20	May 1	October 1-20	November 1
April 21-30	June 1	October 21-31	December 1
May 1-20	June 1	November 1-20	December 1
May 21-31	July 1	November 21-30	January 1
June 1-20	July 1	December 1-20	January 1
June 21-31	August 1	December 21-31	February 1

Your new spouse’s TPRADFM 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 Figure 6.1 to determine when coverage begins.

After Humana Military processes the application, your new spouse will receive a letter identifying his or her primary care manager (PCM) with an enrollment card.

Divorce

Sponsors must update DEERS when there is a divorce. You will need to provide a copy of the divorce decree.

Children

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.

Former Spouses

Certain former spouses are eligible for TRICARE coverage if the following requirements are met:

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” (PFP) nation member
Must meet the requirements of one of the following three situations in Figure 6.2

Figure 6.2 Eligibility Requirements for Former Spouses

1	Must have been married to the same member or former member for at least 20 years, and at least 20 of those years must have been creditable in determining the member’s eligibility for retirement pay. If the date of the final decree of divorce or annulment was on or after February 1, 1983, the former spouse is eligible for TRICARE coverage of health care that is received after the date of the divorce or annulment. If the date of the final decree is before February 1, 1983, the former spouse is eligible for TRICARE coverage of health care received on or after January 1, 1985. Eligibility continues as long as the preceding requirements continue to be met.
2	Must have been married to the same military member or former member for at least 20 years, and at least 15—but less than 20—of those married years must have been creditable in determining the member’s eligibility for retirement pay. If the date of the final decree of divorce or annulment is before April 1, 1985, the former spouse is eligible only for care received on or after January 1, 1985, or the date of the decree, whichever is later. Eligibility continues as long as the preceding requirements continue to be met. However, if the date of the final divorce decree or annulment is on or after April 1, 1985, but before September 29, 1988, the former spouse is eligible for care received from the date of the decree until December 31, 1988, or two years from the date of the decree, whichever is later.
3	Must have been married to the same military member or former member for at least 20 years, and at least 15—but less than 20—of those married years must have been creditable in determining the member’s eligibility for retirement pay. If the date of the final decree of divorce or annulment is on or after September 29, 1988, the former spouse is eligible only for care received for one year from the date of the decree.

When a former spouse is eligible for TRICARE coverage, he or she must change his or her personal information in DEERS so that his or her 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. A former spouse may not remain enrolled in TPRADFM; however, a former spouse is eligible for coverage under TRICARE Prime, TRICARE Standard, or TRICARE Extra.

Last Reviewed: July 30, 2009