TRS coverage may be terminated for a number of reasons. When TRS coverage is terminated, Humana Military will initiate your premium payment refund process within 10 days of receiving a written TRS termination request. When your TRS coverage is terminated for any reason, your family members’ coverage automatically ends as well.
Loss of Eligibility
Sponsors or family members may lose eligibility for TRS coverage for the following reasons.
Note: This list is not all-inclusive.
- Sponsor or family member becomes eligible for, or covered under, the Federal Employees Health Benefits program
- Sponsor leaves the Selected Reserve
- Divorce
- Child reaches age 21 (or 23 if enrolled as a full-time student in college)
Eligibility for Other TRICARE Coverage
You may become eligible for other TRICARE coverage at any time. If you become eligible for other TRICARE coverage for a period of 30 days or less, TRS coverage will continue unchanged.
If you become eligible for other TRICARE coverage for a period of more than 30 consecutive days, TRS coverage will terminate. Other TRICARE coverage may include coverage before (early eligibility), during (active duty coverage), and after (Transitional Assistance Management Program or TAMP) periods of activation. Any premium amounts already paid for periods beyond the termination date will be refunded as described previously. If you, the National Guard or Reserve member, become eligible for other TRICARE coverage through a family member, then you as the sponsor, as well as any TRS-enrolled family members, may terminate TRS coverage without incurring a lockout.
Additionally, if you become eligible for one of the programs listed below, your TRS coverage will be terminated.
- CHAMPVA
- Another federally sponsored health benefits program, such as the Federal Employees Health Benefits program.
- Medicaid or similar state-sponsored program
It is important to note that TRS coverage will not automatically resume after other TRICARE coverage ends. If you want to enroll for TRS coverage at that time, you must follow the procedures to qualify for and purchase TRS coverage again, the same as any beneficiary purchasing new coverage.
Voluntary Termination
You may request to terminate TRS coverage at any time. If you want to terminate coverage, do not just stop making payments. You must take the following action to end your TRS coverage:
A one-year TRS purchase lockout will apply to members who voluntarily terminate TRS coverage. A purchase lockout means you will not be able to purchase TRS coverage for one year from the effective date of termination. If you do not take action to terminate coverage and you simply stop making premium payments, your coverage terminates. However, you are still responsible for any premium amounts that were due prior to the date you were officially terminated from TRS.
Termination Due to Non-Payment
Your payment is due no later than the last day of each month. Your payment will apply to the following month of coverage. Failure to pay monthly premiums on time will result in termination of coverage, but you must still pay any overdue amounts. (This may result in up to two months or more of overdue premium payments.) Termination of coverage due to nonpayment will result in a TRS purchase lockout for one year or until overdue premiums are paid in full, whichever is longer.
Note: The government pursues collection action for overdue and delinquent premiums and may notify your commander and collect these amounts from your National Guard or Reserve pay.
Certificate of Creditable Coverage
When your TRS coverage ends, you will 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.
The Defense Manpower Data Center Support Office (DSO) will issue a certificate of creditable coverage to sponsors and family members upon loss of eligibility. Certificates reflect the most recent period of continuous coverage under TRICARE.
Certificates issued upon request of a beneficiary 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 your written requests for a certificate of creditable coverage to the 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 Social Security number
-
Name of person for whom the certificate is requested
-
Reason for the request
-
Name and address to whom and where the certificate should be sent
-
Requester’s signature
You cannot request a certificate 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 the DSO fax the certificate to a particular number.
For more information, contact the DSO at 1-800-538-9552. For TTY/TDD, dial 1-866-363-2883. You may send questions via e-mail to the TRICARE Management Activity Office of HIPAA Electronic Standards at
hipaamail@tma.osd.mil or visit
TRICARE's web site.
Continued Health Care Benefit Program
Once your eligibility under TRS ends, you may be able to apply for temporary, transitional medical coverage under the
Continued Health Care Benefit Program (CHCBP). CHCBP is a premium-based health care program and is similar to, but not part of, TRICARE. If you qualify, you must enroll yourself and your eligible family members in CHCBP within 30 days after termination of TRS coverage. Benefits under CHCBP are virtually the same as those under TRS. To find out if you are eligible for CHCBP, contact Humana Military.
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