Rollout Approaches for Young Adult (up to age 26) TRICARE Enrollment

  • Published
  • By Donna Miles
  • Air Force Reserve Command
WASHINGTON --  Qualified young adults up to age 26 soon will be able purchase TRICARE military health plan coverage on a month-to-month basis.

TRICARE officials announced plans to roll out the new Young Adult Program -- including an option to make coverage retroactive to Jan. 1 -- in the near future.

This, officials said, will ensure military families aren't left out as the new national health care reform law extends parents' health insurance for their children up to age 26.

The new program will allow qualified, unmarried military children up to age 26 to buy health care coverage under their parents' TRICARE plans through age 26. That's up from the current maximum age of 21, or age 23 for full-time college students whose parents provide more than half of their financial support.

Those who are eligible to purchase coverage should save their receipts after the first of the year, as the benefit will be retroactive to Jan. 1, 2011, provided premiums are also paid back to January 1. After purchasing coverage, enrollees will be issued a new ID card as verification. Go to http://www.tricare.mil/tya for more info.

Delaware is part of TRICARE North Region, which is managed by Health Net Federal Services, Inc., or call TRICARE North Region Customer Service, 1-877-TRICARE (1-877-874-2273). 

The TRICARE North Region includes Connecticut, Delaware, the District of Columbia, Illinois, Indiana, Kentucky, Maine, Maryland, Massachusetts, Michigan, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Vermont, Virginia, West Virginia, Wisconsin and portions of Iowa (Rock Island Arsenal area), Missouri (St. Louis area) and Tennessee (Ft. Campbell area).

If you live outside TRICARE North Region, you can check here to determine which of the three TRICARE regions in the continental United States your state is in.

The fiscal 2011 National Defense Authorization Act, which President Barack Obama signed Jan. 7, gave the Defense Department the authority it needed to extend TRICARE coverage to young adults, TRICARE spokesman Austin Camacho said.

This ensures benefits extended are in line with those all American families receive under the Patient Protection and Affordable Care Act, which took effect in March 2010.

"We've been working hard to make sure we could put TRICARE Young Adult on a fast track," Navy Rear Adm. (Dr.) Christine S. Hunter, director of the TRICARE Management Activity, told American Forces Press Service. "Fortunately for our beneficiaries concerned about health care coverage for their adult children, the law signed by the president includes opportunities for military families to elect this new premium-based plan retroactive to Jan. 1."

Qualified young adults who do not have access to employer-sponsored health care coverage will be eligible to purchase it through TRICARE on a month-to-month basis, Camacho said.

TRICARE officials expect to announce premium costs shortly, before enrollment begins. But because the 2011 defense authorization specifies that the rates must cover all program costs, Camacho said, premiums will be based on commercial insurance data about the costs of providing care.

Once premiums are determined, officials encourage eligible beneficiaries to explore all of their health care coverage options to choose a plan that makes sense for them.

Hunter estimated that the program, once in place, could extend TRICARE coverage to several hundred thousand additional beneficiaries.

"The premium allows us to provide the excellent benefit to our military families while responsibly addressing the impact of health care costs on the DOD budget," she said.

Officials plan to roll out the new program in two phases, first offering a premium-based TRICARE Standard/Extra benefit, Camacho said. Then, later this year, they plan to introduce the TRICARE Prime and TRICARE Prime Remote plan, including overseas options, and the Uniformed Services Family Health Plan.

Once the program is in place, eligible young adults may submit an application and premium payment to the appropriate regional or overseas contractor for processing, Camacho said. Cost shares, deductibles and catastrophic caps will vary, based on the plan selected and the sponsor's status.

Young adult beneficiaries will receive an enrollment card after they buy coverage and their payment is reflected in the Defense Eligibility Enrollment Reporting System, Camacho said.

The new beneficiaries may choose to pay premiums back to Jan. 1, which will entitle them to file claims for any health care costs they have accrued since that date. To do so, officials advise that they save all receipts to ease claims processing.

For adults who need health insurance coverage but no longer qualify for TRICARE coverage, officials advise exploring the Continued Heath Care Benefit Program. This premium-based program offers temporary, transitional health coverage for 18 to 36 months.

Coverage must be purchased within 60 days of losing TRICARE eligibility. Information about the program is posted on the TRICARE website.

(Note: Tech. Sgt. Benjamin Matwey, Public Affairs Specialist, 166th Airlift Wing , Delaware Air National Guard, contributed to this article, using information from Air Force Reserve Command, the TRICARE website, and the Health Net Federal Services, Inc., website.)