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- Dec 17, 2009
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Who's eligible for TRICARE benefits?
In order to use TRICARE, you must be listed in the Defense Department's DEERS (Defense Enrollment Eligibility Reporting System) computerized data base as being eligible for military health care benefits.
TRICARE-eligible people include:
(1) Eligible family members of active-duty service members, such as spouses, and unmarried children who are young enough (in most cases, under age 21, or under age 23 if in school full-time) to retain their eligibility. These children (including stepchildren who are adopted by the sponsor) are still covered by TRICARE, even if the spouse gets divorced or remarried. Stepchildren don't have to be adopted by the sponsor to be covered by TRICARE while the sponsor and the mother or father of the stepchildren remain married. But a stepchild who was not adopted by the sponsor loses eligibility on the date the divorce decree is final.
Active-duty service members themselves are enrolled automatically in TRICARE Prime, and may use the local military and civilian provider network (if one is in place) with proper authorization. Their health care remains the top priority of the military health care system, and they'll be the first to be allowed to sign up with primary care managers at military medical facilities;
(2) Military retirees and their eligible family members (same conditions for eligibility as above; these eligibility conditions for children are the same through all categories of eligibility);
(3) Spouses and unmarried children of reservists who are ordered to active duty for more than 30 consecutive days (they are covered only during the reservist's active-duty tour; they can use TRICARE Extra and TRICARE Standard, but they can't enroll in TRICARE Prime unless the reservist's active-duty period lasts at least 180 days), or reservists who die on active duty;
(4) Surviving unremarried spouses and unmarried children of active or retired service members who have died;
(5) Surviving unremarried spouses and unmarried children of reservists, if the reservists are injured or aggravate an injury, illness or disease during--or on the way to--active-duty training for a period of 30 days or less, or a period of inactive-duty training, and die as a result of the specific injuries, illnesses or diseases;
(6) Some unremarried former spouses of active or retired service members, who meet certain length-of-marriage rules and other requirements;
(7) Unmarried children of military sponsors, who are age 21 and over (to age 23, if the child is a full-time student), and who are severely disabled and the disability existed prior to the child's 21st birthday (or prior to the 23rd birthday, if the child is a full-time student);
(8) Dependent wards placed in the custody of a service member or former member, either by a court or by a recognized adoption agency, for a period of at least 12 months. TRICARE eligibility is effective July 1, 1994, if the child is placed by a court. A child placed by a recognized adoption agency is eligible effective on the date the child is placed by the agency, or on Oct. 5, 1994, whichever date is later;
(9) Certain family members of active-duty service members who were court-martialed and separated for spouse or child abuse, or were administratively discharged as a result of such an offense. The victims of the abuse within the family are eligible for treatment of illnesses and injuries related to the abuse for one year from the date of the sponsor's separation from the service. Cost-sharing will be the same as for other active-duty families;
(10) Certain abused spouses, former spouses, or dependent children of service members who were retirement-eligible, but who lost that eligibility as a result of abuse of the spouse or child. This benefit is effective for medically necessary services and supplies provided under TRICARE Standard on or after Oct. 23, 1992. It isn't limited to one year of eligibility (as is the category described immediately above), nor is it limited to illnesses and injuries resulting from the abuse;
(11) Illegitimate children of current or retired service members or their spouses may be eligible for TRICARE benefits under certain circumstances. Check with your nearest health benefits adviser (HBA), health care finder (HCF), or TRICARE service center (TSC);
(12) Spouses and children of North Atlantic Treaty Organization (NATO) nation representatives, under certain circumstances (outpatient care only);
(13) Certain former active-duty members and their families may be eligible for limited periods of TRICARE benefits under the Transitional Assistance Management Program (TAMP). Check with your HBA or your military personnel office for details.
In order to use TRICARE Prime or TRICARE Extra, you must live in an area where TRICARE is in operation, and a civilian provider network has been established to support the program.
Eligibility is determined by the individual service branches. They also provide eligibility information to DEERS computer data files. Contractors then check the DEERS files for eligibility when processing claims.
Who's not eligible for TRICARE benefits?
(1) Most persons who are eligible for Medicare because of age (except active-duty family members). People who are Medicare-eligible because of disability or end-stage kidney disease, and are under 65, may retain TRICARE eligibility until they reach 65, but they must be enrolled in Medicare Part B;
(2) Parents and parents-in-law of active-duty service members or uniformed services retirees, or of deceased active-duty members or retirees, are not TRICARE-eligible. They may be able to receive treatment in military medical facilities, as space permits;
(3) Persons who are eligible for benefits under the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA).
News Releases - WHO'S ELIGIBLE FOR TRICARE? WHO'S NOT ELIGIBLE?
EVERY veteran is not eligible for TriCare. Most veterans are not retirees.
The information is out there. You just aren't availing yourself of any of it.
It doesn't matter what they CALL it, dimwit.
Call it VetCare and carry on with the discussion as is...
Only veterans who are retirees are eligible for Tricare. The 19 year old who just got back from Iraq, and did not reenlist is not. It would seem that you are the dimwit as you clearly don't know what you are talking about.