• Sat. Dec 2nd, 2023

Explore how TRICARE covers youth | Health and fitness

Explore how TRICARE covers youth |  Health and fitness

Falls Church, Va. – Is your child a recent high school or college graduate? You may wonder how this affects their TRICARE eligibility.

“TRICARE options for young family members depend on their age, student status and a few other factors,” said Debra Fisher, TRICARE health plan policy and program analyst at the Defense Health Agency. “It’s important to know what these options are so you and your child can choose the health care that best suits their needs.”

Learn how elderly family members can use TRICARE.

Coverage before age 21 and during college

Adult children are eligible to continue their existing TRICARE coverage until at least age 21. College students may be eligible to stay in their existing TRICARE plan until they graduate or turn 23—whichever is sooner. They must be a full-time student at an accredited institution of higher learning, and their sponsor must provide more than 50% of their financial aid. Be sure to update their student status in the Defense Enrollment Eligibility Reporting System (DEERS). If you have questions about your child’s eligibility, contact your local ID card office.

Moving to college is a Tricare qualifying life event. This means that college students and other family members may be eligible to change TRICARE health plans within 90 days of removal. Don’t forget to update your student’s address in DEERS. If they’re eligible for TRICARE Prime and TRICARE Select, some things to consider when choosing a plan are how far they live from home, their health needs, and costs. Visit Going to College (https://www.tricare.mil/LifeEvents/College) to learn more.

TRICARE Young Adult Program

Most older children lose eligibility for regular TRICARE when they reach puberty or graduate from college. However, they may qualify for TRICARE Young Adults (TYA) if they meet all of these criteria:

  • Unmarried adult child of eligible uniformed service sponsor
  • At least 21 years of age (23 years if a full-time student) but not yet 26 years of age
  • Not eligible to enroll in own employer-sponsored health plan
  • Not eligible for other TRICARE program coverage
  • Not a member of the uniformed services

TYA coverage includes medical and pharmacy benefits, but does not include dental or vision benefits. How your child receives care at TYA depends on whether they enroll in TYA Prime or TYA Select. Eligibility for these options is based on sponsor status and where the child lives, as described in the TRICARE Young Adult Program Fact Sheet (download at https://www.tricare.mil/Publications/Fact-Sheets/young_adult). TYA has a monthly premium. Additional costs are based on whether they enroll in TYA Prime or TYA Select, their sponsor status, and the care they receive. To learn more about these costs, check out the TRICARE Compare Costs tool.

Unlike TRICARE Prime and TRICARE Select plans, TRICARE Open Season does not apply to TYA. Children can purchase TYA coverage at any time if they are shown to be eligible for TYA in DEERS. They can also end TYA coverage at any time. Certain changes in status, such as turning 26 or getting married, can also cause their TYA coverage to end.

Continuing Health Care Benefit Program

Young people may be eligible for temporary health care coverage through the Continuing Health Care Benefit Program (CHCBP) in any of the following situations:

  • They lose eligibility for regular TRICARE and are not eligible for TYA
  • They lose their eligibility for TYA

Older children who choose to purchase CHCBP must do so within 60 days of losing TRICARE or TYA eligibility. CHCBP is a premium-based plan, with coverage and other costs similar to TRICARE Select. Check out the TRICARE Cost to Cost Tool to learn more.

Other coverage options

Even if eligible for TYA or CHCBP, older children may have other health care options. Search the health insurance marketplace to find options that are within your family’s budget and meet your child’s needs. Your child may qualify for financial assistance for commercial health plans available through the Health Insurance Marketplace. They may qualify for Medicaid coverage depending on their status and state of residence.

So before choosing a health plan, be sure to research all your options. If you are a parent, involve your child in deciding which plan is right for them. If you have questions about your TRICARE plan options, talk to your TRICARE contractor.

Would you like the latest TRICARE news sent to you by email? Visit TRICARE Subscriptions and create your personalized profile to receive benefit updates, news and more.

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