Editor’s Note: This article was updated in October 2022 is part of MOAA’s 2022-23 TRICARE Guide, brought to you by MOAA Insurance Plans, administered by Association Member Benefits Advisors (AMBA). A version of the guide appeared in the November 2022 issue of Military Officer magazine.
TRICARE’s lack of coverage for young adults can lead to confusion regarding eligibility and coverage for military kids transitioning to adulthood. Here’s a primer.
Commercial and employer-sponsored plans are required by law to cover young adult dependents up to age 26 with no additional premium, but TRICARE coverage ends at age 21 (or 23 if enrolled full-time in college).
For coverage up to age 26, military dependents can purchase the premium-based TRICARE Young Adult (TYA) plan, but at a steep cost — in 2022, premiums are $512 per month for TYA Prime and $265 per month for TYA Select.
[RELATED: 2023 Costs Announced for TRICARE Reserve, Retiree, Young Adult Plans]
Military kids deal with unique challenges and sacrifices as part of military life. They deserve the same health care protections afforded to their peers in civilian families. MOAA has advocated to fix the TRICARE young adult parity issue and will continue our efforts in 2023 with the 118th Congress.
In the meantime, it is important for families to understand TRICARE coverage limitations for young adults. Here’s what you should know:
- Unmarried dependent children are eligible for TRICARE until age 21.
- Young adults can extend TRICARE coverage until their 23rd birthday or graduation (whichever comes first) if enrolled full time in college. They must provide proof of enrollment. Contact an ID card office to see what documents are needed.
- Students under age 23 going directly from undergrad to graduate school are generally covered during this transition. The sponsor must provide letters from the school registrar certifying 1) full-time enrollment before the break, and 2) acceptance or enrollment in the graduate program immediately after the break.
- Children incapable of self-support because of a mental or physical incapacity may qualify as a secondary dependent with TRICARE eligibility beyond age 21. The Defense Finance and Accounting Service (DFAS) website provides details and contact information regarding secondary dependency determinations.
After any status update with the Defense Enrollment Eligibility Reporting System (DEERS), MOAA recommends following up with your TRICARE contractor to confirm TRICARE enrollment, but TRICARE cannot assist with eligibility issues — those must be handled with DEERS, typically at an ID card office, or the individual service branch.
If young adults purchase TYA, they may be able to continue TRICARE coverage beyond age 26 with the Continued Health Care Benefit Program (CHCBP), a premium-based health plan providing continued health care coverage for 18 to 36 months after the loss of military health care benefits.
CHCBP premiums cover the full cost of the program so they are expensive but may be worthwhile for young adults who need TRICARE’s comprehensive coverage. In 2022, the CHCBP premium for individual coverage is $1,654 per quarter.
Have More Questions About Your Health Care Benefit?
MOAA's TRICARE Guide answers some commonly asked questions.