If you have college-aged children heading off to school as the summer winds down, make sure you are setting them up for success when it comes to getting health care when they are sick or injured far from home.
Your health care options depend on where your child is attending school and your choice of health plan. TRICARE considers going away to college a qualifying life event (QLE), which means you have 90 days to change your child’s health plan.
Choose the Right Plan
If your child is headed to school in a Prime Service Area (PSA), you can enroll them in TRICARE Prime at their college address – you can find out whether they will be in a PSA by filling out TRICARE’s online plan finder. They would then have an assigned Primary Care Manager (PCM) and would be able to make appointments with the PCM or get a referral to specialists from the PCM.
If you do this, make sure your child has transportation to get to the doctor and will be able to navigate the world of TRICARE referrals and benefit statements, as those will be sent directly to your child at their address.
The US Family Health Plan is another Prime option but is limited to six geographical regions of the U.S.
If you are enrolled in Prime but your child is not heading to a PSA, or you don’t want to change your child’s enrollment, your current assigned PCM may be willing to provide most care and give referrals to your child if they need care while at college. However, if your PCM won’t work with you and your child seeks care while at school, you may be charged point-of-service fees.
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You also can enroll your child in TRICARE Select, which would allow them to visit any TRICARE-authorized provider with no need for referrals. That would give them more flexibility for health care when they are both at school and at home during breaks.
If your child is studying abroad, you can enroll them in TRICARE Select Overseas (TRICARE Prime Overseas is only available to students who are command-sponsored and live with their active duty family overseas).
If you decide to sign up your child for the university’s health care plan, be aware that TRICARE will consider this to be other health insurance. You will have to coordinate benefits as TRICARE, by law, is always the last payer.
[UPDATED MONTHLY: MOAA’s TRICARE Toolkit]
Same Family, Different Plans
Family members can be on different plans at the same time. You could have one family member on TRICARE Prime and the rest on TRICARE Select, for example.
You also can have the entire family on TRICARE Prime but enrolled in different regions. This is known as split enrollment. If you are on TRICARE Prime in the East region and your child is headed out west, for instance, notify the regional contractor in each region so you pay just one enrollment fee.
Children age out of TRICARE when they turn 21, but coverage is extended until age 23 for full-time college students. If your child is over 21 and still a college student, the sponsor will need to obtain a letter from the school registrar’s office confirming full-time enrollment and take it to an ID Card Office to update the student’s status in the Defense Enrollment Eligibility Reporting System (DEERS).
If the child is between 21 and 26 years old and is not a full-time student, they may be eligible for TRICARE Young Adult, a premium-based plan.
Power of Attorney and Other Legal Paperwork
Many parents don’t realize that as soon as their child turns 18, they no longer have access to their medical records and have no ability to speak to TRICARE or a medical provider on their child’s behalf.
If your child has an accident or a medical emergency at school, you’ll want to have authorization to be able to speak to medical providers and, in the case of incapacitation, be able to make medical decisions on their behalf. You’ll need a health care proxy, also called (depending on the state) a medical power of attorney, a health care power of attorney, or durable power of attorney for health care.
You can also consider having your child fill out a HIPAA (Health Insurance Portability and Accountability Act) Release. If you want to be able to make financial decisions on the student’s behalf, you’ll need a durable power of attorney.
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These forms vary from state to state. Your local legal assistance office can often assist in drawing up this paperwork.
Getting ready for the school year can be hectic and emotional. While it’s important to set your child up for academic success, it’s equally important that they be able to access health care when – and where – they need it.
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