TRICARE Toolkit: Aging Out of TRICARE Coverage

TRICARE Toolkit: Aging Out of TRICARE Coverage
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TRICARE-Toolkit-logo-draft.jpgMOAA’s TRICARE Toolkit provides insight and tips for navigating your TRICARE benefits. Have a question or suggestion for an upcoming column? Email beninfo@moaa.org. Read other TRICARE Toolkit columns at MOAA.org/tricaretoolkit.

 

Active duty and retiree dependent children “age out” of their TRICARE benefit on their 21st birthday. Coverage can be extended to their 23rd birthday if they are still enrolled in college.

 

After that, young adults entering the workforce must consider health care when applying for employment. In 2020, only 55% of small firms (less than 200 employees) offered medical coverage, compared to 99% of large firms, according to a survey by the Kaiser Family Foundation and Health Research & Educational Trust.

 

An employer medical plan is typically the most economical solution to an employee’s health care needs. If you take a position that offers no health care coverage, there are two health care exchanges to check for coverage. The first is sponsored through the federal government, Healthcare.gov. The other is sponsored by national medical providers.

 

[AT TRICARE.MIL: TRICARE Coverage for Children]

 

Children of servicemembers or retirees have another option: TRICARE Young Adult (TYA). Unmarried young adults under age 26 are eligible for either TYA Prime or TYA Select.

 

TYA Prime operates like TRICARE Prime: The beneficiary must reside in a Prime Service Area (dependents of active duty or retirees) and/or have access to a military treatment facility (dependents of active duty only). TYA Prime comes with a $512 monthly premium (for 2022), has no annual deductible, and falls under the Group B copay and catastrophic cap cost structure.

 

TYA Select offers the same flexibility as TRICARE Select; there is no need to secure a referral for specialty care. In 2022, the program comes with a $265 monthly premium, and it also follows the Group B cost structure for deductibles, copays, and the catastrophic cap.

 

MOAA supports legislation that would extend TRICARE benefits from age 23 to age 26 without requiring a monthly premium.

 

TRICARE options available after turning 26 include Continued Health Care Benefit Program (CHCBP), managed by Humana Military, which provides up to an additional 36 months of medical coverage if the young adult participated in TYA. A CHCBP beneficiary incurs a $1,654 quarterly premium and follows the TRICARE Select Group B cost structure, even if the active duty or retiree sponsor falls under Group A.

 

Have More Questions About Your Health Care Benefit?

MOAA's TRICARE Guide answers some commonly asked questions.

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About the Author

Capt. Paul J. Frost, AFC®, USN (Ret)
Capt. Paul J. Frost, AFC®, USN (Ret)

Frost co-leads MOAA's Financial and Benefits Education program and is also an accredited Veteran Service Officer (VSO), providing VA disability compensation claim and appeal information and advice to the military community.