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Tricare Help: '20/20/20' rule may apply to ex-spouse

Jun. 4, 2014 - 10:43AM   |  

Q. My sister is a divorced military spouse and receives monthly retirement checks from her ex’s pension. He was in service over 20 years and they were married for over 20 years while he was in service. She has not been enrolled in Tricare for many years because she was under an employer plan. She is now 60 years old and no longer under that plan. Is she still eligible for Tricare?

A. If your sister meets the criteria of the “20/20/20” rule, which she does according to your description, she indeed remains eligible for Tricare coverage, under one huge condition: She must not have remarried along the way. If she did, she lost her right to Tricare coverage stemming from her marriage to that military retiree, even if the subsequent marriage ended in death or divorce.

Your sister must contact the Defense Enrollment Eligibility Reporting System, the Defense Department’s eligibility portal for Tricare. She can do that by calling the main DEERS support office in California toll free at 800-538-9552.

Q. My father is an Air Force retiree. He and my mom are now in Tricare for Life. My dad’s mother, my grandmother, lives in Germany, and she is not a U.S. citizen. She’s having difficulty finding health care options there, as our extended family there tends to neglect her. Could she be covered under my dad’s sponsorship if she became my dad’s legal dependent?

A. Tricare does cover parents who are legal dependents of Tricare beneficiaries, but under only one option, Tricare Plus, which offers primary care through U.S. military hospitals and clinics. However, not all military treatment facilities offer Tricare Plus; whether they do depends on each facility’s staffing and available patient capacity.

If your grandmother does not live relatively close to a U.S. military installation in Germany that has a hospital or clinic offering Tricare Plus, she would not be able to use Tricare even if your parents had her declared a legal dependent. Dependent parents and parents-in-law are ineligible for all other Tricare options.

More information on Tricare Plus is here: www.tricare.mil/welcome/specialprograms/plus.aspx.

Q. I recently retired from the Army Reserve. Am I eligible for any medical benefits as a gray-area retiree, or when I turn 60 years old? I can’t seem to get a straight answer from my unit or peers.

A. While you are in “gray area” status, your only Tricare option is a relatively new program called Tricare Retired Reserve, which requires enrollment and payment of monthly premiums.

But once you reach age 60, you become eligible for full military retirement benefits, including Tricare health and prescription drug coverage. Your main options will be Tricare Prime, the military’s version of an HMO, or Tricare Standard, the military’s version of a fee-for-service plan. Once you reach age 65, you would transition to Tricare for Life, which consists of Medicare as first payer and Tricare Standard as second payer.

More information on the various Tricare plans is here: www.tricare.mil/welcome/plans.aspx.

Write to tricarehelp@militarytimes.com. Include the word “Tricare” in the subject line and do not attach files.

Answers by RallyPoint

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