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Tricare Help: Son is turning 23, what are his options?

July 24, 2016 (Photo Credit: Thinkstock/Staff)

Q. I am a military spouse in Georgia with a son who turns 23 in September and is still attending a university. He will no longer be eligible for Tricare. His only other option is Tricare Young Adult, but the problem is the cost. Tricare Young Adult Prime costs $306 and Tricare Young Adult Standard is $208. This is without dental care. Where does the government think we can get this extra money from? Who pays $3,672 per year for health care for a 23-year old? He can’t afford to pay it. And our income didn’t go up that much to cover this extra cost. Under ObamaCare, if he doesn’t have health insurance, we'll be fined.

A. Your son has other health care options besides Tricare Young Adult. You didn’t mention what school he attends but most colleges and universities — nearly all of which require students to have health insurance — offer health care plans for students with monthly premiums that may be less expensive or on par with Tricare Young Adult Standard.

Another option would be to enroll him in the other parent's health insurance plan, if one is available.

And finally, he could buy a plan through his state's health insurance exchange or the federal marketplace. Depending on income and place of residence, lower-cost plans may be available. He also may be eligible for a tax credit that would lower the premiums.

Although the Tricare Young Adult program is 4 years old, military families continue to be surprised by its premium requirements, especially those whose sponsors are on active duty and who have not paid annual fees for health care coverage before. When the Affordable Care Act passed, Tricare was intentionally protected from the act's requirements. But that left Tricare out of sync with the provision that allowed adult children to stay on their parents' health plans until age 26 if employer-sponsored care is unavailable. The law creating Tricare Young Adult required the program to be cost-neutral, meaning it must pay for itself. TYA premiums jumped sharply in 2016 after an analysis of data indicated that enrollees use the benefit more than originally projected, driving up costs.

According to the Kaiser Family Foundation, the average annual premium paid by families using a preferred provider network similar to Tricare was $5,410 in 2015. In the same year, active-duty families without any children enrolled in Tricare Young Adult paid no annual premiums for their health care, while retirees with families using Tricare Prime paid $555 a year. Retiree families using Tricare Standard pay no enrollment fees or monthly premiums. 

Have a question? E-mail Tricare Help at tricarehelp@militarytimes.com. Please be sure to include the word "Tricare" in the subject line.

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