Q. I plan to marry my girlfriend next spring, and I plan to separate from the military in March 2016. I remember something from my basic pay and allowances class about a requirement that I have at least a year left on my service contract in order to enroll my spouse in Tricare. Is that right?
A. If you are on active duty and you get married, your spouse is eligible for Tricare as of the date of your marriage for as long as you remain on active duty. However, in order for her to use Tricare benefits, you must get her enrolled in the Defense Enrollment Eligibility Reporting System and get her a military ID card. When the time comes, you can do that by visiting the ID Card/DEERS office on your military installation.
Your recollection from that briefing is likely related to one specific Tricare option, Tricare Prime, the military's HMO-style health plan. All active-duty members are required to use Prime, but their family members may use Prime or Tricare Standard, the military's fee-for-service plan, which does not require enrollment.
Family members wishing to use Prime must enroll for a minimum of 12 months. But since there is no enrollment required for Standard, your new bride may use that program instead without having to worry about how much time is left on your contract. In addition, there is another option that also does not require enrollment, called Tricare Extra.
Here's a brief rundown of the three plans:
■ Under Prime, active-duty family members receive most of their health care from military hospitals and clinics. They establish a primary care manager at the local military treatment facility, who is the point of contact for making all referrals to civilian doctors for any specialty care required. Prime carries the lowest out-of-pocket costs of any Tricare option.
■ Standard does not involve a primary care manager; beneficiaries may seek care from any Tricare-authorized provider in the civilian community. They may also seek care at a military treatment facility if the facility has space available. Standard offers the widest possible choice of health care providers, but depending on how much health care a beneficiary uses, Standard likely will carry higher out-of-pocket costs than Prime in the form of co-pays and cost shares.
■ Under Tricare Extra, family members may seek health care from civilian doctors and specialists in a select network in the local community. In return for beneficiaries accepting a slightly more restrictive choice of providers than under Standard, the government will pay a larger share of the costs than under Standard. Again, beneficiaries may also seek care at a military treatment facility on a space-available basis.
You can get more information from the managed-care contractor for the Tricare region in which you are located. Toll-free customer service contacts for all Tricare regions is here: www.tricare.mil/ContactUs/CallUs.aspx
Email tricarehelp@militarytimes.com. Include the word "Tricare" in the subject line and do not attach files. Get Tricare advice any time at http://blogs.militarytimes.com/tricarehelp/.
