Q. If a military spouse gets pregnant by someone other than her active-duty husband, does Tricare still cover the prenatal, maternity and delivery care? Will the baby be eligible for coverage after it is born? And can the pregnant mother receive care at any military treatment facility?
A. The spouse and baby would remain eligible for all necessary maternity and prenatal care under Tricare as long as the spouse remains married to the active-duty member. Similarly, any care for either mother or child after the baby arrives would be covered as long as the marriage remains intact.
However, if the parents divorce down the road, the mother would lose Tricare coverage as of the date of the divorce. The child — the stepchild — of that active-duty sponsor also would lose Tricare coverage as of the date of the divorce.
A spouse remains eligible for Tricare after divorce only if three specific criteria are met: The active-duty member must have at least 20 years of service; the marriage must have lasted 20 years; and the member's service and the marriage must have overlapped by at least 20 years.
Where the spouse received maternity/prenatal care would depend on what type of Tricare plan she uses. Tricare Prime involves setting up a primary care manager at a specific military treatment facility. Tricare Standard offers a wider variety of provider choice.
Once the baby is born, the child would not be eligible for Tricare coverage unless and until the active-duty sponsor registered the baby in the Defense Eligibility Enrollment Reporting System as his dependent stepchild. More information is available from the ID Card/DEERS office on any military installation or the main DEERS support office in California at 800-538-9552.
Q. I am a retiree with a 21-year-old son. He wants to skip college for the spring semester to earn more money toward his college fund. I told him if he does, I'm pretty sure he'll have to drop off my Tricare until he returns to college in the fall. Can I still carry him on Tricare until this summer, or will he definitely be off Tricare until he returns to college full time?
A. If your son takes a full semester off, he quite likely will no longer be considered a full-time college student, and since he's over 21, that would indeed make him ineligible for ordinary Tricare under your sponsorship. However, Tricare does not make full-time student eligibility determinations; the schools do that. So you should check with your son's school.
If he is, in fact, ineligible for Tricare that semester, you can enroll him in Tricare Young Adult, which requires enrollment and payment of monthly premiums, and then move him back to ordinary Tricare when he resumes full-time student status. You probably know this, but his eligibility in that status lasts until he hits age 23, then TYA remains his only option until age 26.
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