TRICARE Q&A – TRICARE Young Adult

August 10, 2011 | Terry Howell

TriWest Healthcare Alliance, the West Region contractor for the TRICARE program, helps answer general TRICARE questions each month on Military.com. This month’s topic: TRICARE Young Adult.

Question: My son is 24 years old and without health insurance. How can he enroll into the TRICARE Young Adult program?

Answer: Your son can enroll into TRICARE Young Adult (TYA), provided that he is eligible. You can find eligibility information at TRICARE’s TYA page. Once you’ve confirmed he’s eligible, you have to submit an enrollment application and three months of premiums.

Fill out and print the TYA Application for your son’s region (North, South, West). The young adult has to sign the completed form. Mail or fax the completed form to the regional contractor where your son lives, along with the initial three-month premium payment. Worried about missing monthly payments? Set up automatic recurring credit card or electronic funds transfer (from a checking or savings account) payments on the TYA Application.

Editor’s Note: Please post your TRICARE questions in the Comments section below.

Comments

  1. I,m turning 65 at the end of the year. Why must I go to medicare, I like tricare and now it seems I am loosing another benifit. It seems they are trying to get rid of the older people, I guess we are living to long now. I wonder why I have an ID card, I am proud to have served 23 years in the Air Force, my son Just hit 20 years in the Air Force and reached E-8,

    • i have tri care and medicare both. i dont know what the difference in our circumstances is but when i got medicare i already had tri care and it continued. i am a widow of a deceased military man and have had tri care for long time. i now have tri care for life. medicare is my primary payee and what medicare dont pay tri care does. it might be good if you checked further into it.

    • Hi Darriell!! Not to worry, as you are about to receive Tricaare for Life TFL which will mpay any residue that Medicare does not pay. Tricar that you have now does not do that, so you should have some change in your popcket. Hal S/F

    • TriCare will not cover 100% of your expenses on a referral to a civilian provider. Medicare and Tri-Care -for-Life pays for just about everything. It is an unbeatable combination, just hope Obama does not decide to cut one or the other for those who have earned both. Military facilities are constantly being downgraded from full hospital service to a clinic. Forget about serious illness or surgeries.

      • Its not Obama that's trying hard to get rid of these programs. It the Republican Party that wants hand out vouchers and leave everyone at the mercy of Insurance companies…

        • Well how does that koolaide drinking working for you… Obama wants to stop all private paying insurance and make everyone on the government controlled insurance programs and no coverage for seniors…

    • I thought much as you do when I turned 65. Now however I am really happy with the combination of medicare and tricare. First I can see any doctor I want and not always a military doctor. Secondly, medicare is better know than tricare and there is less problem with signing up with medicare. Medicare pays 80% of the bill and tricare pays the balance leaving me with 0 to pay. The only co-pay is for prescription medications. I now think it is a great program.

    • Sir, once you get Medicare they have a small charge but you will have Medicare A and B. You will also be switched to Tricare for life. I was told by Tricare that this combination is the best insurance in the country and at a very low price. So you are not losing anything, you are gaining. Lucky us, so be happy about it.

  2. kaaren niver says:

    I will be 65 next month, and I understand that Tricare will become my secondary. Do I hav e to sign up w/Tricare to get my prescription (I have one that I take every day) filled through Tricare, or will I continue as I do now?? I do not plan to sign up for Medicare Part D because I believe that I can continue to do as I have done so in the past 5 years when I became eligible for TriCare. Thanks,

    • jan of sw fla says:

      I turned 65 last April. I use express scripts for my maint meds 3 bucks for 3 mos. of generic meds

    • As a retiree you are automatically enrolled in TriCare for Life when you renew your retired military ID. The only drawback is you are required to purchase Part B of medicare. The cost is approximately $115 a month. After that tricare will pay for co-pays and most anything that is not covered by medicare. No other parts of medicare is required. If you live close to a military hospital, all prescriptions are free.

  3. I just wonder why I have to stop going to the tricare clinic and find a Dr on the outside when I turn 65?

  4. I am 66 and retired Navy. I was told by the social security office and by the Naval facility to update my ID card that I must enrole in medicare in order to be eligible for tricare for life. I am still employed and am already paying into medicare through work, so why do I need to enrole if I am not going to receive benifits from medicare? Why can't I still use Tricare as a secondary insurance, since I am insured through a group insurance plan at present?

    • You do need to renew your ID card. You are automatically enrolled in medicare at the age of 65. You are then eligible for Tricare . Do not take part B that cost approximately $115 monthly. If you chose to enroll for Tricare for Life at a later date, then take part B and it is automatic. Caution: enrollment time is restricted to the first 2-3 months of the year and thanks to our congress rules continue to change often. Log on to the social security site for up to date information.

    • You talked to the wrong person. Medicare will pay the first 80% and Tricare for life will pay for the rest. It is a great deal.

  5. TFL Picks up what medicare does not pay but you must sign up for and pay for medicare part B to be eligible for TFL. Being retired Army I believe our having to pay for Part B goes against the health care for life the Army seemed to indicate we would have if we served the 20 years for retirement.
    Congress should look at their own benefits for savings.

  6. I will be 65 next year and eligible for TFL. My wife is four years younger. I am also a retired federal worker and am currently covered by FEHB. I plan to suspend that when I turn 65. What tricare coverage will my wife have since she will still be under 65?

    • This is a good question. I'm in this same scenario.

    • I am now 71,retired fed. worker and army. I suspend my FEHB at 63 and went under tricare for myself and my wife until I was 65, had some copay. My wife is 3 years younger and she stayed on tricare until she was 65. Before you reach 65 there is a 3000 dollar cap per year, after that they pay full coverage. This was 8 yr. ago. Call tricare and check, that was what I did.

    • I am retired Air Force and have been on Medicare and Tricare For Life for two years. My wife stays on Tricare Prime until Sept. of this year. Up until now we still paid for her Tricare Prime premiums for her to stay on it.

    • Your wife will retain the same Tricare coverage as she always had. I'm in the same boat. She has to pay a $12 copay, but I don't pay for anything except prescriptions. And if you live close to a military base or VA clinic, you can get you scripts filled for free.

  7. Why will Tricare not cover the Shingles immunization, Zostavax, when given at the local health department or a local pharmacy.? There are no providers in our area who will administer this vaccination and I want very much to have it.

    Does anyone have any information on this?

    • mrginseng says:

      If you live near a military post, you can get one there on retirees appreciation day.

    • Contact your local VA Hospital. If you are eligible to be treated there you may be able to receive the immunization. FYI, for those who are eligible and depending on the level of disability, the VA may do a means test to determine the amount they need have to charge for each visit. The more you earn, the more they charge but it's very very reasonable. Note: they do not accept Medicare or TFL. I received the Shingles immunization at a clinic visit (no charge for the immunization; the clinic charge was $35 because I'm fully employed.)

    • Re check the rules changed and I understand they will now give the shot through TLF. wife of AF 23 year retiree

  8. Don Dodson says:

    Chaz: Next year when you go under Medicare, sign up for Part B or you will not be eligble for TFL. Your SSN will be decreased but you HAVE to go this rout. ASK anyone including Medicare. For the years before your wife is egible for Medicare you will have to keep her enrolled in FEHB. I know it will cost you but again you will be harmed money wise if you don't. When she turns 65 you will see a wind fall when you and her SUSPEND FEHB. Whatever you do make sure you SUSPEND. Speak to OMB and they will tell you why. The reason is that at any time it is benifical to you you can return to FEHB. Repeat….Suspend do not drop. Be careful when signing the form.

    Don

    • Why not just use Tricare Std. for your wife until she reaches 65. No monthly premiums only $150 per year and if your doctors are network providers, only 15% copay.

  9. I serve 3 yrs active duty and 21 years national guard. I retired at 41. I don’t get my pension until age 60. Why are you charging $400.00 a month for medical insurance. This so call gray area is unfair to national guard and reserves.

  10. Harold Patterson says:

    I asked you people a question last week and have not gotrten an answer as of this date. I would greatly apprecate an answer to my previous question.
    THANKS.

    • You should ask your question again Harold so we know your question.

      And Harold, we are not just "You people". We are just like you, just retired military. We don't work for any government medical service. The guys an Gals on here share the info they were given. The people share out of the goodness of their heart. We are not working for you.

      Now, what was that question again?

  11. Kevin Burrow says:

    I am active duty Air Force stationed at Holloman AFB, NM. We are in the Tri-West region of Tricare. There are a lot of types of medical care that require many people to drive to El Paso, TX to recieve care. There just isn't available care closer. It is a 90 mile drive one way. Earlier this year Tricare stopped paying milage re-inbursement for trips made to El Paso. Some people like myself have had to make many numerous trips there and back. I would like it explained as to why this re-imbursement is no longer provided for us. It's not our fault better care isn't available closer to our home.

    • jazzman0747 says:

      I wish that I had an answer as to why they have stopped paying mileage, but I would be interested in knowing myself. However, if you do not already, keep track of all your trips and expenses for these trips and deduct them from medical expenses on your tax forms. You will be surprised how much money you can deduct, but keeping records is important. Wish I had the answer that you seek.

  12. My husband is active duty military. My mother recently passed away and my mentally handicapped aunt, who is 55, has had to come live with us. She has the mental capacity of a 4 to 6 yr old. She draws a small SS check, but it is not nearly enough to support her as she depends on us totally. Is there any way to have her added as our dependent? This would make things a lot easier.

    • jazzman0747 says:

      The first step would be to enroll your aunt in DEERS and have a legal document making her your legal dependent. Once enrolled, contact Tricare and explain the situation to them. Without legal documents, your good intentions will yield you nothing. I would engage an attorney and have her made your dependent through the courts, since you can also use this as proof of dependency for tax purposes. Hope this helps.

  13. i was married for 25 years,divorced in june this year.
    my husband served 26 years in the air force,for 17 of those active duty years,i followed him around the world and ended up thousands of miles away from my family,our 3 boys have grown up here. After all this support i am only eligible to ONE year of tricare coverage, i understand the 20 year rule,but my husband retired. I am horrified that i dont at least receive a percentage like 80% of the cost of health coverage…….i may have to leave the country and my sons in order to get health care. Is this really a decent way to treat military families?

    • Kate, If you are over 55 and do not remarry and are receiving a portion of his retirement, after the one year you can get Humana Military Healthcare Services Continued Health Care Benefit Program (CHCBP) – it is $988.00 every 3 months but at my age and health has been a life saver – it is handled through Tri-Care. They don't really tell you about it – you have to ask for it – and you have to get it immediately after your 1 year of coverage expires 1-800-444-5445 – See 10 USC sec. 1078a

      • The medical coverage is given to the person serving in the military at no cost because of their service, dependents are just that, dependents. Why should you continue to receive the health care when you are divorced, you didn't serve, he did.

  14. william hall says:

    You should have been on Tricare along time ago. You would have alot more money in your pocket.I cancled my FEHB three years ago and have been well satisfied.

    • Simon, I strongly dissagree with your suggestion, there are benifits for a divorcee if special requirements regarding the time spent married to her husband are met and to see if she qualifys. I should know, I am a divorcee of 31 years of marriage to my ex husband who retired and am eligible for base priviledges, and TriCare for life. She should go to the nearest legal office and speak with an attorney who is familiar with all the legal and civil affairs.

  15. I am 64 and will go on medicare in about 9 months. My wife is non-military and 9 years my junior. Will she be able to continue Tricare Standard until she is 65? I also, have ASI Tricare supplemental insurance if she is able to continue Tricare Standard will she also, be able to continue the ASI?

  16. jazzman0747 says:

    This is the first time that I have seen this blog and have found it very helpful because I also am in the 64/65 Tricare/Medicare dilemma. So thank you all who have contributed your experiences and knowledge. I would like to add however, that some of the questions I see can be answered by reading the Tricare Handbook or going to the Tricare Website. I will very glad to help anyone who is stumped and can do some research for you since I do some time on my hands…I am retired and do whatever excites me and helping fellow vets and their families excites me. My email is listed below, not sure if you can see it, but if not, please contact me at jazzman0747@yahoo.com. I am also a 20 year USAF retiree, so you can have faith in my ability to help if possible.

    • Steve Acree says:

      I, have a question or questions for you. I spent over 20 years in the Army reserves. In Sept of this year I will start drawing my montly benefit. Is Tricare a benefit that I can apply for and is there a cost. Where would a person get a copy of the Tricare handbook. I can't seem to get any answers. It sounds like I may be able to get Trcare until 65? My email is abuzzee@aol.com Thank you retired SFC

  17. Glenn Little ETCS(SS) USN Ret says:

    I am on a maintenance medication. I am seen by a board certified specialist that Tricare recognizes. I routinely cannot refill the prescription due to a preauthorization required. This requires the pharmacist to call the doctor, then the doctor to call Tricare to get the authorization to dispense the maintenance medication. Why does Tricare require a preauthorization that a specialist has determined is necessary for my health?? If I do not take the medication other people’s live may be in jeopardy. Do the administrative staff at Tricare know more about my medical condition than does my specialist? Why not flag my account with something to the effect that this medication has been determined to be necessary by a specialist?? This would save Tricare time and money, it would save the pharmacist time and money, it would save the specialist time and money and it would save me time and from inconvenience of having to go back to pick up the prescription after this paper work drill has been completed. Not to mention it would make me trust the system more rather than having a paper pusher second guessing a specialist.

  18. I am 68 . 10 years active duty air force. 12 years ANG. retired civil service at 50 with FEHB medical benefits. military retirement at 60 and switched to TriCare prime.At 65 enrolled in medicare with Tricare as secondary.55 year old spouse remained on individual Tricare prime. transition to medicare was seamless. we are 30 miles from MTF where my wife utilizes all services. I can use all services at MTFexcept seeing a primary provider.
    I have not had ANY copays since switch to medicare.Tricare has picked up whatever medicare didn't pay.
    We are both very grateful for the quality of service offered through Tricare and the low cost.

  19. Mark Engley says:

    21 years retired USN. As a requirement of my present employer, I must receive my maintenance prescription meds via mail order from Medcor. I believe this is the same company that Tricare uses, btw…I want to file my copays with Tricare as a secondary insurance. Tricare requires a laundry list of information about each Rx that Medcor doesn't provide before they will approve reimbursement. Why can't Tricare accept the standard Rx info provided on a Medcor receipt to process the claim? Medcor doesn;t provide it as a routine and Tricare will not accept additional info downloaded from Medcor's website.

  20. I have Tricare Prime. I live near Pittsburgh, Pa. When I turn 65 do I need to go on medicare or can I stay on Tricare Prime? My wife is a year younger. If I go to medicare does she stay on tricare prime???

    • She will stay on Tricare prime. You will go on Medicare and have Tricare for life. Make sure you get Medicare part a and B. It was automatic for me, so it will be for you too. Don't worry. when your wife hits 65, she will get the same as you. Very good coverage at a low price.

  21. My husband is a Navy Retiree and will turn 65 in September this year. We are now staying in the Philippines with our two children (ages 18 & 13), I understand Medicare is not honored here in the Philippines, does he have any options left for his medical needs. Furthermore, Tricare providers in this country are all running away from servicing tricare beneficiaries because they are not getting paid by TRICARE…

    • Not sure what you mean. In most foreign countries you need to pay in advance. TRICARE then reimburses you.

  22. When she hits 65 she will need to sign up for part B. My wife is 74 and doesn't have medicare B and thus does not get tricare for life or tri–care prime. The cost of part B goes up drastically for each year she is over 65 so it is too expensive. I have tri-care for life but went on medicare when I was 65.

  23. Bob Albracht says:

    Here is the answer:
    Chaz: Next year when you go under Medicare, sign up for Part B or you will not be eligble for TFL. Your SSN will be decreased but you HAVE to go this rout. ASK anyone including Medicare. For the years before your wife is egible for Medicare you will have to keep her enrolled in FEHB. I know it will cost you but again you will be harmed money wise if you don't. When she turns 65 you will see a wind fall when you and her SUSPEND FEHB. Whatever you do make sure you SUSPEND. Speak to OMB and they will tell you why. The reason is that at any time it is benifical to you you can return to FEHB. Repeat….Suspend do not drop. Be careful when signing the form.

    My Question: I am 67 yoa, retired Federal and retired active army/army reserve, does suspending FEHB, in my case (BC/BS) cost anything per month?

  24. My husband just passed away May this year. He was 100% service connected disability.Will I continue to have tricare coverage as my secondary insurance? I too am disabled, but am only a dependant.

  25. Richard Izbicki says:

    Does TRL comver the IV delivery of RECLAST?

  26. I will be 65 in a few months and my wife is younger. We have Tricare Prime. Question is, will she still be covered with Tricare Prime or do we have to change?

    Thank you

    • Yes, I had the same situation. Your premium for Prime will be cut in half. But you will need to start paying the fee for medicare for you. About $105 for me.

    • Streit,

      You will now be paying $22.44 per month for the single plan for your wife, and you will no longer pay for prime, but now you will have to pay for Medicare $99.00 per month (unless it went up). Now when you get sick, you will use Medicare, and what they don't pay, your Tricare For Life (TFL) will kick in and pay the rest.

      All this is still a good deal at our age when compared.

  27. I thought this blog here was about Tricare YOUNG adult? That's what the heading says above, why is everyone talking about everything but…

  28. Carolyn says:

    I am a widow of a disabled Vet. My military ID expired in 2006 when I was 73. I was told that I didn't need to renew after age 70. Is this correct. They ask for my ID when I get medical services.

  29. will tricare pay for shingles shots?

    • paul little says:

      will Tricare for life pay for shingles shots, Reliant of Westboro
      Ma says there is a 48.00 admin fee My wife and I in
      our 70's are on Tricare for life

      Paul A Little USCG RMC RET

      • paul little,

        Shingles Vaccine

        TRICARE covers the shingles vaccine, Zostavax, as recommended by the Centers for Disease Control and Prevention (CDC). Zostavax is recommended for beneficiaries 60 and older. To learn more about shingles and the vaccine, visit the CDC Web site.

        You may receive the shingles vaccine at no cost from your doctor's office or at a participating TRICARE retail network pharmacy. To find a pharmacy that participates in the vaccine program, search for a participating pharmacy online or call 1-877-363-1303. Call the pharmacy first to:

        •verify the days and times you can come in for a vaccine.
        •see if there are any restrictions.
        •make sure the pharmacy has the vaccine you need as some, such as shingles, may be in short supply.
        •make sure a pharmacist gives the vaccines and not a provider from an in-pharmacy clinic to avoid potential cost shares or copayments.

        Note: If you get the vaccine from your provider, you may have to pay copayments or cost shares for the office visit or other services received during the office visit.

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