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Are you wondering if your child has TRICARE coverage? Most childrenOpens TRICARE.mil of service members and retirees can get TRICARE until they turn age 21 (or 23 if they’re in college).
“TRICARE is committed to ensuring our military families have access to quality health care,” said Shane Pham, an analyst with TRICARE Policy and Programs at the Defense Health Agency. “We encourage all service members and retirees to promptly register your children in the Defense Enrollment Eligibility Reporting System and understand what their TRICARE options are. Taking care of these steps early means uninterrupted health coverage for your kids.”
Who’s eligible?
TRICARE coverage for children is broad, but there are specific rules about who qualifies. All children qualified must be unmarried, and there are three main groups of children eligible for TRICARE:
- Biological children
- Adopted children
- Stepchildren
These children are eligible for TRICARE until they turn age 21. Alternatively, if they’re in college full-time, they can keep TRICARE coverage until they’re 23 or out of school, whichever comes first. See Going to College on TRICARE.mil/college for specific details on qualified student status. An exception is children with severe disabilities, who may be able to keep TRICARE beyond these age limits.
New child in the family? It’s a Qualifying Life Event
Adding a child to your family is a big change — and is a TRICARE Qualifying Life Event. According to the TRICARE Qualifying Life Events Fact Sheet, a QLE for one family member means all family members may make enrollment changes during the QLE period. Here’s what you need to know about QLEs and kids:
Birth: Giving birth is a QLE. When your baby is born, you have 90 days (120 days if you live overseas) to register them in DEERS.
Adoption: Adopting a child is also a QLE. Your 90-day window to add your child to a TRICARE plan starts on the day the adoption is final.
Foster children: When you become a foster parent, it’s not automatically a QLE. However, if you’re named as the legal guardian, it becomes a QLE.
Stepchildren: Marrying someone with children is a QLE. You can add your new stepchildren to your TRICARE plan within 90 days of the marriage.
Legal guardianship: If you’re granted legal guardianship of a child, it’s a QLE. Your 90-day window starts when the guardianship becomes official.
During these 90-day periods, you can add the child to your current plan or change the new child’s coverage to a different TRICARE plan, if eligible.
Be sure to sign up on time. If you don’t sign up on time:
Your child won’t show as TRICARE-eligible.
TRICARE will deny claims for your child after 90 days (or 120 days if overseas).
How to get TRICARE for your child
TRICARE makes it easy for you to start the process of getting coverage for your child.
First, register your child in the DEERS. You don’t need a Social Security number to register your child, but remember to update DEERS as soon as you have their SSN. Remember, registration in DEERS doesn’t mean your child is enrolled in TRICARE. After registration in DEERS, the next step is to choose a TRICARE health plan and enroll your child. You need to do both steps to ensure your child is in a TRICARE health plan.
For some, enrollment might be automatic, depending on your status and where you live.
If you’re an active duty service member, your child will automatically get enrolled in a TRICARE plan when you sign them up in DEERS. In most cases, for stateside active duty families:
Your child is automatically enrolled in TRICARE PrimeOpens TRICARE.mil if living in a Prime Service Area.
If living outside of a Prime Service Area, your child is automatically enrolled in TRICARE Select.
However, even if your child is automatically enrolled in a TRICARE plan, you can choose a different plan (if eligible) during the QLE period.
If you’re retired, you must choose a plan and enroll your child yourself.
Use the TRICARE Plan Finder tool to help yourself choose the right plan for you and your family. You can find more information about enrollment on TRICARE.mil.
Coverage for adult children
When your child turns age 21 (or 23 if they’re in college), they might still need health insurance. That’s where TRICARE Young Adult comes in.
TYA lets adult children of TRICARE-eligible sponsors keep their TRICARE coverage until they turn age 26. It’s a premium-based plan that offers the same TRICARE coverage they’ve been used to with TRICARE PrimeOpens TRICARE.mil or TRICARE Select.
To get TYA, your child must not be married; not be eligible for their own employer-sponsored health coverage; and not be in the Uniformed Services themselves.
If your child is nearing the age limit for regular TRICARE, you may want to explore TRICARE Young Adult to keep them covered. Has your child recently graduated from college? They may still be eligible for TYA. To learn more, check out the TRICARE Newsroom article, “Recent Graduate? Learn How TRICARE Covers Young Adults.”
Don’t wait to get your young adult covered. Sign them up as soon as you can to make sure they have the health care they need.
Taking care of your child’s health should be a top priority. By understanding TRICARE’s rules for children, you can ensure your kids have the coverage they need as your family grows and changes.
