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TRICARE will soon allow qualified young adults, up to age 26, to purchase military health plan coverage on a month-to-month basis.
TRICARE officials announced plans to roll out the new Young Adult Program, including an option to make coverage retroactive to Jan. 1, in the near future.
This will ensure military families aren’t left out as the new national health care reform law extends parents’ health insurance for their children up to age 26, officials said.
The new program will allow qualified, unmarried children of service members without access to employer-sponsored health care coverage to buy health care coverage under their parents’ TRICARE plans through age 26. That’s up from the current maximum age of 21, or age 23 for full-time college students whose parents provide more than half of their financial support.
The fiscal 2011 National Defense Authorization Act, which President Barack Obama signed Jan. 7, gave the Defense Department the authority it needed to extend TRICARE coverage to young adults, TRICARE spokesman Austin Camacho said. This ensures benefits extended are in line with those all American families receive under the Patient Protection and Affordable Care Act, which took effect in March 2010.
“We’ve been working hard to make sure we could put TRICARE Young Adult on a fast track,” said Navy Rear Adm. (Dr.) Christine S. Hunter, the director of the TRICARE Management Activity. “Fortunately for our beneficiaries concerned about health care coverage for their adult children, the law signed by the president includes opportunities for military families to elect this new premium-based plan retroactive to Jan. 1.”
TRICARE officials expect to announce premium costs shortly, before enrollment begins. But because the 2011 defense authorization specifies that the rates must cover all program costs, Camacho said, premiums will be based on commercial insurance data about the costs of providing care.
Once premiums are determined, officials encourage eligible beneficiaries to explore all of their health care coverage options to choose a plan that makes sense for them.
Hunter estimated that the program, once in place, could extend TRICARE coverage to several hundred thousand additional beneficiaries.
“The premium allows us to provide the excellent benefit to our military families while responsibly addressing the impact of health care costs on the DOD budget,” she said.
Officials plan to roll out the new program in two phases, first offering a premium-based TRICARE Standard/Extra benefit, Camacho said. Then, later this year, they plan to introduce the TRICARE Prime and TRICARE Prime Remote plan, including overseas options, and the Uniformed Services Family Health Plan.
Once the program is in place, eligible beneficiaries may submit an application and premium payment to the appropriate regional or overseas contractor for processing, Camacho said. Cost shares, deductibles and catastrophic caps will vary based on the plan selected and the sponsor’s status.
Young adult beneficiaries will receive an enrollment card after they buy coverage and their payment is reflected in the Defense Eligibility Enrollment Reporting System, Camacho said.
The new beneficiaries may choose to pay premiums back to Jan. 1, which will entitle them to file claims for any health care costs they have accrued since that date. To do so, officials advise beneficiaries save all receipts to ease claims processing.
For adults who need health insurance coverage but no longer qualify for TRICARE coverage, officials advise exploring the Continued Heath Care Benefit Program. This premium-based program offers temporary, transitional health coverage for 18 to 36 months.
Coverage must be purchased within 60 days of losing TRICARE eligibility. Information about the program is posted on the TRICARE website.
