USATRICARE to Extend Dependent Coverage to Age 26

WASHINGTON, Jan. 14, 2011 — To ensure mil­i­tary fam­i­lies don’t get left out as the new nation­al health care reform law extends parent’s health insur­ance to their chil­dren up to age 26, TRICARE plans to roll out its new Young Adult Pro­gram by spring and to pro­vide an option to make cov­er­age retroac­tive to Jan. 1.

The new pro­gram will allow qual­i­fied, unmar­ried mil­i­tary chil­dren up to age 26 to buy health care cov­er­age under their par­ents’ TRICARE plans through age 26, defense offi­cials announced yes­ter­day. That’s up from the cur­rent max­i­mum age of 21, or 23 for full-time col­lege stu­dents whose par­ents pro­vide more than half their finan­cial sup­port.

The fis­cal 2011 Nation­al Defense Autho­riza­tion Act 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 explained. This ensures ben­e­fits extend­ed under TRICARE are in line with those all Amer­i­can fam­i­lies receive under the Patient Pro­tec­tion and Afford­able Care Act that took effect in March.

“We’ve been work­ing hard to make sure we could put TRICARE Young Adult on a fast track,” said Navy Rear Adm. (Dr.) Chris­tine Hunter, who heads 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.”

Qual­i­fied young adults who don’t have access to employ­er-spon­sored health care cov­er­age will be eli­gi­ble to pur­chase it through TRICARE on a month-to-month basis, Cama­cho said.

Details about how much those pre­mi­ums will cost under the new pro­gram still are being final­ized. 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 the new pro­gram is in place, Hunter esti­mat­ed that it 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.

Mean­while, the TRICARE staff has moved into over­drive to iron out the pro­gram details: deter­min­ing eli­gi­bil­i­ty and cov­er­age cri­te­ria and costs; design­ing, test­ing and imple­ment­ing the required soft­ware and sys­tems changes; updat­ing eli­gi­bil­i­ty data­bas­es; and craft­ing edu­ca­tion efforts, Cama­cho 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 young adults 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 that they 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.

U.S. Depart­ment of Defense
Office of the Assis­tant Sec­re­tary of Defense (Pub­lic Affairs)

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