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Health Insurance TRICARE

One of the many wonderful benefits provided to service-members through the military is health insurance. The Department of Defense Healthcare Program is known as TRICARE. TRICARE provides health care coverage for medical services, medications, and dental care for military folks, retirees and their families.

The big question that comes into play is how a divorce will affect healthcare benefits for the ex-spouse who is not the service-member. Children, for the most part, will be eligible for healthcare benefits as long as their active duty service-member parent is eligible. The good news for unremarried former spouses of service-members, is that there is a program called the Continued Health Care Benefit Program (“CHCBP”) available to them. CHCBP is a premium-based health care program administered by Humana Military Healthcare Services, Inc. If you qualify, CHCBP provides an unremarried former spouse with continued health care coverage for 18 to 36 months after that person loses military health care benefits. CHCBP is not a TRICARE program, but it offers coverage comparable to TRICARE Standard with similar benefits, providers, and program rules. You are encouraged to consult with an attorney, local military legal service office and the internet to learn more about the CHCBP program and to see if you qualify.

While the military healthcare system is affordable and readily available to service-members and their families, it can also be extremely confusing. Even for the active duty folks, they have to choose between any number of TRICARE health plans. TRICARE gets its name based on three levels of coverage: TRICARE Prime, TRICARE Standard, and TRICARE Extra. On top of that, there is also something called TRICARE Survivor Benefits for folks left behind when the active duty service-member dies, as well as TRICARE plans for Reservists and retired Reservists.

TRICARE Prime / TRICARE Standard / TRICARE Extra
The main difference between TRICARE Prime and TRICARE Standard is that with TRICARE Prime, most health care will come directly from a military treatment facility, along with TRICARE contracted Civilian Medical Providers called the Preferred Provider Network. It is also normally the most cost-effective option of active duty service-members’ families. TRICARE Standard, on the other hand, offers a bit more provider choice. Beneficiaries may choose any TRICARE-authorized provider and it allows TRICARE Standard beneficiaries to self-refer for specialty care. Of course, with that added flexibility normally comes additional fees and costs. These choices are not for the active duty service-member, by the way, who is normally required to be enrolled in TRICARE Prime. TRICARE Extra, like TRICARE Standard is a fee-for-service plan available to non-active duty beneficiaries throughout the United States.

The costs and fees vary between TRICARE Standard and TRICARE Extra, so additional homework is necessary and to confuse matters even more, you can sometimes switch between the Standard and Extra options. If you visit a non-network provider, you’re using the Standard option. If you visit a network provider, you’re using the Extra option. Each of these involves varying out of pocket payments and sometimes you may be filing your healthcare claims on your own behalf. It is important to thoroughly research each of the plans listed above before choosing on which one is right for you. Finally, depending on where you live, you may want to opt for an independent healthcare plan. There is no one right answer and this decision (and the research to make this decision) should not be taken lightly.

TRICARE Reserve Select / TRICARE Retired Reserve
It is worth mentioning two other TRICARE related healthcare plans: TRICARE Reserve Select and TRICARE Retired Reserve.

TRICARE Reserve Select is a premium-based health plan available worldwide for qualified Selected Reserve members of the Ready Reserve and their families. It is not free – but in our experience, it is a cheaper alternative than most employer-sponsored health plans. For example, if you are a drilling Reservist and not eligible for other federal health insurance, this might be a great alternative than paying for an expensive employer-sponsored plan. Again, many factors can go into this, and where you live and the benefits you receive from your employer may change the decision making process. Suffice it to say, this is worth looking into if you are a member of the Selected Reserves of the Ready Reserves, not on active duty orders and not eligible under the Federal Employees Health Benefit plan.

With Tricare Retired Reserve, qualified retired Reserve members, their families and survivors are covered. This is a premium-based health plan for members of the retired Reserve Component who have qualified for non-regular military retirement. These folks must be under age 60 and not eligible for Federal Employees Health Benefits. It is available to family members of qualified Retired Reserve members and survivors of retired Reserve members if the sponsor was covered by TRICARE Retired Reserve when he or she died. There are many details that go along with plan and you are encouraged to visit the Tricare website and consult with the plan administrators for eligibility.

Finally…
This is just the tip of the iceberg on various TRICARE and CHCBP plan options available. While the plans detailed under this section provide a quick overview of what they are, each plan comes with a comprehensive manual and specific advantages and disadvantages, as well as varying cost and fee structures. There are also additional TRICARE plans not mentioned here such as TRICARE overseas and TRICARE for life (for eligible folks on Medicare). Do not simply rely on the information in this section when making a decision as important as healthcare for you and your family. There is no doubt that military health insurance is a wonderful benefit to active duty military, reservists, and their families. Unfortunately, as with so many things in the military, it can be confusing and intimidating. It gets even more complicated for the ex-spouse of a military service-member. Consult with plan administrators, legal service JAG Attorneys, or civilian attorneys who understand military specific laws and regulations. There is also a voluminous amount of information available on the internet. You are encouraged to seek all of this information before making any decisions in this regard.

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Military Divorce PC.com

Tel: (757) 961-3321|Fax: 757-490-7804|E-mail: Lawyer@MilitaryDivorcePC.com

One Columbus Center, Suite 600 Virginia Beach, VA 23462

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