TRICARE is the military’s healthcare program for active duty service members (ADSMs), family members of ADSMs, National Guard and Reserve members and their family members, retirees and the family members of retirees, survivors, and certain former spouses worldwide.
TRICARE includes the full health care resources of the Military Health System including military hospitals and clinics. TRICARE also includes “a network of civilian health care professionals, institutions, pharmacies, and suppliers.” The Department of Defense (DoD) operates many military hospitals and clinics. The civilian network of TRICARE-authorized providers is fairly comprehensive. You may even be eligible to see a non-network TRICARE-authorized provider.
Eligibility for the various plans post-divorce depends on who you are and who your sponsor is.
TRICARE for children – eligibility
Children are eligible for TRICARE as follows:
Unmarried biological children, stepchildren, and adopted children are eligible for TRICARE until age 21. The eligibility for TRICARE may extend to age 23 if the child is in college. After 21 to 23, children may qualify for TRICARE Young Adult.
Children who are severely disabled may also be entitled to TRICARE coverage after ages 21 or 23.
Children should be registered through the Defense Enrollment Eligibility Reporting System (DEERS).
The sponsor must go to a Uniformed Services ID card office and present the child’s official birth certificate or SF-240 Consular Report of Birth Abroad, record of adoption, or letter of placement of your child into your home by a recognized placement or adoption agency or the court.
The TRICARE insurance for children can end earlier than 21 or 23 if the service member “leaves the military before they have enough service for retirement.” So in short, it is possible that your children will lose their TRICARE coverage if you or your spouse (whomever is in the service) leaves the military.
TRICARE for former spouses – eligibility
Former spouses who have not remarried are eligible for TRICARE. The former spouse can register in the DEERS system. TRICARE determines your eligibility based on your own Social Security number (SSN), not your former sponsor’s (your former spouse’s). TRICARE states that you will use your name and SSN to file claims and schedule appointments.
To be eligible, you must fit into one of the following eligibility criteria categories. In both criteria categories, your spouse must have “at least 20 years of creditable service towards determining retirement pay.” The unmarried former spouse will also need to provide their marriage certificate, divorce decree, and “DD Form 214 or Statement of Service from the applicable Service Personnel Component.”
Eligibility Category 1. The “20-20-20” Rule
If you are an unmarried former spouse, you are eligible for TRICARE “as your own sponsor under your own Social Security Number” provided the following criteria apply:
- 20 – Your sponsor has at least 20 years of creditable service towards determining retirement pay.
- 20 – You were married to the same sponsor/service member for at least 20 years.
- 20 – All 20 years of marriage overlap the 20 years of creditable (Active or Reserve) service which counted towards your sponsor’s retirement.
Per TRICARE, “If the Service Personnel Component determines that you meet the 20-20-20 eligibility criteria, you will be issued a new ID card with your own name and your Social Security number listed as the ‘sponsor Social Security number’ the first time you renew your card after the divorce/annulment effective date.”
Eligibility Category 2: The “20-20-15” Rule
As a former spouse, you should also be eligible for TRICARE under your own Social Security Number provided the following criteria apply:
- 20– Your sponsor has at least 20 years of creditable service towards determining retirement pay.
- 20– You were married to the same sponsor/service member for at least 20 years.
- 15– 15 of those years overlap the 20 years of creditable (Active or Reserve) service which counted towards your sponsor’s retirement.
In this second eligibility category, your coverage was/is determined by the date of the divorce. Generally, the eligibility for TRICARE healthcare benefits as a former spouse is limited. For marriages that end after September 29, 1988, the eligibility period is only one year.
Former spouses who qualify for TRICARE are entitled to the same benefits as a retired family member.
Formers spouses under either eligibility category lose their TRICARE eligibility if they remarry, buy, or are covered by an employer-sponsored health plan, or were the former spouse of a North Atlantic Treaty Organization or Partners for Peace nation member.
A quick note about military ID cards
Children should obtain their military-dependent ID cards (or renew them) as soon as possible after the divorce is final. Normally, children aren’t given IDs until they’re 10 years old. However, children younger than 10 can receive IDs if they don’t live with an ID card holder (such as a father or mother who is a member of the military).
The amount of benefits may depend on how much child support the military member is providing. If the military member is providing more than half of the child support obligation, “the children can continue to use all Morale, Welfare & Recreation (MWR) benefits and base exchange stores. If less, they won’t have access to those things.”
Per TRICARE, “Unfortunately, dependent children of divorced service members are not able to use the commissary under their own ID cards regardless of how much support they receive.”
The benefits for children may also depend on whether the former spouse meets either of the two eligibility criteria categories discussed above.
If your children are not eligible for TRICARE insurance, then the payment terms for civil health insurance for your children should be made part of the child support order.
Learn more about military healthcare coverage
TRICARE offers different types of plans including the following:
- New Active Duty Service Members
- New Spouse
- National Guard and Reserve Members
- Family Members of National Guard or Reserve Members
- Foreign Force Members and Families
Additional TRICARE plan options include:
- TRICARE Prime
- TRICARE Prime Remote
- TRICARE Prime Overseas
- TRICARE Prime Remote Overseas
- TRICARE Select
- TRICARE Select Overseas
- TRICARE For Life
- TRICARE Reserve Select
- TRICARE Retired Reserve
- TRICARE Young Adult
- TRICARE Plus
- US Family Health Plan
You need health insurance. Your children need health insurance. Just one night in a hospital or one surgery can affect your finances for years. At Grable Grimshaw PLLC, when spouses divorce, we focus on the issues that affect your financial future and that of your children – including property division, spousal maintenance, child custody, child support, and health insurance coverage for you and your kids. Call our office in San Antonio or submit our contact form to schedule a free consultation.