Keith Mack
Getting married is a Tricare Qualifying Life Event (QLE) that impacts your health plan options. Spouses of active-duty, reserve, and retired members are eligible for Tricare coverage, but common-law couples or cohabitating partners are not. To enroll a new spouse in Tricare, the Defense Enrollment Eligibility Reporting System (DEERS) requires documents such as a marriage license, birth certificate, Social Security card, and photo ID. The two most common plans are Prime and Select, differing in the choice of Primary Care Manager and the presence or absence of copays and enrollment fees. Post-divorce Tricare benefits are determined by eligibility requirements such as the duration of marriage and service overlap, with temporary transitional coverage options available through the Continued Health Care Benefit Program (CHCBP).
| Characteristics | Values |
|---|---|
| Common-law couples or cohabitating partners | Not eligible for Tricare coverage |
| Spouses of active duty, reserve, and retired members | Eligible for Tricare coverage |
| Same-sex spouses | Eligible for Tricare coverage |
| Enrollment in DEERS | Required for Tricare coverage |
| Documents required for enrollment | Marriage license, spouse's birth certificate, Social Security card, and photo ID |
| Tricare plans | Prime and Select |
| Prime plan features | Fewer options for Primary Care Manager, no copays or enrollment fees |
| Select plan features | More options for Primary Care Manager, copays required for treatment |
| Post-divorce Tricare benefits | Available under the 20/20/20 rule or the 20/20/15 rule |
| Temporary transitional coverage | Available through the Continued Health Care Benefit Program (CHCBP) for up to 36 months after Tricare eligibility ends |
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What You'll Learn
Common-law couples are not eligible for Tricare coverage
Tricare is a health plan for spouses of service members. It is a benefit for spouses of active-duty, reserve, and retired military members. While same-sex spouses are covered by Tricare, common-law couples or cohabitating partners are not eligible for Tricare coverage. This is because common-law marriage is not legally recognized as a valid form of marriage under Tricare regulations.
To be eligible for Tricare coverage, spouses must be legally married and able to present a marriage license. This is because Tricare is a benefit that is only available to those who are legally recognized as spouses of service members. Common-law couples, by definition, do not have a legal marriage license and, therefore, cannot enrol in Tricare.
It is important to note that, in the context of Tricare, a "spouse" is defined as someone who is legally married to a service member. This definition does not extend to common-law partners or cohabitating partners, even if they are in a long-term, committed relationship with a service member. As such, common-law couples are not eligible for any of the benefits that are available to legally married spouses of service members, including Tricare coverage.
Tricare coverage for spouses of service members is a valuable benefit that provides access to healthcare services. However, it is important to understand that this benefit is only available to those who are legally recognized as spouses, which excludes common-law couples. This means that, in the event of a medical issue, common-law partners of service members would need to seek alternative forms of healthcare coverage or pay out of pocket for any necessary treatment.
It is recommended that spouses of service members enrol in the Defense Enrollment Eligibility Reporting System (DEERS) and obtain a military ID as soon as possible after receiving their marriage license. This will ensure that they have access to Tricare and other military benefits. Enrolling in DEERS is a straightforward process and is typically done as part of the military ID card issuance procedure. By enrolling in DEERS and obtaining a military ID, spouses can rest assured that they will have access to the healthcare coverage provided by Tricare.
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Spouses of active duty, reserve and retired members are eligible
Spouses of active-duty, reserve, and retired military personnel are eligible for TRICARE coverage. TRICARE is the health care program for uniformed service members, retirees, and their families. It offers comprehensive health care coverage, including medical, dental, and pharmacy benefits. To ensure that your spouse is eligible for TRICARE, there are a few important steps to take.
Firstly, it is crucial to enrol your spouse in the Defense Enrollment Eligibility Reporting System (DEERS). This is a database that manages eligibility information for military health benefits. To enrol your spouse in DEERS, you will need to provide certain documents, including your marriage license, your spouse's birth certificate, Social Security card, and photo ID. Enrolling your spouse in DEERS is typically done as part of the military ID card issuance process, and possessing a dependent ID can serve as proof of TRICARE enrolment. It is recommended that you complete this process as soon as possible after receiving your marriage license to guarantee timely access to TRICARE benefits.
Once your spouse is enrolled in DEERS, you can select a TRICARE health plan. The two most common plans are PRIME and Select. TRICARE Prime offers fewer options for choosing your Primary Care Manager, but it has no copays or enrolment fees, making it generally more affordable. With TRICARE Prime, the provider will handle all claims, minimising paperwork for you. On the other hand, TRICARE Select provides a wider range of options for selecting your Primary Care Manager but comes with copays for treatment, resulting in more choice at a higher cost. It's important to carefully consider your needs and preferences when choosing between these plans.
It's worth noting that same-sex spouses are also covered by TRICARE once they are enrolled in DEERS. Additionally, if you and your spouse are living apart or are legally separated, your spouse remains eligible for TRICARE coverage as long as the marriage has not been legally terminated. In some cases, military spouses may opt for legal separation instead of divorce to maintain TRICARE coverage for the dependent spouse.
In the event of divorce, it's important to understand the eligibility criteria for maintaining TRICARE benefits. Under the 20/20/20 rule, an ex-spouse can retain TRICARE health care benefits if they were married to the service member for at least 20 years, the service member served in the armed forces for a minimum of 20 years, and the marriage overlapped with the period of service for at least 20 years. If the 20/20/20 criteria are not met, the ex-spouse may still qualify for reduced benefits under the 20/20/15 rule or receive temporary transitional coverage through the Continued Health Care Benefit Program (CHCBP) for up to 36 months after TRICARE eligibility ends.
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Same-sex spouses are covered once enrolled in DEERS
Getting married is a Tricare Qualifying Life Event (QLE) that may impact your health plan options. Spouses of active-duty, reserve, and retired military members are eligible for Tricare coverage. Same-sex spouses are also covered by Tricare once they are enrolled in the Defense Enrollment Eligibility Reporting System (DEERS). To enrol a spouse in DEERS, you will need to present documents such as your marriage license, your spouse's birth certificate, Social Security card, and photo ID. Enrolling in DEERS is part of the military ID card issuance process, and dependent IDs can be used as proof of Tricare enrolment. It is recommended that you enrol your spouse in DEERS and obtain a military ID as soon after receiving your marriage license as possible to ensure they have access to Tricare and other military benefits.
Tricare offers two common plans: Prime and Select. Tricare Prime provides fewer options for selecting a Primary Care Manager, but has no copays or enrollment fees, making it generally less expensive. The provider will fill in all claims, so paperwork is limited. Tricare Select offers more options for choosing a Primary Care Manager but requires copays for treatment, resulting in more choice at a higher cost. Once you decide on a plan, you can make your selection via web beneficiary enrolment.
It is important to note that common-law couples or cohabitating partners are not eligible for Tricare coverage. Additionally, Tricare coverage for spouses ends in the event of divorce from the eligible sponsor or if the spouse of a deceased member remarries. However, under the 20/20/20 rule, an ex-spouse can retain Tricare health care benefits if they meet specific requirements: they were married to the service member (referred to as the "sponsor") for at least 20 years, the service member served in the armed forces for a minimum of 20 years, and the marriage overlapped with the period of service for at least 20 years. If the ex-spouse meets the 20/20/20 rule, they are eligible for comprehensive Tricare benefits until the age of 65.
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Tricare Prime and Select are the two most common plans
Tricare Prime and Tricare Select are the two most common plans available to military families. Both plans offer excellent coverage, but they differ in terms of flexibility, cost, and provider choice.
Tricare Prime is ideal for those who prefer a structured and simple approach to their healthcare. It offers a coordinated care experience, where beneficiaries receive care on base or from a network of Tricare-approved doctors and hospitals. One of the advantages of Tricare Prime is that it has no deductibles or copays for in-network primary or specialty care. It also has no out-of-pocket costs, making it a cost-effective option. However, it offers fewer options for selecting a Primary Care Manager (PCM) and requires referrals to see specialists.
On the other hand, Tricare Select provides more flexibility and freedom of choice. Beneficiaries can see any doctor or specialist who accepts Tricare, regardless of whether they are on base or off. There is no requirement for a Primary Care Manager with Tricare Select. However, it does come with an annual deductible and copays for office visits, prescriptions, and other services. The costs vary depending on whether the provider is in-network or out-of-network. Tricare Select is ideal for those who value the flexibility to choose their healthcare providers and prefer receiving care outside of military bases.
It's important to note that while Tricare recognizes spouses of active-duty, reserve, and retired members as eligible for coverage, common-law couples or cohabitating partners are not eligible for Tricare coverage.
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Post-divorce Tricare benefits are available under the 20/20/20 rule
Divorce, annulment, or the dissolution of a marriage is a Tricare Qualifying Life Event (QLE). Post-divorce Tricare benefits are available under the 20/20/20 rule, which states that non-military ex-spouses can retain full Tricare benefits if they meet the following requirements: they were married to the service member (or "sponsor") for at least 20 years; the service member served in the armed forces for at least 20 years; and the marriage overlapped with the period of service for at least 20 years.
If the ex-spouse meets the 20/20/20 rule, they are eligible for the full Tricare package, including access to the military Post Exchange (PX) and base and commissary privileges, until the age of 65. They will be issued a new ID card with their name and Social Security Number (SSN) listed as the "sponsor Social Security number" after the divorce/annulment date.
It is important to note that post-divorce Tricare benefits will end if the ex-spouse remarries or purchases and is covered by an employer-sponsored health plan. If an individual does not qualify under the 20/20/20 rule, they may still be eligible for temporary transitional coverage through the Continued Health Care Benefit Program (CHCBP), which provides Tricare benefits for up to 36 months after eligibility ends. However, this option is not available to former spouses of NATO or Partners for Peace members, and it is not free.
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Frequently asked questions
No, common-law couples or cohabitating partners are not eligible for Tricare coverage.
Spouses of active duty, reserve, and retired members are eligible for Tricare coverage. Same-sex spouses are also covered by Tricare once they are enrolled in the Defense Enrollment Eligibility Reporting System (DEERS).
To enrol your spouse in Tricare, you need to present documents including your marriage license, your spouse's birth certificate, Social Security card, and photo ID. It is recommended that you enrol your spouse in DEERS and get them a military ID as soon as possible after receiving your marriage license to ensure they have access to Tricare and other military benefits.
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