To get TRICARE military insurance, you have to meet requirements. There are two main groups that can get coverage: military members (or sponsors) and their family. Current or past United States military members, National Guard/Reserve members and people who have gotten the Medal of Honor are all part of the “sponsors” category. Husbands/wives and children of military members are part of the family category.
The TRICARE benefits and coverage that you can get might be based on factors like where you or your spouse/parent served. Find out more about military health insurance requirements when you download our free guide.
What are the main requirements for TRICARE?
One of the first steps to meeting TRICARE requirements is to sign up your family for the Defense Enrollment Eligibility Reporting System (DEERS). Military members don’t have to have their requirements checked because they already qualify. So this is mainly for family. Life events that can make you qualified to get TRICARE coverage if you are a family member include:
- Getting married.
- Having a baby.
- Signing up for Medicare.
- Moving to a new place.
- The death of a sponsor or family member.
- Any change in a sponsor’s status.
To make sure you keep getting TRICARE coverage, let your regional contractor know about any changes like these.
What are the TRICARE requirements for military members on active duty?
All military members who are on active duty and their families automatically qualify for TRICARE. But the plans you can sign up for depend on where you are stationed. These plans include:
- TRICARE Prime.
- TRICARE Prime Remote.
- TRICARE Prime Overseas.
- TRICARE Prime Remote Overseas.
Family members can sign up for the same plans as their sponsor. They can check to see if they qualify for other plans, too. Other plans include TRICARE Select, TRICARE for Life, TRICARE Select Overseas, TRICARE Young Adult or a U.S. Family Health Plan.
What are the TRICARE requirements for National Guard/Reserve members?
Requirements for members of the National Guard/Reserve are different. To see if you qualify, you have to log on to the Defense Manpower Data Center (DMDC) Beneficiary Web Enrollment database. To log on, you will need one of these items:
- A Department of Defense (DoD) Self-Service Logon (also known as a DS Logon)
- A Common Access Card (CAC)
- A DFAS MyPay account
Most National Guard/Reserve sponsors can get TRICARE dental coverage. But they might not qualify for other TRICARE benefits unless they are on active duty or they were recently called back. An eligibility check might be necessary.
What are the TRICARE requirements for retired service members?
If you are a retired military member, an eligibility check is not needed. Retired military members and their families can get insurance from these plans: TRICARE Prime, TRICARE Select, TRICARE Select Overseas, TRICARE for Life and U.S. Family Health Plan. Retired military members can also get benefits from the Retiree Dental Program automatically.
To keep benefits as a retired military member, regular evaluations are necessary.
Learn About Requirements for Survivors and Children
Family members can keep getting TRICARE coverage after their sponsor passes away. But there are some requirements they have to meet to keep the coverage. A husband or wife of a military member who passes away can keep their TRICARE coverage up until they get remarried. Spouses that outlive the military member in their household will have the same TRICARE coverage and costs for three years or until they remarry.
There are different rules for spouses of military members, National Guard/Reserve members and retired members.
Children can keep their TRICARE coverage, too. It doesn’t matter if they are adopted, step-children or children of the military member. Kids can receive TRICARE until they are 21. Sometimes, kids can get TRICARE coverage up until they are 23 if they are full-time students in college. They can keep their coverage for even longer if they have a disability.
Find Out About Requirements for Other Groups
People who got the Medal of Honor can get the same TRICARE coverage as other military members. TRICARE Plus plans and military hospitals/clinics are available to their family members, too. The requirement is that the military member has to have served for at least 30 days. Dependent parents and parents-in-law can even fill prescriptions at military pharmacies with a TRICARE Plus plan.
Foreign Force members might also qualify for TRICARE coverage. But an eligibility check in the United States will be needed. Foreign Force Members who are part of the Partnership for Peace Agreement (PFP) or Reciprocal Health Care Agreement can get medical services, too.
For more information on TRICARE requirements, download our free guide today.