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Learn About TRICARE Young Adult

TRICARE Young Adult medical coverage is for adult children between 21 and 25 years of age. The TRICARE Young Adult cost varies depending on certain factors. Furthermore, qualification depends on certain eligibility requirements. Enrollment is an effective alternative to other coverage options for qualifying young adults who are no longer covered under regular or other TRICARE plans. Regular TRICARE ends at 21 or 23 years of age depending on situational circumstances.

More information about TRICARE Young Adult enrollment, the cost of coverage and eligibility for coverage is included below. Additionally, TRICARE Young Adult Prime features are also explained here. Learn more about available health coverage for young adults via this plan and discover if this is the right coverage for you below.

What is TRICARE Young Adult?

TRICARE dependent coverage to age 26 is a premium-based health coverage option for dependent children of active duty, medically retired and retired uniformed service members. Additionally, coverage is available to survivors of medically retired uniformed service members.

TRICARE Young Adult coverage meets or exceeds the minimum essential coverage conditions of the Affordable Care Act. This means that participants covered under this program are not subject to penalties, fines or taxes imposed on individuals for inadequate or nonexistent health care coverage. TRICARE Young Adult cost varies depending on the participant’s situation, but coverage is maintained through the payment of required monthly premiums.

What are the requirements for TRICARE Young Adult plans?

Through the TRICARE Young Adult program, if eligible, you can continue to receive TRICARE dependent coverage to age 26 (not yet 26 years of age) once you are no longer otherwise eligible for regular TRICARE. If you are an adult child of an eligible sponsor, then you may qualify for coverage under this program.

What is an “eligible sponsor?”

An eligible sponsor for qualifying TRICARE Young Adult recipients is defined by the terms explained below:

  • Active duty or retired service members
  • Activated members of the Guard and Reserve
  • Non-activated members of the Guard and Reserve who use TRICARE Reserve Select
  • Retired Guard and Reserve members who receive TRICARE Retired Reserve coverage
  • Former spouses service members who are registered under their own Social Security Number with the Defense Enrollment Eligibility Reporting System (DEERS), as long as they are not remarried

Do I qualify for TRICARE Young Adult enrollment?

Eligibility for TRICARE Young Adult coverage is dependent on the conditions described below. Young adults within the range of 21 to 25 years of age may qualify for TRICARE Young Adult enrollment if they are unmarried, not eligible for enrollment in a health plan offered by their own employer, the adult child of an eligible sponsor and not otherwise qualified for TRICARE coverage.

How much does a TRICARE Young Adult plan cost?

The cost of TRICARE Young Adult coverage varies by individual case. A participant’s cost for coverage depends on the following:

  • The military status of the individual’s eligible sponsor
  • Annual rate of monthly premium
  • Deductible
  • Where care is received

These variables determine the out-of-pocket cost for TRICARE Young Adult. The health care plan option also determines the cost of coverage, whether Prime or Select. In simple terms, TRICARE Young Adult Prime enrollment fees (monthly premiums) are set higher with no or low deductibles, while Young Adult Select plans feature significantly lower enrollment fees and varying deductibles.

Learn how to compare plans side by side by downloading our comprehensive guide.

How to Enroll in TRICARE Young Adult

If you qualify for coverage, then you can enroll in TRICARE Young Adult via one of four ways:

  • Online
  • By phone
  • By fax
  • By mail

What is TRICARE Young Adult Prime?

If you choose the TRICARE Young Adult Prime coverage option, then you will have a primary care manager (PCM) assigned to you. Your PCM will provide the majority of your care.

The Prime option is available to all young adult children of active duty eligible sponsors anywhere in the U.S. Additionally, overseas coverage is available to all command-sponsored participants. Young adult children of retired sponsors are only eligible for the Prime TRICARE Young Adult program in specific Prime service areas.

Note that despite all other eligibility requirements for the TRICARE young adult program, you are ineligible for Prime coverage if your sponsor uses TRICARE Reserve Select or TRICARE Retired Reserve.

How to End TRICARE Young Adult Coverage

TRICARE Young Adult Enrollment may end for a variety of reasons, whether voluntary or involuntary. You are no longer eligible for Young Adult or Young Adult Prime on your 26th birthday. If you wish to disenroll prior to this time, then you are subject to a one-year lock-out. You will also be disenrolled and incur a one-year lock-out from the TRICARE Young Adult program for failure to pay premiums. Other instances that will terminate TRICARE enrollment are listed below:

  • You get married
  • You become eligible for health care coverage through your employer
  • You become eligible for a different TRICARE plan
  • Your sponsor terminates or loses eligibility for coverage under TRICARE

Because you are only eligible for TRICARE dependent coverage to age 26, following disenrollment, if eligible, you can apply for the Continued Health Care Benefit Program (CHCBP). This program offers a segue between military health coverage benefits and civilian health coverage. CHCBP is available for up to 18 to 36 months (depending on sponsor category) following the loss of TRICARE coverage.

Applicants may not apply for CHCBP if they are currently locked out of the TRICARE program. Qualified applicants may apply for these benefits within 60 days of losing TRICARE eligibility. CHCBP meets Affordable Care Act essential coverage minimums. CHCBP is a premium-based plan that offers the same health coverage and prescription benefits as TRICARE Select.

For details on how to enroll in a TRICARE Young Adult plan, download our free guide.