This blog is the most recent in a series helping members of the Coast Guard family understand how to use their TRICARE benefits. The blog series will continue every Monday, right here on Coast Guard All Hands.
Written by Cmdr. Paul Fawcett
Who is eligible?
Spouses of active duty, reserve and retired members are eligible for TRICARE coverage. Dependents of active and retired members are automatically covered as soon as they are enrolled to DEERs, spouses of reserve members must purchase TRICARE Reserve Select if they want TRICARE coverage. You can get more information about that plan on the TRICARE website. Same sex spouses are also covered by TRICARE once they are enrolled to DEERs. Eligibility for TRICARE coverage ends when a spouse becomes divorced from their eligible sponsor or when a spouse of a deceased member remarries. Common law couples or cohabitating partners are not eligible for TRICARE coverage.
How do I enroll my Spouse in TRICARE?
You’ll first need to ensure that your spouse is enrolled in the Defense Enrollment Eligibility Reporting System (DEERS). To do that you’ll need to present documents including; your marriage license, your spouse’s birth certificate, Social Security card and photo ID. You can do this by making an appointment at your local DOD or Coast Guard military ID card office. The enrollment in DEERS is part of the military ID card issuance process. Dependent IDs can be used as proof of TRICARE enrollment. It is recommend that you enroll 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.
What plan should I choose and how do I select it?
The two most common plans are PRIME and Standard. TRICARE Prime provides fewer options to select your Primary Care Manager, but has no copays or enrollment fees so it is generally less expensive. The provider will fill in all claims for you; therefore, you should have limited paperwork. TRICARE Standard has more options to choose from for your Primary Care Manager, but does require copays for treatment; more choice at higher cost. Once you decide what plan you want, you can make your selection on web beneficiary enrollment. You can then select your Primary Care Manager from the List on the TRICARE website and enroll as a patient. You may change your mind and switch plans if you wish, but you may only do so once a year.
Q: My spouse didn’t change his/her name when we married but is doing so now. Should we update TRICARE?
A: Yes, to avoid billing and access to care issues you should update DEERS with your spouse’s new name and receive a new military ID card. That should replicate all changes throughout the TRICARE/DEERS and benefits systems.
Q: My new spouse has children from a previous relationship. Are they eligible for TRICARE coverage?
A: Yes, stepchildren are eligible as long as the parents of the children and military sponsor are married.
Q: My new spouse and I are TRICARE beneficiaries on our own (dual military couples or dual retiree couples), do we need to do anything?
A: No, your coverage remains the same. If one member changed his/her name you must update DEERS and receive a new military ID card.
Q: Do spouses receive a pharmacy benefit?
A: Yes. Spouses are eligible to receive prescribed medication through the TRICARE Mail Order Pharmacy program or at network pharmacies. Visit the TRICARE pharmacy page for more information.
If you have TRICARE questions or need assistance in enrolling, you can call the Coast Guard health benefits assistance line at 1-800-9-HBA-HBA or email us at CGHBA@uscg.mil.
Have more questions about your TRICARE benefits? Leave a note in the comments below.