TRICARE Health Coverage Options for Young Adults
Falls Church, VA, June 3, 2021 - Is your child graduating from college this year? Or, are they a recent graduate? This is typically a time of transitions, whether to a new job, home, or city. It’s also a time for many new graduates to transition to their own independent health care coverage. If your child is one of them, TRICARE Young Adult (TYA) is one of several health care coverage options that may fit their needs.
“Recent graduates and young adults have lots of options for finding health coverage,” said Debra Fisher, program analyst with the Policy and Programs Section of the TRICARE Health Plan at the Defense Health Agency.” It’s important to explore all of the different ways you can get health coverage so you don’t experience a gap in coverage. One option you may have to maintain health coverage is TRICARE Young Adult.”
TYA coverage isn’t automatic. If your child is graduating college or aging out of regular TRICARE, here are some key things to know about TRICARE Young Adult.
What is TRICARE Young Adult?
TYA is a premium-based health care plan that qualified young adults can purchase after eligibility for regular TRICARE coverage ends at age 21 (or 23 if enrolled in college). TYA is only available for individuals and isn’t offered as a family plan. When you enroll, you can choose either TRICARE Prime (in certain areas) or TRICARE Select coverage. If you live in a US Family Health Plan (USFHP) service area and are qualified, you can choose to enroll in USFHP for your TYA Prime option. How you get care depends on which option you choose.
As stated in the TRICARE Young Adult Fact Sheet, TYA coverage includes medical and pharmacy benefits. However, it doesn’t include dental and vision coverage. You must pay monthly premiums for TYA, as well as associated costs for care. To see current TYA costs, visit the TRICARE Compare Cost Tool.
Who qualifies for TRICARE Young Adult?
Your child may qualify to purchase TYA if they meet the following criteria:
Unmarried, adult child of an eligible uniformed service sponsor
At least age 21 (age 23 if a full-time student) but not yet age 26
Ineligible to enroll in their own employer-sponsored health plan
Ineligible for other TRICARE program coverage
Isn’t a member of the uniformed services
How does a child enroll in TRICARE Young Adult?
“You must show as eligible in the Defense Enrollment Eligibility Reporting System (DEERS) to enroll in TYA,” as described in the TRICARE Young Adult Fact Sheet. If you qualify, you may purchase TYA coverage at any time. Unlike TRICARE Prime and TRICARE Select plans, TRICARE Open Season doesn’t apply to TYA.
What if you’re child isn’t already registered in DEERS? You must add your child to the system. Once your child shows as eligible in DEERS, you can purchase TYA online, by phone, by fax, or through the mail. If you enroll by fax or mail, download the TRICARE Young Adult Application (DD Form 2947) and submit it to your regional contractor. Your completed application must include the first two months of premium payments. After you get confirmation that your application processed, your child must obtain a new ID card at an ID card office.
With TYA, you can end your coverage at any time. There are also certain changes in status that will no longer make you eligible to continue with TYA. For example, if your young adult gets married or becomes eligible for employer-sponsored health coverage, their TYA coverage ends.
“The sponsor should keep all information updated in DEERS whenever there’s a change in family or military status,” said Fisher.
If your child doesn’t purchase TYA or is no longer eligible, another option they may qualify for is the Continued Health Care Benefit Program. This health plan provides temporary health coverage for 18-36 months after losing TRICARE. You can also search other health plan options available for young adults through the Health Insurance Marketplace.
Keep in mind, when children become an adult it’s a TRICARE Qualifying Life Event (QLE). A QLE may mean different TRICARE health plan options are available to you and your family members. If you want to make a change to your TRICARE health plan, you must make eligible enrollment changes within 90 days of the date of the QLE. You can learn more about QLEs by downloading the TRICARE Qualifying Life Events Fact Sheet.
Your child should review all of their health plan options, including military and commercial, before deciding if TYA is the right plan for them. Download the TRICARE Young Adult Fact Sheet to learn more about TYA eligibility, enrollment, and costs. If you have a young adult, help them take command of their health and coverage.