What Happens to TRICARE After a Military Divorce?

Start with two dates: when the marriage legally ends and when each person’s existing health coverage ends. If you expect to qualify for former-spouse TRICARE, verify that status before relying on it. If you expect to lose eligibility, compare replacement coverage while there is still time to enroll.

Can I keep using my military ID after the divorce?

Check eligibility through the Defense Enrollment Eligibility Reporting System (DEERS) and the appropriate ID card office. TRICARE says eligibility generally ends on the divorce date unless you meet former-spouse criteria. Report the divorce promptly. An ID card that has yet to expire can give a misleading impression, and TRICARE may seek repayment for claims paid during a period of ineligibility. TRICARE’s divorce eligibility guidance

How much time do I have to buy continuation coverage?

The Continued Health Care Benefit Program (CHCBP) offers premium-based continuation coverage for eligible people. TRICARE gives applicants 60 days from the loss of TRICARE eligibility to purchase coverage. Its application guidance lists DD Form 2837, evidence of eligibility, the initial quarterly premium, and a copy of the final decree for unremarried former spouses. Compare premiums, providers, prescriptions, and effective dates with employer coverage or a marketplace plan. TRICARE’s CHCBP enrollment instructions

What happens to my children’s coverage?

Verify each child separately. A sponsor’s eligible biological and adopted children generally retain eligibility following divorce. A stepchild whom the sponsor has not adopted can lose eligibility at divorce. TRICARE also gives the sponsor and eligible children a 90-day window to make qualifying plan changes after divorce. Calendar that window separately from any CHCBP deadline. TRICARE’s guidance for children and former spouses

What belongs in the settlement discussion?

Write down the projected coverage end date, the cost and start date of replacement insurance, and any care that could be interrupted. If one parent will arrange a child’s coverage, discuss who will handle enrollment and share the information needed to use it. For a spouse in ongoing treatment, compare the actual provider network and prescription coverage before valuing a proposed contribution toward premiums.

A California settlement can address financial responsibility for coverage. Eligibility itself is determined under the federal program. Related draft on the 20/20/20 and 20/20/15 rules

Which dates should go on my calendar?

Put the effective date of dissolution, the verified end date of coverage for each person, and each replacement plan’s enrollment deadline on one page. The day you sign a settlement can differ from the day your marital status ends. If the court ends marital status while leaving financial issues open, confirm the date in the entered order and plan for insurance before that date arrives.

Give each child a separate line. A parent may need replacement insurance while a child continues on the sponsor’s plan. Record which parent will handle enrollment, where the child will receive care, and how the other parent will obtain the insurance information needed for an appointment.

What if I expect to qualify as a former spouse?

Ask the appropriate ID card office what it needs to establish your status. TRICARE identifies a marriage certificate, a divorce decree, and proof of the member’s service as documents used in that determination. Confirm which service records the office will accept, especially if the member served in different components or you lack the complete service history. Ask how to obtain a corrected record if an agency has the wrong date. TRICARE’s guidance on establishing eligibility

If you expect transitional former-spouse coverage, ask for both the start and end dates. That answer determines when to shop for replacement coverage. Keep the eligibility decision with the decree and any confirmation of your enrollment. If you later need to challenge a denied claim, those documents help establish what coverage was supposed to be in effect on the date of care.

How do I compare CHCBP with other coverage?

Start with the cost of the first quarter, then compare the deductible, the cost of a typical appointment, and the cost of your regular prescriptions. Ask whether your existing doctors participate and whether a scheduled procedure needs a new authorization. Confirm the effective date with each plan. A lower monthly premium can be outweighed by a provider change or a gap in coverage. TRICARE’s CHCBP costs

TRICARE lists up to 36 months of CHCBP coverage for eligible unremarried former spouses and identifies circumstances in which coverage may last longer. Ask the administrator to confirm your eligibility and expected duration. Set a reminder well before the coverage ends so you have time to compare the next set of options. TRICARE’s CHCBP eligibility and coverage periods

What if I have treatment scheduled around the divorce date?

Suppose your decree will take effect two weeks before a scheduled infusion. Ask your current insurer and the prospective replacement insurer about coverage on the treatment date. Ask the provider whether it participates in the new plan and who will submit any authorization. Keep a record of the answers so your attorney can use actual costs and timing when negotiating responsibility for premiums or uncovered bills.

If the settlement provides for reimbursement, specify the expenses covered, how proof will be exchanged, and when payment is due. That gives each spouse a way to budget and gives the person arranging treatment a clear process for getting the bill paid.

Edgar & Dow can help you evaluate the California family law issues and prepare for the next decision. Contact Edgar & Dow to schedule a consultation.

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