How does tri-care work for retiree children?

Discussion in 'Off Topic' started by Pima, Dec 4, 2013.

  1. Pima

    Pima Parent

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    It just came to me that our DD will graduate in May, and she has been accepted to Grad school (fellowship). I know how it works while in college full time, but what about grad school directly after graduation?

    With the ACA does anyone know how this impacts retirees dependents. Typically they just show proof of enrollment and will be able to remain until they are 23, but she will turn 23 while in the fellowship program. She will graduate from grad school 3 months after turning 23. Will they continue to cover her?

    I haven't asked Bullet yet, because it just came into my mind today, and I was hoping someone else here knows how this gray shade of insurance works in case he doesn't. (DS1 went AF so it was not on our radar, and we assumed she would be going workforce, not fellowship) I am sure we could just pay for it via college, but I have also read that colleges are now dropping insurance programs due to ACA.

    Just curious if any retiree knows the path, if they allow it to be extended until she graduates?

    Not saying Bullet doesn't know, he probably does, but I also thought that any and all answers will help others too, especially ROTC parents and their children going casual status.
     
  2. LineInTheSand

    LineInTheSand USCGA 2006

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    You would be surprised about how little is known out there. They're very far behind on it too.


    My understanding (and I may be wrong, but I also know very few of us REALLY know anyway) is dependents are covered by parents policies until they are 26 provided they are students (why is that crazy, because in theory, someone still on their parent's insurance could run from the U.S. House of Representatives.... wow).

    I do think this is going to get much messier before it gets better.
     
  3. HMQ

    HMQ Member

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    I found the following on the U.S. Dept. of Labor website - apparently, adult children are covered up to the age of 26 no matter their student status:

    Q1: How does the Affordable Care Act help young adults?
    Before the President signed the Affordable Care Act into law, many health plans and issuers could remove adult children from their parents' policies because of their age, whether or not they were a student or where they lived. The Affordable Care Act requires plans and issuers that offer dependent coverage to make the coverage available until the adult child reaches the age of 26. Many parents and their children who worried about losing health insurance after they graduated from college no longer have to worry.

    Q2: What plans are required to extend dependent coverage up to age 26?
    The Affordable Care Act requires plans and issuers that offer dependent coverage to make the coverage available until a child reaches the age of 26. Both married and unmarried children qualify for this coverage. This rule applies to all plans in the individual market and to new employer plans. It also applies to existing employer plans unless the adult child has another offer of employer-based coverage (such as through his or her job). Beginning in 2014, children up to age 26 can stay on their parent's employer plan even if they have another offer of coverage through an employer.​
     
  4. Pima

    Pima Parent

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    I thought so too, but our friend's DS is no longer on tri-care, and he is 24.
    Caveat, even though he has not got his undergrad yet, but was always in college (long story...changed majors almost every yr), they were informed last April he was no longer covered.

    Hence, my post. She was the one that brought it up to me Monday night during a phone conversation. It had not crossed my mind before that because I assumed as a full time student she would be covered until she turned 24, but she reminded me that we were told 23 in school. Than after that I remembered Bullet every yr sends in paperwork to prove full time enrollment at the college. So is it 23 that day of the birth, or 23 and 364 days until their 24th birthday?

    Her military I.D. has an end date of her 22nd Birthday in Feb. It means we are looking at getting her paperwork in order not only for her ID, but also insurance. She will only be home for winter break, and if we have to get on top of it, we need to start addressing it now.

    I.E. No new military ID, if she gets injured or ill and needs medical coverage it may be an issue from an insurance reasons.

    I am not talking about shopping on base.

    OBTW, I agree it is going to get messier regarding ACA.
     
  5. kinnem

    kinnem Moderator

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    Pima, when I originally saw your first post I was going to mention that ACA allows coverage to 26. But I also seem to recall hearing or reading a story that this provision does not apply to active military and retirees, so you may need to look further. Her status as a grad student would be relevant as well and of course that may allow you to continue to insure her through tricare. Anyway, because of the ACA, how convoluted it is, and the story I mentioned, you might be best served just by getting on the phone to get the authoritative answer. Right now Health Care is sort of like AFROTC and AFA.... things change every year!

    Hope this is helpful and I haven't lead you on a wild goose chase, but I sure do remember that news story as I scratched my head saying "That makes no sense!".
     
  6. Pima

    Pima Parent

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    LMAO kinnem.

    Obviously you have never dealt with Tri-Care via phone....most people would have a root canal 1st over dealing with the paperwork.

    ~ A close friend; AF wife that followed DH around the world for 20 yrs, and was an Army brat just got denied a hip replacement via Tri-Care. She is too young according to them. OBTW they sent her to their specialist, which took 6 months of paperwork, and they were the ones to say she needed the operation.
    ~~~ The docs at 1st told her it had to be declined because it was done in Sept. (out of money) They re-submitted in Nov., after the shutdown and she was declined again.

    Welcome to what ACA will be like.

    Back on topic. I am sure the answer is out there, and Bullet may already know. Just putting this out there that the ACA can impact ROTC grads too.
     
  7. kinnem

    kinnem Moderator

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    You're right. Haven't dealt with tricare at all. Haven't had a root canal either. But have you met my wife? :rolleyes:

    Well, really just wanted you to know about the news story. I shouldn't have worried because I know you wouldn't have made any assumptions! :smile:
     
  8. HMQ

    HMQ Member

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    OK - back to my google-search, I found this on the TriCare website: http://www.tricare.mil/tya/

    TRICARE Young Adult is a plan that qualified adult children can purchase after eligibility for "regular" TRICARE coverage ends at age 21 (or 23 if enrolled in college, learn more).

    If purchased, TRICARE Young Adult is minimum essential coverage under the Affordable Care Act.

    Eligibility
    You may qualify to purchase TRICARE Young Adult if you're:

    •An unmarried, adult child of an eligible sponsorEligible sponsors include: active duty service members, retired service members, activated Guard/Reserve members, non-activated Guard/Reserve members using TRICARE Reserve Select, and retired Guard/Reserve members using TRICARE Retired Reserve..
    •At least age 21 but not yet 26 years old.
    ◦If enrolled in a full course of study at an approved institution of higher learning and your sponsor provides more than 50 percent of your financial support, your eligibility may not begin until age 23 or upon graduation, whichever comes first.
    •Not eligible to enroll in an employer-sponsored health plan based on your own employment
    •Not otherwise eligible for TRICARE coverage ​
     
  9. Pima

    Pima Parent

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    HMQ,

    Thanks for the info.

    I guess when Bullet gets home tonight, we need to discuss this issue from a fiscal perspective, AND Tri-Care. I.E. what exactly is 50% support. Fellowships pick up the tab for tuition and give a small stipend, not enough to cover rent, cell phone, car insurance, utilities AND anything else.

    Thus, what is 50% in their mind?

    Like I said Bullet and I will be discussing this, but I hope this thread also helps others in ROTC with ED options.
     
  10. kinnem

    kinnem Moderator

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    I assume (I know, shoot me) they are going off the IRS definition to determine if someone is your dependent. I'm pretty sure that would not include tuition and fees but check what the IRS says. Ought to be available online somewhere.
     
  11. kp2001

    kp2001 USMMA Alumnus

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    As far as I understand HMQ's post above is the info you need regarding the young adult option. I have no clue how they calculate the dependency status; however, as you are well aware you'd probably get 6 different answers if you asked 2 different representatives of TriCare.

    What is known is that she will absolutely lose her regular TriCare the day she turns 23. Make sure she gets a big set of refilled medicine right before if she's on any. I've seen some people have some issues with reimbursements etc as the plans switch over.
     

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