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Health Care U: TRICARE coverage for college-bound children

VANDENBERG AIR FORCE BASE, Calif. --  The Centers for Disease Control and Prevention estimates that nearly 30 percent of college-age young adults have no health insurance. Fortunately for TRICARE-eligible families, full-time students remain covered up to their 23rd birthday. (Courtesy photo graphic)

VANDENBERG AIR FORCE BASE, Calif. -- The Centers for Disease Control and Prevention estimates that nearly 30 percent of college-age young adults have no health insurance. Fortunately for TRICARE-eligible families, full-time students remain covered up to their 23rd birthday. (Courtesy photo graphic)

VANDENBERG AIR FORCE BASE, Calif. -- College-bound dependents of active duty or retired service members can take comfort that their TRICARE coverage will make the journey with them, at home or away. For many students, this will be the first time away from home and may be the first time they have to manage their own health care decisions.

The Centers for Disease Control and Prevention estimates that nearly 30 percent of college-age young adults have no health insurance. Fortunately for TRICARE-eligible families, full-time students remain covered up to their 23rd birthday.

Coverage can extend past the 21st birthday
Dependents usually lose eligibility for TRICARE benefits at the age of 21. However, children attending college can extend their TRICARE benefits until age 23 if the following three conditions are met: 

· More than 50 percent of the student's financial support is provided by the sponsor
· The student remains enrolled full-time at an accredited institution
· Documentation for the above is provided to a uniformed services ID card-issuing facility prior to the child's 21st birthday.

Keep your child eligible
One important step to keeping your child eligible, no matter their age, is to make sure their address and personal information is always updated in the Defense Enrollment Eligibility Reporting System. An up-to-date record may help prevent delays or denials of claims if your child changes location. Your child should also have a valid uniformed service ID card that shows TRICARE eligibility. You can find information about updating DEERS and finding a local ID card-issuing facility at www.tricare.mil/deers.

Location, location, location
TRICARE-eligible children staying close to home can use TRICARE as usual. But if your child is moving away from home, the TRICARE program they had been using may not be available in their new location.

Eligible students can use TRICARE Prime benefits in TRICARE Prime Service Areas (usually near a military treatment facility or other designated areas). Students using TRICARE Prime will have a local primary care manager and will access their care through the PCM. TriWest Healthcare Alliance has information for those beneficiaries who move and might have questions about Prime availability, changing their PCM or updating their contact information online at www.triwest.com or by calling 1-888-TRIWEST (874-9378).

Outside of areas with Prime coverage, TRICARE Standard and Extra will be the only programs available for your child living away from home. Your student will be able to access care from TRICARE-authorized or network providers and is not required to enroll for Standard and Extra coverage. However, if your child previously had Prime coverage, he will have to disenroll from Prime (visit www.triwest.com to download a disenrollment form).

Don't pay two enrollment fees!
Split enrollment allows a student with Prime coverage to live in a different TRICARE region than their sponsor while the family pays only one annual Prime enrollment fee (if applicable). Contact the TRICARE contractor in your family's home region and the contractor in your child's new TRICARE region to set up the split enrollment.

On the road
When your child travels or returns home, TRICARE coverage follows. Students with Prime coverage will have to coordinate non-emergency care with the student's PCM. For long stays (over 30 days) outside of their home region, enrollment can easily be transferred over to the new regional contractor. Students with TRICARE Standard and Extra coverage will still be responsible for applicable deductibles, cost-shares and, in most cases, completing/filing the claim paperwork while out of their home region.

Other health insurance
TRICARE benefits pay second to any other health insurance (OHI), including student-specific health plans or employer-sponsored health insurance. Visit www.triwest.com for information on how to keep your OHI information current.

For students in, or moving out of TRICARE's 21-state West Region, TriWest has the information to help you manage your benefits at www.triwest.com. For tips on managing your overall health, visit the Healthy Living Portal at www.triwest.com.