WASHINGTON, Jan. 14, 2011 -- To ensure military families don't get left out as the new national health care reform law extends parent's health insurance to their children up to age 26, TRICARE plans to roll out its new Young Adult Program by spring, and to provide an option to make coverage retroactive to Jan. 1.
The new program will allow qualified, unmarried military children up to age 26 to buy health care coverage under their parents' TRICARE plans through age 26, defense officials announced yesterday. That's up from the current maximum age of 21, or 23 for full-time college students whose parents provide more than half their financial support.
The Fiscal Year 2011 National Defense Authorization Act President Barack Obama signed Jan. 7, gave the Defense Department the authority it needed to extend TRICARE coverage to young adults, TRICARE spokesman Austin Camacho explained. This ensures benefits extended under TRICARE are in line with those all American families receive under the Patient Protection and Affordable Care Act that took effect in March.
"We've been working hard to make sure we could put TRICARE Young Adult on a fast track," said Navy Rear Adm. (Dr.) Christine Hunter, who heads the TRICARE Management Activity. "Fortunately for our beneficiaries concerned about health care coverage for their adult children, the law signed by the president includes opportunities for military families to elect this new premium-based plan retroactive to Jan. 1."
Qualified young adults who don't have access to employer-sponsored health care coverage will be eligible to purchase it through TRICARE on a month-to-month basis, Camacho said.
Details about how much those premiums will cost under the new program still are being finalized. But because the 2011 defense authorization specifies that the rates must cover all program costs, Camacho said, premiums will be based on commercial insurance data about the costs of providing care.
Once the new program is in place, Hunter estimated that it could extend TRICARE coverage to several hundred thousand additional beneficiaries.
"The premium allows us to provide the excellent benefit to our military families while responsibly addressing the impact of health care costs on the DoD budget," she said.
Meanwhile, the TRICARE staff has moved into overdrive to iron out the program details: determining eligibility and coverage criteria and costs; designing, testing and implementing the required software and systems changes; updating eligibility databases; and crafting education efforts, Camacho said.
Officials plan to roll out the new program in two phases, first offering a premium-based TRICARE Standard/Extra benefit, Camacho said. Then, later this year, they plan to introduce the TRICARE Prime and TRICARE Prime Remote plan, including overseas options, and the Uniformed Services Family Health Plan.
Once the program is in place, eligible young adults may submit an application and premium payment to the appropriate regional or overseas contractor for processing, Camacho said. Cost shares, deductibles and catastrophic caps will vary, based on the plan selected and the sponsor's status.
Young adult beneficiaries will receive an enrollment card after they buy coverage, and their payment is reflected in the Defense Eligibility Enrollment Reporting System, Camacho said.
The new beneficiaries may choose to pay premiums back to Jan. 1, which will entitle them to file claims for any health care costs they have accrued since that date. To do so, officials advise that they save all receipts to ease claims processing.
For adults who need health insurance coverage but no longer qualify for TRICARE coverage, officials advise exploring the Continued Heath Care Benefit Program. This premium-based program offers temporary, transitional health coverage for 18 to 36 months. Coverage must be purchased within 60 days of losing TRICARE eligibility. Information about the program is posted on the TRICARE website.