Jeffrey Wade
If you are the spouse of a service member, you are eligible for TRICARE coverage. To purchase medical insurance for your spouse, they must first be enrolled in the Defense Enrollment Eligibility Reporting System (DEERS). You will need to present documents such as your marriage license, your spouse's birth certificate, Social Security card, and photo ID. Once your spouse is enrolled in DEERS, they will be eligible for TRICARE health plans and can also enroll in a separate dental plan.
| Characteristics | Values |
|---|---|
| Spouse's eligibility | Spouses of service members are eligible for Tricare coverage including active duty, reserve, and retired members |
| Documents required | Marriage license, spouse's birth certificate, Social Security card, and photo ID |
| Enrollment process | Enroll spouse in the Defense Enrollment Eligibility Reporting System (DEERS) at a local DOD or military ID card office |
| Timeline | Enroll within 90 days from the date of marriage |
| Plan options | TRICARE Prime, TRICARE Select, and dental plan |
| Pharmacy benefit | Spouses are eligible to receive prescribed medication through the Tricare Mail Order Pharmacy program or at network pharmacies |
| Cost | Health care costs are based on the sponsor's military status and the chosen health plan |
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What You'll Learn
- Spouse of a retiree: Enroll in Tricare within 90 days of marriage
- Spouse of an active duty, reserve, or retired member: Automatically eligible for Tricare
- Enrollment in the Defense Enrollment Eligibility Reporting System (DEERS)
- Choosing a Tricare plan: Prime or Select
- Dental and vision insurance: Available for purchase separately
Spouse of a retiree: Enroll in Tricare within 90 days of marriage
If you're the spouse of a retiree, it's important to get your spouse's military benefits, including TRICARE, set up as soon as possible. You need to enroll in a TRICARE plan within 90 days from the date of your marriage. This applies whether you live stateside or overseas.
Firstly, your sponsor (spouse) must register you in the Defense Enrollment Eligibility Reporting System (DEERS). You will then be issued with a new "dependent" ID card. This ID card can be used as proof of Tricare enrollment. To enroll in DEERS, you will need to present documents such as your marriage license, birth certificate, Social Security card, and photo ID. You can make an appointment at your local DOD or military ID card office to do this.
Once you are enrolled in DEERS, you are eligible for TRICARE. Your health plan options are based on your spouse's military status. TRICARE covers most inpatient and outpatient care that is deemed medically necessary, i.e., it is appropriate, reasonable, and adequate for your condition. It also provides a pharmacy benefit, allowing spouses to receive prescribed medication through the Tricare Mail Order Pharmacy program or at network pharmacies.
You may also be eligible for dental coverage through the Federal Employees Dental and Vision Insurance Program (FEDVIP). Your healthcare costs are based on your spouse's status (active duty or retired) and which health plan option you choose. The two most common plans are PRIME and Select. TRICARE Prime provides fewer options for selecting your Primary Care Manager, but has no copays or enrollment fees so it is generally less expensive. TRICARE Select has more options but requires copays for treatment, so it is a higher-cost option.
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Spouse of an active duty, reserve, or retired member: Automatically eligible for Tricare
If you are the spouse of an active-duty, reserve, or retired member of the military, you are automatically eligible for Tricare coverage. To ensure coverage, you need to be enrolled in the Defense Enrollment Eligibility Reporting System (DEERS) as your spouse's dependent. You can do this by presenting the necessary documents, including your marriage license, birth certificate, Social Security card, and photo ID, at your local DOD or military ID card office. It is recommended that you do this as soon as possible after receiving your marriage license to ensure you have access to Tricare and other military benefits.
Once you are enrolled in DEERS, you will receive a new "dependent" ID card, which can be used as proof of Tricare enrollment. Your health plan options under Tricare will depend on your spouse's military status and where you live. The two most common plans are PRIME and Select. Tricare Prime provides fewer options for selecting your Primary Care Manager, but it has no copays or enrollment fees, so it is generally less expensive. Tricare Select offers more options for choosing your Primary Care Manager but requires copays for treatment, so you get more choice at a higher cost.
As a spouse covered by Tricare, you are also eligible to receive prescribed medication through the Tricare Mail Order Pharmacy program or at network pharmacies. Additionally, Tricare offers a separate dental plan that you can purchase. If you are retired, you and your family members may qualify to purchase dental coverage through the Federal Employees Dental and Vision Insurance Program (FEDVIP).
It is important to note that if your spouse changes their name after marriage, you must update DEERS and receive a new military ID card to avoid billing and access-to-care issues.
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Enrollment in the Defense Enrollment Eligibility Reporting System (DEERS)
To enroll your spouse in DEERS, you need to present certain documents, including your marriage license, your spouse's birth certificate, Social Security card, and photo ID. You can make an appointment at your local DOD or military ID card office to initiate the enrollment process, which is typically done when obtaining a military ID card. It is recommended that you enroll your spouse in DEERS as soon as possible after receiving your marriage license to ensure they have timely access to TRICARE and other military benefits.
If your spouse decides to change their name after marriage, it is important to update DEERS with their new name and obtain a new military ID card. This update should be reflected across the TRICARE/DEERS and benefits systems. Similarly, any changes in your life circumstances, such as marriage, birth, divorce, or death, must be reported to DEERS to maintain accurate records and ensure continued eligibility for benefits.
DEERS enrollment is not limited to spouses; you can also add your children as dependents in DEERS, making them eligible for TRICARE as well. It is important to keep your DEERS information up-to-date to avoid issues with claims, authorization letters, and the delivery of prescriptions.
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Choosing a Tricare plan: Prime or Select
To purchase medical insurance for your spouse through Tricare, you must first ensure that your spouse is enrolled in the Defense Enrollment Eligibility Reporting System (DEERS). This is a prerequisite to accessing Tricare and other military benefits. To enrol your spouse in DEERS, you will need to present documents, including your marriage license, your spouse's birth certificate, Social Security card, and photo ID. This can be done by making an appointment at your local DOD or military ID card office. Once enrolled, your spouse will receive a "dependent" ID card, which serves as proof of Tricare enrollment.
Now, choosing a Tricare plan depends on your specific needs and preferences. The two most common plans are Prime and Select. Here's a detailed comparison to help you decide:
Tricare Prime:
Tricare Prime is a managed care option available in specific Prime Service Areas, which are geographic areas in the US. Active duty service members must enrol in a Tricare Prime option. Tricare Prime provides fewer options for selecting a Primary Care Manager (PCM). However, it has no copays or enrolment fees, making it generally less expensive. Prime Service Areas are built around Base Realignment and Closure sites, enhancing the medical readiness of active-duty personnel.
Tricare Select:
Tricare Select offers more flexibility in choosing your PCM but comes with copays for treatment. This means you have more choice but at a higher cost. With Tricare Select, you have the option to select your PCM from the list on the Tricare website and enrol as a patient. While Select may offer more initial choices, it is important to remember that you can switch plans once a year if needed.
When deciding between Tricare Prime and Select, consider your location, healthcare needs, and budget. Compare the features of each plan, and remember that you can switch plans annually if your circumstances or preferences change.
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Dental and vision insurance: Available for purchase separately
If you are a spouse of an active-duty, reserve, or retired member of the military, you are eligible for TRICARE coverage. To access this benefit, you must first be enrolled in the Defense Enrollment Eligibility Reporting System (DEERS) as your spouse's dependent. You can do this by presenting documents such as your marriage license, birth certificate, Social Security card, and photo ID at your local DOD or military ID card office. Once enrolled, you will receive a "'dependent' ID card" and gain access to TRICARE and other military benefits.
Dental and vision insurance are available for purchase separately through the Federal Employees Dental and Vision Insurance Program (FEDVIP). Dental coverage through TRICARE requires special enrollment and is currently administered by United Concordia for active-duty family members and Guard and Reserve members and their families. The minimum enrollment period is 12 months, after which coverage can be continued on a month-to-month basis. Orthodontic coverage is also offered, with a lifetime maximum coverage of $1,750 per person. For orthodontics, you will pay 50% out of pocket, with the other half covered by the plan.
Vision benefits under TRICARE are limited and depend on your type of coverage. Medically necessary vision benefits are available under all TRICARE plans. FEDVIP, offered to retirees and active-duty family members, is an optional enrollee-pay-all dental and vision insurance program. Monthly rates for vision coverage through FEDVIP range from $6 to $15 for self-coverage and $20 to $32 for self and multiple family members.
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Frequently asked questions
To purchase medical insurance for your spouse through Tricare, you must first ensure that your spouse is enrolled in the Defense Enrollment Eligibility Reporting System (DEERS). To do this, you will need to present documents such as your marriage license, your spouse's birth certificate, Social Security card, and photo ID. Once your spouse is enrolled in DEERS, they will be eligible for Tricare coverage. You can then select a Tricare plan that best meets your needs and enroll your spouse in that plan.
You will need to provide your marriage license, your spouse's birth certificate, their Social Security card, and a photo ID.
You can enrol your spouse in DEERS at any ID card-issuing office, such as your local DOD or military ID card office.
The Tricare plan you choose for your spouse will depend on your specific needs and circumstances. Factors to consider include your spouse's military status, where you live, and your budget. Tricare Prime, for example, provides fewer options for selecting a Primary Care Manager but has no copays or enrollment fees, while Tricare Select offers more choices at a higher cost.
