Jane Dotson
Military service is a qualifying event for insurance. A qualifying event for insurance is a change in life situation that makes a person eligible to enroll in health insurance outside of the annual Open Enrollment Period. Military service is a qualifying life event (QLE) that allows individuals to make changes to their Tricare insurance plans outside of the open season. Additionally, those who have served in the military may be eligible for VA health care benefits, Servicemembers' Group Life Insurance (SGLI), or the conversion of their SGLI coverage to a permanent, individual insurance policy.
| Characteristics | Values |
|---|---|
| Qualifying life events (QLEs) | Marriage, divorce, parenthood, death of a spouse, aging out of a parent's plan, becoming eligible for Medicaid, AmeriCorps VISTA members beginning or ending service, and returning from military service. |
| Enrollment period | A special enrollment period typically lasts 30-60 days before or after the qualifying event. |
| Documentation | Proof of prior coverage, birth certificate, adoption record, etc. |
| Military-specific insurance | Servicemembers' Group Life Insurance (SGLI) offers low-cost term coverage to eligible active-duty service members. |
| VA health care benefits eligibility | Former prisoners of war, recipients of the Purple Heart or Medal of Honor, those who qualify for Medicaid, those exposed to toxins or hazards during service, and those discharged for a disability or hardship are eligible for VA health care benefits. |
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What You'll Learn
Military service and health insurance
Military service can impact health insurance in several ways. Firstly, losing health insurance coverage due to returning from military service is considered a qualifying life event (QLE) that allows individuals to make changes to their health insurance plans outside of the annual Open Enrollment Period. This special enrollment period typically lasts 30 to 60 days before or after the qualifying event, during which individuals can enrol in a new insurance plan or change their existing coverage. It is important to note that short-term health insurance may not qualify as minimum essential coverage and may not cover all essential health benefits.
For those serving in the military, the Servicemembers' Group Life Insurance (SGLI) offers low-cost term coverage to eligible active-duty service members across various branches of the military, including the Army, Navy, Air Force, Space Force, Marines, and Coast Guard. Commissioned members of the National Oceanic and Atmospheric Administration (NOAA) or the U.S. Public Health Service (USPHS) and cadets or midshipmen of the U.S. military academies are also eligible. Enrolment in SGLI is automatic for those who qualify, and beneficiaries can be chosen or changed as needed. Additionally, SGLI provides options for part-time coverage for reserve members who don't qualify for full-time coverage.
Upon leaving the military, individuals have the option to convert their SGLI coverage to a permanent, individual insurance policy within 120 days of their discharge date, without needing to provide proof of good health. Moreover, in the case of total disability, free coverage can be extended for up to two years after leaving the military. For those who have served in the active military, naval, or air service and have not received a dishonorable discharge, VA health care benefits may be available. To qualify, individuals typically must have served 24 continuous months or the full period for which they were called to active duty. Exceptions to this minimum duty requirement include cases where individuals were discharged due to a disability incurred or aggravated by their active-duty service or due to hardship.
In addition to these benefits, military service members and their spouses are granted special protections under the Servicemembers Civil Relief Act. While the specific protections provided by this Act are not explicitly mentioned, it is important to understand how it may impact health insurance options and coverage for those with a military background. Overall, it is clear that military service can significantly influence an individual's health insurance options, and it is important to stay informed about the various benefits and protections available to ensure a smooth transition into post-military life.
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Qualifying life events for Tricare
TRICARE is a healthcare program for active-duty service members, their family members, retirees and their families, survivors, and certain former spouses worldwide. TRICARE is available worldwide, and your benefits remain the same no matter where you live.
During the annual TRICARE Open Season, you can enroll in or change your TRICARE Prime or TRICARE Select health plan. Outside of the open season, you can only make changes to your plan if you experience a Qualifying Life Event (QLE). A QLE is a significant life event or change in your situation or household that allows you to change your insurance plan or coverage outside of the open enrollment period. For TRICARE, QLEs include activating or deactivating for reserve or guard service.
If you experience a QLE, you must make any enrollment changes within 90 days of the event and pay any applicable fees or premiums. If you make the changes within this window, your new coverage will be effective from the date of the QLE. It is important to note that if one family member experiences a QLE, all eligible family members may change their enrollment status during the QLE period.
TRICARE plan options and costs vary, and you can use the TRICARE Compare Costs tool to view and compare costs for covered services, enrollment fees, and plan premiums. TRICARE also offers prescription drug coverage, and you can use the TRICARE Covered Services tool to see if a specific service or treatment is covered.
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Servicemembers' Group Life Insurance (SGLI)
To be eligible for full-time SGLI coverage, you must meet at least one of the following requirements:
- You are an active-duty member of the Army, Navy, Air Force, Space Force, Marines, or Coast Guard.
- You are a commissioned member of the National Oceanic and Atmospheric Administration (NOAA) or the U.S. Public Health Service (USPHS).
- You are a cadet or midshipman at one of the U.S. military academies.
- You are a member, cadet, or midshipman of the Reserve Officers Training Corps (ROTC) engaged in authorized training and practice cruises.
- You are a member of the Ready Reserve or National Guard, assigned to a unit, and scheduled to perform at least 12 periods of inactive training per year.
If you qualify for SGLI, you can choose your level of coverage or even decline coverage altogether. You can also select your beneficiaries, or the people who will receive the money from your life insurance policy if you pass away. You are allowed to update your beneficiaries as needed.
When you leave the military, you have the option to convert your SGLI coverage to a permanent, individual insurance policy within 120 days of your discharge date without proof of good health. You may be able to maintain your coverage for up to two years after leaving the military at no cost if you meet certain requirements, such as permanent loss of speech or the permanent loss of use of your hands, feet, or eyes. To apply for an extension in this scenario, you must fill out the SGLI Disability Extension Application (SGLV 8715) and send it to the OSGLI address.
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VA health care benefits eligibility
Military service is a qualifying event for insurance. Servicemembers' Group Life Insurance (SGLI) offers low-cost term coverage to eligible active-duty service members. When you leave the military, you have the option to convert your SGLI coverage to a permanent, individual insurance policy within 120 days from your date of discharge.
As for VA health care benefits eligibility, you may be eligible if you are a veteran who has served in the Vietnam War, Gulf War, Iraq, Afghanistan, or any other combat zone after 9/11. You may also qualify for enhanced eligibility status if you meet the minimum active-duty service and discharge requirements and at least one of the following descriptions is true for you:
- You receive financial compensation (payments) from the VA for a service-connected disability.
- You were discharged for a disability resulting from or worsened by something that happened to you in the line of duty.
- You are a combat veteran discharged or released on or after September 11, 2001.
Additionally, if you are separating from service due to a service-connected illness or injury, you may be eligible for VA health care benefits and certain TRICARE benefits. OEF/OIF/OND combat veterans who have recently returned from service can receive free medical care for any condition related to their service in Iraq or Afghanistan for 10 years after discharge.
In certain cases, dental care may also be included as part of your VA health benefits if you have an illness or injury that was caused or made worse by your active-duty service. As the family member or caregiver of a veteran, you may also qualify for VA health care benefits, compensation, or caregiver support programs.
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Short-term health insurance after military service
If you are transitioning from military service, you may be eligible for short-term health insurance. This type of insurance is designed to bridge gaps in coverage until you decide on a long-term healthcare solution. It is important to note that short-term health insurance does not qualify as minimum essential coverage under the Affordable Care Act and may not cover all Essential Health Benefits in your state. Signing up for this coverage may even result in a tax penalty.
Servicemembers' Group Life Insurance (SGLI)
If you are a service member who meets certain criteria, you will be automatically signed up for Servicemembers' Group Life Insurance (SGLI). SGLI offers low-cost term coverage to eligible service members. You may be eligible for full-time SGLI coverage if you meet at least one of the following requirements:
- You are an active-duty member of the Army, Navy, Air Force, Space Force, Marines, or Coast Guard.
- You are a commissioned member of the National Oceanic and Atmospheric Administration (NOAA) or the U.S. Public Health Service (USPHS).
- You are a cadet or midshipman of the U.S. military academies.
- You are a member, cadet, or midshipman of the Reserve Officers Training Corps (ROTC) engaged in authorized training and practice cruises.
- You are a member of the Ready Reserve or National Guard, assigned to a unit and scheduled to perform at least 12 periods of inactive training per year.
Transitional Assistance Management Program (TAMP)
If you are separating from service but not retiring, you may be eligible for transitional TRICARE coverage through the Transitional Assistance Management Program (TAMP). TAMP offers transitional health coverage to certain separating active-duty members and their eligible family members for up to 180 days. After TAMP eligibility expires, you or your family members may apply for temporary, transitional medical coverage under the Continued Health Care Benefit Program (CHCBP). CHCBP is a premium-based health care program providing medical coverage to a select group of former military beneficiaries.
Qualifying Life Events (QLEs)
Certain life events or changes in your situation may qualify you for a special enrollment period, allowing you to enroll in a new insurance plan or change your coverage outside of the annual open enrollment period. These Qualifying Life Events (QLEs) include activating or deactivating for reserve or guard service. If you experience a QLE, you must make any enrollment changes within a specific timeframe, usually 60 days after the date of the event. If you make the changes within this window, your new coverage will become effective on the date of the QLE.
Conversion of SGLI Coverage
When you leave the military, you have the option to convert your SGLI coverage to a permanent, individual insurance policy within 120 days from your date of discharge without proof of good health. You may also be able to keep your SGLI coverage for up to 2 years after leaving the military at no cost if you meet certain requirements, such as permanent loss of use of your hands, feet, or eyes.
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Frequently asked questions
Military service is a qualifying event for insurance. If you lose your health coverage after returning from military service, you can sign up for a new health insurance plan. You have up to 60 days to make health insurance changes.
A qualifying life event (QLE) is a change in life situation that makes a person eligible to enroll in health insurance outside of the annual Open Enrollment Period. Marriage, divorce, and parenthood are all common examples of QLEs.
Servicemembers’ Group Life Insurance (SGLI) offers low-cost term coverage to eligible active-duty service members. If you qualify for SGLI, you will be automatically signed up through your service branch.
The special enrollment period generally lasts 30-60 days before or after the qualifying event. You will need to provide certain documentation to become eligible, which must be submitted within 30 or 60 days, depending on the plan.
