Military Retirement and TRICARE

Joe Wallace

The transition from active duty to retirement marks one of the most important milestones in your military career. It affects your income, your education benefit options, and your healthcare. Those enrolled in TRICARE when they “drop papers” for retirement should know that healthcare changes are common as well. Do you know how to prepare?

Military Retirement and TRICARE

The retiree must keep all family information in the DEERS database accurate to prevent a loss of coverage for dependents. This includes keeping DEERS updated after a move, a marriage, or a divorce. If a child reaches age 21 and attends college, the retiree must provide proof of enrollment to the system. Failure to maintain these records can result in denied claims or the termination of benefits for family members.

Military Retirement is a TRICARE Qualifying Life Event

Military retirement acts as a Qualifying Life Event. That means the previous TRICARE coverage plan ends on the final day of service and requires the member to select a new plan within a specific timeframe.

If you don’t understand the differences between available programs like TRICARE Prime and TRICARE Select, as well as the unique requirements for National Guard and Reserve members, you’ll want to review the information below for essential steps to get the right healthcare benefits.

Timeline for a Military Retiree to Enroll in a New TRICARE Plan

A retiree must enroll in a new TRICARE health plan within 90 days of their retirement date. This 90-day window starts on the day the member leaves active duty. Failure to act within this timeframe results in a total loss of coverage. If a member misses this deadline, they must wait until the next annual open enrollment season to regain coverage.

Update your information in the Defense Enrollment Eligibility Reporting System (DEERS). The record must show the member is officially retired before the system allows the selection of a retiree health plan. This update can be done at a personnel office or through the milConnect website.

Primary differences between TRICARE Prime and TRICARE Select

TRICARE Prime functions like a Health Maintenance Organization. It requires a primary care manager and involves annual or quarterly enrollment fees and small copayments.

TRICARE Select operates more like a Preferred Provider Organization. Select allows the member to choose their own doctors from an approved list, does not require referrals, but does have an annual deductible and a higher percentage of care costs.

TRICARE For Retired Guard and Reserve Members

National Guard and Reserve members who retire before age 60 are considered gray-area retirees and may not immediately qualify for standard TRICARE retiree health care. They can purchase TRICARE Retired Reserve by paying the full monthly premium. Once a member reaches age 60, they become eligible for regular retiree benefits and can move to a Prime or Select plan.

A retiree must take specific steps upon reaching age 65 to retain their military benefits. The member must enroll in Medicare Part A and Medicare Part B. Once enrolled, the military coverage transitions to TRICARE For Life. This plan acts as a secondary payer to Medicare and covers many costs that Medicare does not. The member must continue to pay the Medicare Part B premium to remain eligible.

Costs for TRICARE Group A, Group B

The military determines enrollment fees and out-of-pocket costs based on when the member first entered the service. Retirees are divided into Group A and Group B. Group A includes those who joined the military before 2018. Group B includes those who joined in 2018 or later. Members in Group B generally pay higher enrollment fees and higher medical service costs than those in Group A.

Dental and Vision Benefits for Military Retirees

Standard retiree health plans do not include dental or vision coverage. Enrollees must purchase these benefits separately through the Federal Employees Dental and Vision Insurance Program, which is managed by the Office of Personnel Management.

This program allows military retirees to choose from a list of private insurance providers. Enrollment for these supplemental benefits usually occurs during the annual Federal Benefits Open Season for active duty, National Guard, and Reserve members.