Divorce can bring significant life changes, and among the immediate concerns is healthcare coverage, especially for those who have been receiving benefits through a spouse’s TRICARE program. Understanding what happens to your TRICARE benefits after divorce is crucial for planning your future healthcare. This article clarifies the TRICARE options available to former spouses, ensuring you are informed about your eligibility and choices.
TRICARE Eligibility for Former Spouses: Key Criteria
Generally, divorce means the end of TRICARE coverage for a former spouse. However, TRICARE provides for continued coverage under specific conditions, primarily based on the duration of the marriage and the military service of the sponsor. It’s important to note that your sponsor’s military service component is the authority that determines your eligibility. Until a divorce is finalized, separation or living apart does not impact your TRICARE benefits.
Once a divorce is final, it’s essential for the military sponsor to update the Defense Enrollment Eligibility System (DEERS) with a certified copy of the divorce decree at a local ID card office. This update is a necessary administrative step following a divorce.
Certificate of divorce
The 20/20/20 Rule: Lifetime TRICARE Benefits
The most comprehensive benefit for former spouses is under the 20/20/20 rule. This rule allows for continued TRICARE benefits indefinitely if you meet all three of the following conditions:
- 20 Years of Marriage: You were married to the service member for a minimum of 20 years.
- 20 Years of Service: The service member served at least 20 years of creditable service in the armed forces.
- 20 Year Overlap: There was an overlap of at least 20 years between the marriage and the military service.
If you satisfy the 20/20/20 rule, you are entitled to TRICARE coverage as long as you remain eligible, essentially mirroring the benefits of a retired military family member.
The 20/20/15 Rule: Transitional TRICARE Benefits
For those who almost meet the 20/20/20 criteria, the 20/20/15 rule offers a transitional safety net. Under this rule, you can maintain TRICARE benefits for one year from the date of divorce if you meet these conditions:
- 20 Years of Marriage: You were married to the service member for at least 20 years.
- 20 Years of Service: The service member served at least 20 years of creditable service.
- 15 Year Overlap: The marriage and military service overlapped for at least 15 years.
This one-year period provides a window to secure alternative health coverage while still benefiting from TRICARE.
Establishing Continued Eligibility and Benefits
If you meet either the 20/20/20 or 20/20/15 rule, you will need to take action to establish your continued eligibility. Visit a local ID card office and bring the following documents:
- Your marriage certificate
- The divorce decree
- Proof of service for your former spouse (DD Form 214 or Statement of Service from the relevant Service Personnel Component)
Upon verification, you will be registered in DEERS under your own Social Security number or Department of Defense Benefits Number, not under your former spouse’s. As a qualifying former spouse, your TRICARE health plan options will be similar to those available to retired family members, depending on your location. It’s important to remember that remarrying or enrolling in an employer-sponsored health plan will terminate your TRICARE benefits as a former spouse.
Healthcare Options If You Don’t Qualify for Continued TRICARE
If you do not meet the criteria for continued TRICARE eligibility under the 20/20/20 or 20/20/15 rules, your TRICARE benefits will end on the day your divorce is finalized. However, you still have several healthcare options to consider:
- Continued Health Care Benefit Program (CHCBP): You can purchase temporary health coverage through CHCBP. Applications must be made within 60 days of the divorce. Note that CHCBP is not available if your former spouse served in NATO or Partners for Peace. Certain former spouses who remain unmarried before age 55 might be eligible for extended CHCBP coverage.
- Health Insurance Marketplace: Explore civilian health plans through the Health Insurance Marketplace (healthcare.gov). You may also check your eligibility for Medicaid in your state.
- Employer, School, or University Coverage: Investigate health coverage options that may be available through your employer, school, or university.
Children’s TRICARE Eligibility After Divorce
It’s worth briefly noting that divorce does not affect the TRICARE eligibility of the sponsor’s biological or adopted children. They remain eligible until age 21 (or 23 if in college), marriage, or active duty service. TRICARE Young Adult is also an option for children up to age 26 who are no longer eligible due to age. Stepchildren, unless adopted by the sponsor, lose TRICARE eligibility upon divorce.
Conclusion: Navigating Your TRICARE Options Post-Divorce
Divorce is a challenging life event, and understanding your healthcare options is a critical step in transitioning forward. While TRICARE benefits for former spouses are contingent on specific rules, options like CHCBP and the Health Insurance Marketplace ensure that healthcare coverage remains accessible. By understanding “what TRICARE program does an ex-spouse have,” and exploring all available avenues, you can make informed decisions about your healthcare needs after divorce. For detailed information and personalized guidance, always refer to the official TRICARE website and resources.
