TRICARE is a health care program that caters to military service members and their families. There are two types of recipients: the service members, which are known as “sponsors,” and their family members. All beneficiaries must register for the program through the Defense Enrollment Eligibility Reporting System (DEERS) to verify eligibility. In some cases, sponsors and their families may lose eligibility for the TRICARE program and need to find an alternative health care program. Reasons for loss of TRICARE eligibility include reaching the maximum age limit, remarrying and having inaccurate information in the DEERS system.
If you no longer qualify for the program, there are numerous alternative options available. Your medical eligibility for other programs will depend greatly on your income, medical status and relationship to the service member. For instance, the Spina Bifida Health Care Benefits Program (SBHCBP) only serves a specific community of veterans. However, the Department of Veterans Affairs (VA) offers a health care program with more expansive eligibility requirements. To find out how to get cheap insurance, review the sections below.
There are several reasons why you may lose medical eligibility for the TRICARE program. One of the most common causes of disqualifications is the sponsor’s separation from active duty. TRICARE only provides medical coverage to active duty service members and their families. Sponsors and their families have 90 days to find an alternative health insurance plan from the date of separation. TRICARE recipients who have Medicare part A must purchase part B once they are eligible. If they do not, they may lose eligibility from the TRICARE program. Additional reasons for disqualification include:
CHAMPVA is a federal health insurance program for family members of service members who have a permanent disability as a direct result of service. The program is a subset of the U.S. Department of Veterans Affairs (VA). To qualify for CHAMPVA insurance, applicants must be ineligible for TRICARE and meet one of the following requirements:
CHAMPVA providers offer numerous covered services to eligible policyholders. This includes ambulance service, transplants, hospice and mental health services. The CHAMPVA application process involves filling out the application and certification form as well as proof of Medicare status. Once that step is complete, applicants must submit the required documents to the CHAMPVA Eligibility Unit in Denver, Colorado. The application form requires applicants to provide personal information, such as Social Security number (SSN), address and date of birth. It can take up to eight months to start CHAMPVA coverage, depending on the materials you submit.
The Department of Veteran Affairs’ health care program offers a medical benefits package with numerous covered services to qualified service members. Applicants must have been honorably discharged for active duty to qualify for VA health care. Specific conditions apply in the following cases:
To apply for VA health insurance, you must create an account on the VA’s online portal. From there, you can start an application and submit it online. The application process will entail submitting personal information, such as your Social Security number (SSN), a copy of your military discharge paper and your most recent tax returns. If you need help filling out your form, the department has veterans service officers who are qualified to help applicants complete the form. After completing the application, you should hear from a representative within a week. If not, you may call the department for an update on your case.
VA medical benefits include routine eye exams and preventative tests for vision, dental, physical and mental care. The VA health insurance cost varies depending on the veterans’ household income and the result of the financial assessment during the enrollment process.
The SBHCBP is another subset of the VA health care program, which provides medical assistance to qualified individuals of Korean and Vietnamese descent. To meet the medical eligibility requirements for this program, you must have spina bifida (SB) and be the birth child of a veteran or the Vietnam War or Korean War. The only type of SB that does not qualify is spina bifida occulta. The SBHCBP’s purpose is to offer health care coverage to all Americans at an affordable cost. If you qualify, you can receive monetary allowances, rehabilitation services, vocational training and health care benefits.
To apply for the spina bifida VA benefits program, applicants must contact the VA regional office in Denver, Colorado. Once a caseworker verifies eligibility, he or she will contact the beneficiary with information on their benefits, including:
The program offers a “Meds by Mail” service, which allows program recipients to have non-emergent medications delivered to their door at no cost. It also has a pharmacy network that processes pharmacy claims electronically.
If none of the military-sponsored coverage is available, veterans and dependents can try coverage through the Health Insurance Marketplace. Government health programs include Medicaid and the Children’s Health Insurance Program (CHIP), or Medicare for eligible seniors or people with disabilities.