Medical Benefits for Former Spouses Under TRICARE
Active service members and their families qualify for health benefits under a program called TRICARE. TRICARE offers several plans, but the basic family plan is free for service members. You can learn more about the various TRICARE plans by clicking here.
After divorce, service members’ dependent children are still eligible to receive TRICARE coverage. However, the type and amount of TRICARE health benefits a former spouse may receive depends primarily on the length of the marriage. An ex-spouse won’t qualify for continued care under TRICARE unless they meet either of the following two rules.
Complete coverage under the 20/20/20 rule
Under this rule, former spouses may continue their medical coverage under TRICARE if all of the following criteria are met:
- the marriage lasted at least 20 years
- the military member served in the military for at least 20 years
- the marriage and the military service overlapped by at least 20 years
- the former spouse has not remarried, and
- the former spouse has not enrolled in an employer-sponsored health insurance plan.
Former spouses that meet the 20/20/20 rule are entitled to comprehensive medical coverage continuing through the age of 62, or until they’re eligible for Medicare. Their benefits include the use of military treatment facilities and pharmacies.
Limited coverage under the 20/20/15 rule
Under the 20/20/15 rule, the former spouse must meet all of the requirements stated above, but the overlap required is 15 years rather than 20 years. Medical benefits for a spouse that meets the 20/20/15 rule aren’t as extensive as those available under the 20/20/20 rule. They include continuing medical coverage under TRICARE and access to military treatment facilities and pharmacies for only one year after the divorce. After the first year, 20/20/15 spouses are treated the same as all other former spouses in terms of eligibility for health care benefits.
The Continued Health Care Benefit Program
The Continued Health Care Benefit Program (CHCBP) extends at least some medical benefits to former military spouses, regardless of the length of the marriage. In other words, if you don’t meet the 20/20/20 or 20/20/15 rules, you may still qualify for health care through CHCBP.
Enrollment in CHCBP protects spouses from a lapse in coverage when they transition from military health care plans, such as TRICARE, to new civilian health plans. Spouses enrolled in CHCBP will receive temporary health care coverage following the loss of military benefits. CHCBP benefits are similar to TRICARE benefits. The main differences are that former spouses have to pay in order to participate, and they won’t have access to military treatment facilities or pharmacies. CHCBP may also provide former spouses coverage for preexisting conditions that aren’t covered by a new employer's benefit plan.
Nearly all former spouses, regardless of the length of their marriage, will be eligible to enroll in CHCBP as long as they meet the following requirements:
- the former spouse is not remarried
- the former spouse was enrolled under a health benefits plan such as TRICARE at the time of the divorce, and
- the former spouse enrolls in CHCBP no later than 60 days after losing eligibility (eg., 60 days from the date of the divorce).
If all requirements are met, the former spouse may receive medical coverage through CHCBP for at least 36 months. Some former spouses may be able to continue their coverage beyond 36 months if they meet all of the following criteria:
- the former spouse has not remarried before age 55
- the former spouse was enrolled in an approved health benefits plan at any time during the 18-month period before the date of the divorce
- the former spouse has not enrolled in an employer-sponsored health insurance plan, and
- the former spouse receives (or is eligible to receive) a portion of the service member’s retired pay, or is the beneficiary of a survivor annuity pursuant to a court order or written agreement between the former spouses.
If you’re the former spouse of a military service member, and you meet all of these requirements, you should contact an attorney with experience in military divorces to help you extend your CHCBP coverage.
In addition, it’s very important to note that if you waive (give up) your share of military retirement pay and any survivor annuity benefits, you may not qualify for coverage through CHCBP. You should definitely consult with an attorney before agreeing to waive any of these rights.
The full text of the law that governs CHCBP can be found at 10 U.S.C.A § 1078a.
You can learn more about CHCBP eligibility and enrollment by clicking here.