Common reasons you could lose TRICARE coverage (and how to avoid them) (East Region)

We’ve all been there. Your credit card expires and suddenly you’re left scrambling trying to update every recurring bill. Just don’t forget an important one—your TRICARE premium payment.

Outdated billing information, incomplete enrollment steps during TRICARE Qualifying Life Events, and missed payments are just a few examples of how you and your family members can lose coverage due to avoidable issues, resulting in care interruptions, unfilled prescriptions, and support service interruptions.

Read through the disenrollment common causes and the simple actions you can take to maintain coverage for you and your family members.

Failure to pay

Electronic payment options

To ensure you never lose coverage due to a missed payment, sign up for allotment or electronic funds transfer payments. They’re the safest ways to pay your monthly premiums as TRICARE East automatically withdraws payments directly from your retirement pay or bank account. You can also set up recurring payments to pay your monthly premiums using a credit or debit card.

Go to Payment Options to learn more and find forms to start making electronic payments.

Loss of eligibility due to TRICARE Qualifying Life Events

When life changes for you and your family occur, your TRICARE health plan options may also change. Here are some examples of TRICARE QLEs.

Activation

When you’re activatedCalled or ordered to active duty service for more than 30 days in a row., you’ll receive the same benefits as active duty service members. Your family members also get TRICARE coverage as active duty family members. You have 90 days after your activation date to change your family members’ TRICARE health plan. It’s important to note family members under more than one sponsor may not automatically be enrolled in a plan. Learn more about activating.

Children becoming adults

TRICARE eligibility for biological and adopted children ends at age 21. You have 90 days after your child turns 21 to make changes to your TRICARE health plan. However, there are exceptions, including if your child is a full-time student, gets married, or has a severe disability or is incapacitated. Learn more about children becoming adults.

Going to college

While enrolled in college, children may be eligible for regular TRICARE benefits until their 23rd birthday or graduation, whichever occurs first. As a student, there are steps you need to take in the Defense Enrollment Eligibility Reporting System(DEERS) A database of information on uniformed services members (sponsors), U.S.-sponsored foreign military, DoD and uniformed services civilians, other personnel as directed by the DoD, and their family members. You need to register in DEERS to get TRICARE. to reflect their “student status.” Also, if your child moves away to college, you have 90 days to change your TRICARE health plan to keep them covered. Learn more about children going to college.

Moving

Your TRICARE eligibility doesn’t change when you move. But it may change your health plan options. Relocation must be to a new country, city, region, or ZIP+4 code to be a QLE. You have 90 days from the date of your address change to update your TRICARE health plan. Learn more about moving.

Retirement

After retiring from active duty, you have 90 days to enroll in a new TRICARE health plan. You may also qualify to enroll up to 12 months after retiring from active duty. However, if you don’t act, you’ll lose coverage and will only receive care at military hospitals or clinics if space is available. Learn more about retiring.

Read more about other QLEs and how to maintain coverage during these important transitions in your family’s life.

TRICARE Prime enrollment: Access to care

To enroll in TRICARE Prime, you need to meet certain access to care standards, including:

• Living in a Prime Service Area, or
• Living within 100 miles of a network primary care manager inside the PSA

Learn more about access to care and log in to self-service to view the forms to waive your access to care standards.