Adding a New Family Member Overseas? Take Action to Get TRICARE Coverage for Your Child
Are you giving birth or adopting overseas? A change in your family composition, such as a newborn, adopted child, or placement of a child by a court in your home, is a TRICARE Qualifying Life Event (QLE). The QLE allows you to enroll any new eligible family members. Or to make changes to your TRICARE Overseas Program (TOP) Prime or TOP Select health plan. You must take action to get TRICARE coverage for your new child. Register your newborn or adopted child in the Defense Enrollment Eligibility Reporting System (DEERS), as well as choose a TRICARE health plan and enroll your child in one if necessary.
You Must Register Your Child in DEERS
After birth or adoption, register your child in DEERS. You must register your child in DEERS within 120 days of birth, adoption, or court-appointment. You’ll need a birth certificate, certificate of live birth from the hospital, record of adoption, or letter of placement of the child into your home by the court.
You don’t need a Social Security number to register a newborn in DEERS. Update your child’s DEERS record as soon as he or she gets a Social Security number.
If you don’t register your child in DEERS, TRICARE will deny your claims from overseas civilian providers. This starts on the 121st day after your child’s birth.
Choose a TRICARE Health Plan and Enroll if Necessary
For active duty families, your child will automatically be enrolled in TOP Select once you register them in DEERS. You have 90 days from the date of DEERS registration to enroll, change, or transfer your child’s enrollment to TOP Prime or TOP Prime Remote (if eligible or command-sponsored). After 90 days, you must wait until another QLE or TRICARE Open Season to enroll your child in a different TRICARE health plan.
When the active duty sponsor enrolls the child in TOP Prime or TOP Prime Remote, TRICARE will backdate your coverage to the date of birth, date of adoption, or date of court order. Ask your TOP contractor to re-process any health care claims that TRICARE denied or that they should process under TOP Prime or TOP Prime Remote. If you don’t take action, your child will remain in TOP Select.
For children of overseas retirees, there’s no automatic enrollment. You must enroll your child in a health plan after registering him or her in DEERS within 120 days. If you don’t enroll in a plan, your child can only get health care and pharmacy services at a military hospital or clinic if space is available. After 120 days, you can only enroll your child in a plan following another QLE or during TRICARE Open Season.
Avoid Late DEERS Registration
For active duty families overseas, your child is automatically enrolled in TOP Select when registered in DEERS. Coverage will backdate to the date of birth, date of adoption, or date of court order. You still have 90 days from the automatic enrollment date to change your child’s health plan to TOP Prime or TOP Prime Remote, if you qualify. Ask your TOP contractor to re-process any health care claims that TRICARE denied due to eligibility from day 121 to the date of your child’s auto-enrollment.
For overseas retirees, if you register your child in DEERS late, TRICARE won’t backdate coverage. Your child will only be able to receive care at a military hospital or clinic if space is available until the annual open season or following another QLE. Your child won’t have access to TRICARE covered civilian health care, or retail or home delivery pharmacy services. You’re responsible for all costs from day 121 until you enroll your child in a TRICARE health plan.
If you’re living in the U.S., learn about your
Last Updated 5/9/2019