Qualifying Life Events

When life changes for you and your family, your TRICARE health plan options may also change. These are known as Qualifying Life Events (QLEs).

A QLE is a certain change in your life, such as marriage, birth of a child, or retirement from active duty, which may mean different TRICARE health plan options are available to you. A QLE opens a 90-day period for you to make eligible enrollment changes. A QLE for one family member means all family members may make enrollment changes.

The table below lists TRICARE QLEs. They include military and family changes, as well as government-directed changes.

Depending on your eligibility, a QLE may allow you and your family to:

  • Enroll in a new TRICARE health plan.
  • Change your health plan coverage.

If you want to enroll in or change your health plan, you must:

  • Update DEERS with the QLE.
  • Make the enrollment changes within 90 days following the QLE.
  • Pay any enrollment fees or premiums due during that period.

No matter when you initiate the enrollment change following a QLE, coverage starts on the date of the QLE.

Qualifying Life Event Example
Change in sponsor status that results in ineligibility to continue existing coverage

Change in family composition

Moving (change of address)

Government-directed changes

Change in command sponsorship (overseas only)

Losing sponsor or family member eligibility

Change in eligibility status of any single family member in another family

  • In cases where both parents are sponsors, change in eligibility status for either member of a joint service family

Losing or gaining other health insuranceClick to closeHealth insurance you have in addition to TRICARE, such as Medicare or an employer-sponsored health insurance. TRICARE supplements don’t qualify as "other health insurance." (OHI)

 

What To Do Following a QLE

  1. With any QLE, the first step is to update your or your family member's information in the Defense Enrollment Eligibility Reporting System (DEERS).
  2. Once your change shows in DEERS, you may make any eligible enrollment change online, by mail, or by phone.

What Happens if I Don't Take Any Action?

If you remain eligible for your current health plan and wish to continue coverage following a QLE, you don’t need to take action.

If you aren't already in a health plan and don't enroll in one, you'll only be eligible for care at a military hospital or clinic if space is available.

When retiring from active duty, you must make an enrollment decision within 90 days of your retirement. If you don’t enroll in a health plan within the 90-day period, you’ll lose TRICARE coverage and may only be eligible for care at military hospitals or clinics if space is available.

Making Enrollment Changes When You Haven’t Experienced a QLE

If you and your family haven’t experienced a QLE, you can enroll in or make changes to your health plan during TRICARE Open Season. Open season occurs each fall, beginning on the Monday of the second full week in November to the Monday of the second full week in December.

Visit the Open Season section to learn more.

Last Updated 12/19/2017