Tricare Select Young Adults - One of the hardest parts of having young children is making sure they have health insurance. Although the Affordable Care Act (ACA) mandates that insurance companies provide coverage to children up to age 26, that mandate does not apply to Tricare because Tricare is technically not insured. Federal law prohibits children from staying on a parent's Tricare when they turn 21 or 23 if the child is in school full time. Officially, the National Defense Authorization Act (NDAA) of 2011 allowed the Department of Defense to create a Tricare-based model for children between the ages of 21/23 and 26.
TYA works almost like regular Tricare. Beneficiaries choose between Tricare Prime and Tricare Standard. If you're not on TYA, each program works the same with a few minor adjustments.
Tricare Select Young Adults
In 2022, TYA Select premiums will be $265 per month. The TYA Prime fee will be $512 per month. Additionally, the child will have deductibles and copayments commensurate with their sponsorship level (AD/Retired) and the Tricare they choose, but Group B will pay those copayments regardless of when. Their sponsors entered the army. . TYA fees are recalculated each year to ensure that the costs of this self-financing program are covered.
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Another important expense to consider is disaster coverage. Catastrophic coverage is the most you pay for covered services.
A family member using TYA is subject to Group B disaster sponsor status (AD or retired), even if the sponsor is Group A. But the rest of the family still uses the Group A disaster cap, even if one child uses the TYA.
For example, our family uses Tricare Select as a pensioner and we have a child on Tricare Senior Select. The cost of our family disaster is $3,706 this year, plus per person
, we will stop paying when we reach that limit. But it must collect an additional $215 in fees before it stops paying.
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Catastrophic coverage will return to normal once no one uses TYA. It's all fun and meaningless, but it's true.
Note on Group A and Group B: Group A and Group B refer to the date of military service of the sponsor. If the sponsor entered the military before 1 January 2018, you are Group A - they are always considered Group B, with some exceptions such as those in TYA. You are a group if the sponsor entered the military on or after January 1, 2018. B.
Even when you change status or group or change plans, the payments applicable to your catastrophe cover remain applicable throughout the year.
You need to do this about a month before the child loses regular Tricare eligibility to ensure there is no lapse in coverage. Fees for the first two months must be paid when you sign up.
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TYA is not the only option for children older than standard Tricare coverage. Other options include:
When comparing options, be sure to consider not just the monthly premium, but also the deductibles, cost of care and catastrophic limits. Most families can get cheap insurance, but this is never covered by Tricare. You should think about how much care your child usually uses and what kind of risk you are willing to take in the event of a serious illness or accident.
Young people using TYA are eligible for a military ID that proves eligibility for health care. Your child will need to get a new military ID just for TYA because the old one is expiring. Even if you have already set up TYA, you cannot get a new ID until the child is eligible for TYA.
If DEERS shows that you haven't graduated from college since then, you'll need to update it before you can get a new ID. Sometimes, DEERS and the Tricare contractor do not communicate well. They can get their ID from the local ID card and ID office like everyone else.
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Technically, TYA doesn't have to talk to parents because these kids are legal adults. Your results may vary - some parents can get their kids to sign the phone, in other cases, the child needs to do it themselves.
If your child receives occupational health insurance, do not enroll in TYA right away. This maintains TYA eligibility in case they need to continue in that job and return to TYA.
Keep all your papers and open all your papers. Anecdotal evidence suggests that TYA enrollment has more problems than non-YA enrollment. You never know when you will need to prove that your child is actually registered or falsely registered. It's a lot easier if you know what's going on and have the records to prove it.
TYA is a valuable benefit for children who are older than Tricare, but not yet covered by employer health coverage. As with everything else in life, understanding the program is key to making a good choice.
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