Health Insurance for the Military, Veterans, and Their Families

If you, your spouse, or your child’s other parent is or was a military service member, or if your spouse or your child’s parent died or was disabled in the line of duty, you may qualify for health coverage from a source different from your job or your state health insurance Marketplace.

Veterans benefits

If you were ever on active duty in the military, you might qualify for Veterans Administration (VA) health benefits.

Service-connected health problems are generally covered, although there may be some deductibles. Veterans’ benefits change often, and the number of veterans’ medical facilities has been declining in recent years.

    What You Need to Know About Veterans Benefits

  • For people who served in the military and meet the definition of “veteran”
  • The VA looks at how long you served, type of discharge received, disability, income, availability of VA services in your area, and other factors to decide if you are eligible.
  • Service-connected problems generally are covered.
  • May require some deductibles
  • Veterans’ benefits change often; the number of veterans’ medical facilities has been declining

TRICARE

TRICARE is the Department of Defense’s health insurance program for those in the military, as well as some family members, survivors, and retirees. It offers a number of different plan options to cover people in the US and overseas, and includes family plans as well as plans for certain reservists. Pharmacy plans, dental plans, and other special services are available for some beneficiaries. If you were or are married to a veteran who retired from the military you may be eligible for Tricare. Also, if a parent is a retired veteran, their child, teen, or young adult may be eligible for TRICARE.

Eligible family members, including children, must be registered in the Defense Enrollment Eligibility Reporting System (DEERS) to get health coverage. Records can be kept up to date by the service member or the family members through the nearest military personnel office or ID card-issuing facility, or online at www.military.com.

Kids and young adult children of service members, retirees, and veterans

Unlike insurance plans that are governed by the Affordable Care Act, TRICARE has its own set of rules about young adults. It only covers children as dependents on their parent’s plans up to age 21, or age 23 if they are full-time students who are financially supported by their families.

If the sponsor-parent is on active duty, in reserves, or is retired from the military, individual coverage may be available through TRICARE for unmarried adults up to age 26 if they don’t qualify for coverage at work. However, this is a separate policy with its own premium. Check with your TRICARE office for more on this.

Each TRICARE plan has its own limits and requirements. Pharmacy plans, dental plans, and other special services are available for some people. Choose your plan carefully and know how it works. Contact TRICARE for complete and current information on TRICARE benefits for those who have been in the military and their families, including eligibility, plan details, and cost, as well as how to find providers in your area. You can find this information online, including the number to call in your area, at www.tricare.mil.

Drug Coverage and Medicare Part D for TRICARE and the Veteran’s Administration

If you have TRICARE, or if you get health care from the VA, the drug benefits are considered to be as good as or better than Medicare Part D coverage. This means it will almost always be best to keep your current drug coverage. But, in some cases, adding Medicare Part D can give you extra coverage. Sometimes it can also lower your co-pays.

Get more information from your benefits administrator or your insurer before making any changes. If you lose your TRICARE or VA coverage and your Medicare drug coverage begins within 63 days of the loss, in most cases, you won’t have to pay a penalty. For more on this, see our information on Medicare.

What You Need to Know About TRICARE

  • TRICARE is the Department of Defense’s health insurance program for those in the military, as well as some family members, survivors, and retirees.
  • Some non-active-duty reservists are also eligible
  • Children of military members remain eligible even if parents divorce and remarry
  • Surviving spouses of active duty service members are eligible for benefits, as are their children
  • It only covers children as dependents on their parent’s plans up to age 21, or age 23 if they are full-time students who are financially supported by their families.
  • ·

Health insurance for military reservists called to active duty

Members of the military reserve units who are called up for active duty from private employment have certain rights about the health care coverage they get from their employers. They’re allowed to pay the full cost of their health plan using COBRA during their time away, although they can choose military coverage instead. When they return to work, their health coverage must be re-instated without any waiting period. See “More information from your American Cancer Society” for US Department of Labor contact information.

CHAMPVA: Health insurance for widows, widowers, spouses or children of military members with service-related disabilities

Another program called Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) is available to certain spouses, widows, or widowers and their children who are not eligible for TRICARE. CHAMPVA can cover the spouse or widow(er) and the children of a veteran who:

  • Is permanently and totally disabled due to a service-connected disability as determined by a VA regional office
  • Was rated permanently and totally disabled due to a service-connected condition at the time of death
  • Died from a service-connected disability
  • Died in the line of duty and the family members are not eligible for TRICARE benefits

CHAMPVA is a comprehensive health care program in which the VA shares the cost of covered health care services and supplies with eligible beneficiaries. The program is administered by the VA Health Administration Center. You can find out more about CHAMPVA, including things like eligibility, benefits, finding a provider, and filing claims by calling 1-800-733-8387, or visiting their website, www.va.gov/purchasedcare/programs/dependents/champva/.

    What You Need to Know About CHAMPVA

  • Cannot be eligible for TRICARE benefits
  • VA shares the cost of covered health care services and supplies with eligible beneficiaries.
  • Service member must meet all requirements for disability or death in the line of duty

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Our team is made up of doctors and master’s-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Department of Veterans Affairs
Toll-free number: 1-800-827-1000
Website: www.va.gov

VA Health Administration Center (CHAMPVA)
Toll-free number: 1-800-733-8387
Website: www.va.gov/hac (select CHAMPVA under “Special Programs”)

    For Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)— who lost a military spouse or parent, and spouses and children of military service members family members with service-related disabilities

TRICARE
Website: www.tricare.mil

    Learn about eligibility, plan details, and cost for the health insurance program for military service members, retirees, families, and survivors. You can find information online, learn how to find providers nearby, and get the phone number to call in your area.

Medicare – US Department of Health and Human Services
Toll-free number: 1-800-633-4227
TTY: 1-877-486-2048
Website: www.medicare.gov

    Answers questions, provides literature, and gives referrals to state Medicare offices and local HMO’s with Medicare contracts.

US Department of Labor, Employee Benefits, Security Administration (EBSA)
Toll-free number: 1-866-444-3272
Website: www.dol.gov/ebsa

    Information on employee benefit laws and requirements of employer-based health coverage. Special information for military reservists who must leave their private employers for active duty can be found at: www.dol.gov/elaws/vets/userra/mainmenu.asp

TRICARE Management Activity. Popular Topics. Accessed at www.tricare.mil on February 16, 2015.

US Department of Veterans Affairs. CHAMPVA. Accessed at www.va.gov/purchasedcare/programs/dependents/champva/index.asp on February 16, 2015.

US Department of Veterans Affairs. Federal Benefits for Veterans, Dependents, and Survivors. Accessed at: www.va.gov/opa/publications/benefits_book.asp on February 17, 2015

Last Medical Review: November 19, 2015 Last Revised: March 2, 2016

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