TRICARE Young Adult (TYA) Program

Applications are now available for TRICARE Young Adult, the new premium-based health care plan for adult dependent children up to age 26. TYA provides access to medical and pharmacy benefits. The plan does not include dental coverage.

TRICARE Young Adult coverage can be purchased after eligibility for "regular" TRICARE coverage ends at age 21 (or 23 if enrolled in a full course of study at an approved institution of higher learning). Currently, TRICARE Standard coverage is available worldwide, but TRICARE Prime coverage will be available at a later date.

TYA participants may visit any TRICARE-authorized provider, network or non-network. Care at military treatment facilities is on a space-available basis only. They do not need a referral for any type of care but some services may require prior authorization. The type of provider determines how much the amount of out-of-pocket expenses. Visiting a network provider will result in less out of pocket, in addition to the convenience of having the network provider file the claims directly.



TRICARE Young Adult Eligibility Requirements

To be eligible for TRICARE Young Adult an adult dependent must be:

  • A dependent of an eligible uniformed service sponsor
    • If the sponsor is a non-activated member of the Selected Reserve of the Ready Reserve or of the Retired Reserve, the sponsor must be enrolled in TRICARE Reserve Select or TRICARE Retired Reserve for the dependent to be eligible to purchase TRICARE Young Adult coverage.
  • Unmarried
  • At least age 21 but not yet 26 years old (Note: those enrolled in a full course of study at an approved institution of higher learning and their sponsor provided 50 percent of their financial support, their eligibility may not begin until age 23)
  • Not eligible to enroll in an employer-sponsored health plan based on his or her own employment
  • Not otherwise eligible for other TRICARE program coverage.

The Affordable Care Act, also known as the health care reform law, requires that individuals maintain health insurance or other coverage that meets the definition of minimum essential coverage beginning in 2014. If purchased, TYA is considered minimum essential coverage.

Adult-age dependents are encouraged to evaluate all health care coverage options after aging out of TRICARE. While you may qualify to purchase TYA coverage, it is not your only healthcare coverage option to fulfill the minimum essential coverage requirement under the Affordable Care Act. Financial assistance to purchase commercial health care coverage may be available through the Health Insurance Marketplace. Also, you may qualify for Medicaid coverage, depending on your status and the state you live in.

To assess other health care coverage options before purchasing TYA, go to www.healthcare.gov.

TRICARE Young Adult Costs and Fees

The 2013 monthly premium for TYA Prime coverage is $176,and the TYA Standard monthly premium is $152. For 2014, theTYA Prime monthly premium is $180, and the TYA Standard monthly premium is $156. TYA premiums are adjusted annually,effective January 1. Ongoing premiums must be paid in advance by automated electronic payment. Premiums do not count toward deductibles or catastrophic caps.

TYA Prime has the same copayments as TRICARE Prime in the United States and TRICARE Overseas Program (TOP)Prime overseas. TYA Standard has the same cost-shares asTRICARE Standard and TRICARE Extra in the United States and TOP Standard overseas. Copayments and cost-shares count toward your family’s catastrophic cap. For TYA Standard, TYA cost-shares contribute to individual and family deductibles, which vary based on your sponsor’s category.

For more information on costs, visit www.tricare.mil/costs.

Note: The TRICARE Prime option, once it's available to purchase through TRICARE Young Adult, will have different set of out-of-pocket costs.

Who Should Consider TYA Coverage?

TYA is a great option for unmarried, adult children who have "aged out" of regular TRICARE coverage and who are transitioning to live independent of their parents. The plan provides comprehensive medical and pharmacy benefits. And, because the insured can see any provider, he or she doesn't have to change providers if they already have one. For more information, download a copy of the TYA flyer

Getting TYA Coverage Started

TYA offers open enrollment, so if you qualify, you may purchasecoverage at any time. The TRICARE Young Adult Application(DD Form 2947) is available at www.tricare.mil/tya.

Whenapplying, you must verify that you are not married and noteligible to enroll in an employer-sponsored health plan.

Note: If you are not already in the Defense EnrollmentEligibility Reporting System (DEERS), your sponsor mustadd you to the system before the TYA application process canbegin. For information on adding family members to DEERS,visit www.tricare.mil/deers.

Once you complete and sign DD Form 2947, submit it by faxor mail with the initial premium payment to your regionalcontractor using the contact information provided on the form.

Your completed application must include the first two monthsof premium payments paid by personal check, cashier’s check,money order, or credit/debit card. After the initial payment,premiums must be paid in advance by monthly automatedelectronic payment.

TRICARE wants to remind members to please keep a copy of their application until they receive the enrollment card.  If the beneficiary must seek care before receiving the enrollment card, they should contact their regional contractor to verify their TRICARE Young Adult start date.

Check out the TRICARE Young Adult FAQ's to learn more.

Connect
Get the

Military Report

Sign-up
Newsletter
Deployment Center
© 2014 Military Advantage
A Monster Company.