Eligible surviving family members, whose sponsor dies while on active duty, are entitled to continue to receive Tricare health care benefits. The following is a summary of these benefits:
Survivor Benefits Overview
During the three years following a sponsor's death, surviving spouses and children under 21 years of age (23, if enrolled in a full-time course of study in an institution of higher learning) remain eligible for Tricare Prime without enrollment fees and copayments. Surviving family members may enroll in Tricare Prime where offered, but lose eligibility for Tricare Prime Remote for Active Duty Family Members, if enrolled in that program at the time of the sponsor's death. Surviving family members who are not enrolled in Tricare Prime may use Tricare Select, but are subject to the appropriate active duty cost-shares and annual deductible requirements for each program. During the three-year survivor benefit period, surviving family members are protected from having to pay out-of-pocket expenses of more than $1,000 per fiscal year, for Tricare allowable charges for covered services.
Living Outside the U.S.
Surviving family members who choose to live outside the United States should check with the overseas Tricare Service Center, as their benefits will differ slightly from those available in the U.S.
If the survivor reaches age 65 or is disabled and becomes entitled to Medicare Part A, they must purchase Medicare Part B to retain Tricare coverage. Tricare survivor status ends if the surviving spouse remarries. Surviving spouse status can not be regained later, even if the surviving spouse later divorces or the new spouse dies.
It is extremely important for survivors to update their Tricare eligibility in the Defense Enrollment and Eligibility Reporting System (DEERS). Surviving family members may go to the nearest Uniformed Services identification card facility, or contact the Defense Manpower Data Center Support Office Telephone Center at 800-538-9552. Surviving spouses must contact the ID card facility in advance to determine the range and scope of available services.
After the 3 Year Benefit Period
At the end of the three-year survivor benefit period, eligible surviving family member Tricare coverage converts to that of retiree family members. Eligible family members may enroll in Tricare Prime where available, but must pay the same annual enrollment fees and copays as retiree family members. Those who do not enroll in Tricare Prime convert to retiree family member status under Tricare Select, with the appropriate deductible and cost-share requirements for each program. Beneficiaries remain eligible for Tricare pharmacy benefits and may enroll in the Retiree Dental Program.
The out-of-pocket payment expenses for survivors in retiree family member status are limited to $3,000 per year, for allowable charges for covered services.
Tricare Survivor Dental Program
Surviving family members who are already enrolled in the Tricare Dental Program (TDP) at the time of the service member's death remain eligible for dental care under the plan. They pay no dental premiums during the three-year transitional survivor period. If surviving family members are not already enrolled in the Tricare Dental Program at the time of the service member's death, they are ineligible for the TDP, but may enroll in the Retiree Dental Program. Under the Retiree Dental Program they are responsible for one hundred percent of the premium cost.
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