ALCOAST 216/11

COMDTNOTE 6010
SUBJ: TRICARE YOUNG ADULT COVERAGE NOW AVAILABLE
A. THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (PUBLIC LAW
111-148).
1. REFERENCE (A) REQUIRES CIVILIAN HEALTH PLANS TO PROVIDE COVERAGE
OF ADULT CHILDREN WHO ARE NOT MARRIED UNTIL THE CHILD TURNS 26 YEARS
OF AGE. IN AN EFFORT TO MAKE THE TRICARE ENTITLEMENT COMPARABLE TO
CIVILIAN HEALTHCARE PLANS, CONGRESS INTRODUCED LANGUAGE WITHIN THE
IKE SKELTON NATIONAL DEFENSE AUTHORIZATION ACT FOR FY2011 TO INCREASE
THE AGE OF TRICARE DEPENDENT CHILDREN UP TO 26. THE TRICARE
MANAGEMENT ACTIVITY (TMA) IS REFERRING TO THIS NEW ENTITLEMENT AS
TRICARE YOUNG ADULT (TYA) COVERAGE. TYA DOES NOT AFFECT THE EXISTING
TRICARE PRIME ENTITLEMENT FOR DEPENDENTS UP TO AGE 21 (23 FOR
FULL-TIME COLLEGE STUDENTS).
2. TYA IS PREMIUM BASED, MEANING A FEE IS COLLECTED FROM THE
BENEFICIARY TO COVER PART OF THE COST OF PROVIDING CARE. THE
PUBLISHED RATE FOR TYA IS 186 DOLLARS PER MONTH FOR THE STANDARD
PLAN, WHICH INCLUDES ADDITIONAL CUSTOMARY TRICARE STANDARD COST
SHARING FOR THE BENEFICIARY. THIS BENEFIT INCLUDES AN OPTION TO
RETROACTIVELY PURCHASE COVERAGE BACK TO A 1 JANUARY 2011 EFFECTIVE
DATE. WHEN CONSIDERING THIS RETROACTIVE BENEFIT, THE BENEFICIARY
MUST HAVE ALL HEALTHCARE COST RECEIPTS FOR CARE FROM 1 JANUARY 2011
FORWARD TO BE ELIGIBLE FOR REIMBURSEMENT.
3. ENTITLEMENT FOR THE CHILD IS LINKED TO THE ENTITLEMENT OF THE
SPONSOR, I.E., IF THE SPONSOR LOSES ELIGIBILITY AT ANY TIME THE
DEPENDENT CHILD WOULD ALSO LOSE ELIGIBILITY. THE ENTITLEMENT DOES
HAVE SPECIFIC LIMITATIONS, AMONG THEM THE DEPENDENT IS EXCLUDED FROM
COVERAGE IF THEY ARE ELIGIBLE FOR EMPLOYER SPONSORED INSURANCE OR ARE
MARRIED.
4. STARTING IN MAY 2011, TYA WILL BE OFFERED AS A TRICARE
STANDARD/EXTRA BENEFIT (A PRIME BENEFIT IS EXPECTED IN THE FALL). TO
FIND MORE INFORMATION ON STANDARD BENEFITS AND COSTS, PLEASE VISIT
THE TRICARE WEBSITE AT HTTP://WWW.TRICARE.MIL AND CLICK ON LEARN
ABOUT PLANS AND COSTS.
5. PLEASE GO TO HTTP://WWW.TRICARE.MIL/TYA TO DOWNLOAD THE FORM TO
ENROLL IN TYA. ENROLLMENT IS REGION SPECIFIC AND IS BASED ON THE
ADDRESS OF THE DEPENDENT. FOR EXAMPLE, IF A DEPENDENT LIVES IN THE
TRICARE NORTH REGION, HE/SHE NEEDS TO ENROLL WITH THE NORTH REGION
CONTRACTOR, HEALTHNET. APPLICATIONS FOR COVERAGE BEGINNING THE FIRST
OF THE MONTH NORMALLY MUST BE RECEIVED BY THE END OF THE PREVIOUS
MONTH. BECAUSE THERE MAY NOT BE SUFFICIENT TIME TO SUBMIT
APPLICATIONS FOR COVERAGE TO BEGIN ON 1 MAY 2011, THE APPLY BY DATE
WILL BE EXTENDED AN ADDITIONAL 31 DAYS UNTIL 31 MAY 2011 FOR COVERAGE
BEGINNING IN MAY.
6. COAST GUARD BENEFICIARIES ARE ENCOURAGED TO VISIT THE TRICARE
WEBSITE HTTP://WWW.TRICARE.MIL/TYA, A TRICARE SERVICE CENTER, OR A
BENEFICIARY COUNSELING AND ASSISTANCE COORDINATOR (BCAC) TO GET THE
LATEST INFORMATION ON THIS NEW BENEFIT. THE WEBSITE INCLUDES A
WEBINAR, FREQUENTLY ASKED QUESTIONS, AND LINKS TO ADDITIONAL
INFORMATION.
7. BENEFICIARIES SHOULD PERIODICALLY REVIEW THEIR DEFENSE ELIGIBILITY
ENROLLMENT REPORTING SYSTEM (DEERS) AND DIRECT ACCESS INFORMATION TO
ENSURE THAT ALL RELEVANT FAMILY MEMBER INFORMATION, INCLUDING
ADDRESSES, REMAINS ACCURATE. TYA APPROPRIATE DEPENDENTS MUST BE
ENROLLED IN DEERS AND HAVE PURCHASED TYA TO BE ELIGIBLE FOR COVERAGE.
AFTER DEPENDENTS HAVE BEEN SUCCESSFULLY ENROLLED IN TYA, THEY CAN
VISIT A DEERS ID CARD ISSUING FACILITY TO RECEIVE AN ID CARD WHICH
SERVES AS THE TRICARE INSURANCE CARD. DEPENDENTS WHO ARE
GEOGRAPHICALLY SEPARATED FROM THE SPONSOR MUST PROVIDE AN APPLICATION
FOR DEPARTMENT OF DEFENSE COMMON ACCESS DEERS ENROLLMENT FORM,
DD-1172-2. THAT HAS BEEN SIGNED BY THE SPONSOR TO THE ID CARD ISSUING
FACILITY. THE SPONSOR MAY VISIT ANY ID CARD ISSUING FACILITY TO
REQUEST THE APPLICATION FOR DEPARTMENT OF DEFENSE COMMON ACCESS DEERS
ENROLLMENT FORM, DD-1172-2. ID CARD FACILITIES CAN BE LOCATED BY
VISITING THE RAPIDS SITE LOCATOR (MUST BE TYPED IN ALL LOWER CASE
LETTERS) AT: WWW.DMDC.OSD.MIL/RSL
8. POCS FOR THIS POLICY AT CG HQ ARE CDR DERRICK MASTERS AT (202)
475-5188, DERRICK.T.MASTERS(AT)USCG.MIL AND AT HEALTH, SAFETY, AND
WORK-LIFE SERVICE CENTER, HEALTH BENEFITS ADVISORS AT 1-800-9HB-AHBA
OR CWO4 SHAWN MCELROY AT (757) 628-4370, SHAWN.G.MCELROY(AT)USCG.MIL.
9. RADM MARK TEDESCO, DIRECTOR OF HEALTH, SAFETY, AND WORK-LIFE,
SENDS.
10. INTERNET RELEASE AUTHORIZED.