News | May 10, 2022

How Does TRICARE Change When You Retire from Active Duty?

By TRICARE Communications

Many active duty service members (ADSMs) may eventually retire from their branch of the uniformed services. If you’re an ADSM, are you prepared to make the transition to civilian life? If you retire, you and your family will still qualify for TRICARE. But, it’s important to note you must actively enroll into a TRICARE health plan if you want coverage for civilian care. Learn about the TRICARE health plans available to retirees and their family members now. This will get you ready to make the arrangements for ongoing health care coverage when it’s time.
 
“The date of your retirement counts as a Qualifying Life Event,” said Dr. Danita Hunter, chief of TRICARE Policy and Programs. “This gives you a 90-day window to enroll in a new TRICARE plan. If you don’t enroll in a health plan, you’re only eligible for care at a military hospital or clinic if space is available.”
 
What stays the same with your TRICARE coverage when you retire? Be sure to review the TRICARE Retiring from Active Duty Brochure. While you remain eligible to get care at a military hospital or clinic, you and your family have a lower priority for access than when you were on active duty. Capacity at military hospitals and clinics varies by location. You can still use the military pharmacy to fill your prescription drugs and use other pharmacy options through the TRICARE Pharmacy Program. Keep in mind, most retirees and their family members are required to fill certain maintenance drugs through TRICARE Pharmacy Home Delivery. Also, your TRICARE coverage goes with you when you move or travel.
 
So, what changes about TRICARE with your retirement? See some changes you should know below.
 
New Status
After retirement, your TRICARE status changes. First, you and each of your eligible family members will need to get a new Uniform Services ID card to reflect your retiree status. You’ll also need to update contact information for you and your family members in the Defense Enrollment Eligibility Reporting System (DEERS). Also, if your uniformed service doesn’t update your retired status in DEERS, you can’t reenroll in TRICARE.
 
If you qualify for premium-free Medicare Part A, you’ll need to sign up for Medicare Part B before you retire to keep TRICARE coverage.
 
TRICARE Health Plans
All ADSMs are enrolled in TRICARE Prime. Once you’re retired, you can reenroll in TRICARE Prime if you live in certain areas stateside called a Prime Service Area, where TRICARE Prime is offered. However, TRICARE doesn’t offer TRICARE Prime Remote, TRICARE Prime Overseas, and TRICARE Prime Remote Overseas to retirees and family members.
 
TRICARE health plans available to you and your family might include:  
Check out the TRICARE Plan Finder to learn more about which plans you may qualify for. You can also reach out to your TRICARE contractor with any enrollment questions. If you don’t enroll into a TRICARE health plan within 90 days of your retirement date, you may request a retroactive enrollment up to 12 months after your retirement date. You can learn more about this on the Qualifying Life Events page.
 
New Costs
Once enrolled into a TRICARE health plan, you’ll pay retiree costs. This includes ongoing enrollment fees or monthly premiums. All enrollment fees or monthly premiums must be paid retroactive to your retirement date for continuous coverage. Also, copayments and cost-shares will apply if you get care from a civilian TRICARE network provider. You can review and compare costs online or by downloading the TRICARE Costs and Fees Fact Sheet.
 
New Dental and Vision Plan Options
As a retiree, you no longer qualify for active duty dental benefits, and your family no longer qualifies for dental coverage through the TRICARE Dental Program. Retired service members and family members may purchase dental coverage from the Federal Employees Dental and Vision Insurance Program (FEDVIP), administered by the U.S. Office of Personnel Management. If you’re enrolled in a TRICARE health plan, you may purchase one of the vision plans offered by FEDVIP.
 
Where can you learn more about how your TRICARE changes when you retire from active duty? Go to the Retiring page on the TRICARE website.
 
Are you retiring from the National Guard or Reserve? Then you should read the TRICARE Retiring from the National Guard or Reserve Brochure. A key difference to remember is that you and your family don’t qualify for TRICARE by law until you reach age 60, even if you begin to draw retired pay earlier than age 60.
 
Remaining informed about the best health plan options for you and your family as you prepare for retirement is important to ensure there’s no interruption in your health care coverage.
 
Would you like the latest TRICARE news sent to you by email? Visit the TRICARE Subscriptions page today, and create your personalized profile to get benefit updates, news, and more.
 
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