Retirees, transitioning service members, and their families need to be aware of one simple TRICARE fact: coverage is not continuous. Take it from me, a retiree who just went through the whole process of transitioning to civilian life only to find out that the day you retire; TRICARE will cut you off.
How to avoid the transition pain
Here is what I learned and my experiences while retiring and losing my TRICARE benefits, along with my family. To be honest, I take full responsibility because I went to multiple briefings, summits, information conventions, hiring fairs, and more, only to fall prey to the gaps that we all try to avoid. I took my wife to many of those briefings, I took notes, and I tried to make sure that we would not lose any coverage throughout the process. Still, that did not help.
The Lie
From multiple briefings, sources, and speakers, it is explained that you have 90 days of ‘continuous’ coverage while transitioning. Even on TRICARE’s website, it states that “If you want to keep TRICARE Prime or TRICARE Select with no break in coverage, you must reenroll within 90 days after your retirement date.”
The Truth
The day that your military service is over, you will lose coverage. It happened to me, with zero notification, and without any hesitation on both the military’s and TRICARE’s part. This is because the day that you end your service, your status in the Defense Enrollment Eligibility Reporting System (DEERS) may or may not be changed to retired. It all depends on the DEERS office.
Another step that they don’t explain in detail is that if you are a retiree, you must take your orders, common access card, and secondary ID to your local DEERS office to have yourself transitioned in their system, as well as be issued a retiree CAC. However, make sure that you create this appointment no more than 90 days before you retire, but after you retire, so that you can be first in line to get your status changed. Good luck with this step, since I had to book mine nearly two weeks after I retired, and I booked that appointment two months before I retired. If your DEERS office has any appointments, they are at least 60-90 days booked out. And if they potentially have walk-in appointments, ensure you show up at least an hour or two to get in line because the offices only have a certain amount of appointments they can handle per day and if you don’t make it, you may need to return another day and try it all over again.
Let’s pretend you do get your status changed in the DEERS system. You must then wait a minimum of 24-48 hours for your status to change before you can even consider calling TRICARE to enroll. When you do speak to a live person at TRICARE, you will get competing advice that doesn’t align with other advice that comes directly from TRICARE.
I Apologize
Now, I realize that this is all sounding like Homer Simpson’s dad yelling at the clouds, an old man feebly yelling at a system that is out of anybody’s control, but I feel the need to share my story and my experience to soften the blow to other peoples transitions.
This system is flawed. It is a pain and it should not be this way. There seem to be systems in place to ensure that transitioning service members get their pay set properly, their household goods (although another laughable situation), and more, but TRICARE seems to be the place that a lot of transitioning service members fall through the proverbial ‘gap’. My wife had to cancel very important appointments because we had no idea that our healthcare was getting shut off the moment I retired.
Their Answer
Again, with full transparency, I can admit that I do not have the best memory, so maybe this was my fault. Perhaps there was a moment during a briefing where they explained all of this, and I just happened to miss it every single time during every single briefing I attended. But I honestly doubt that. However, there is one benefit that TRICARE did explain during the numerous phone calls that I placed when trying to figure out why my TRICARE had been completely turned off the moment I retired.
The answer that TRICARE gives is that during the 90 days that you are not ‘enrolled’, and it only applies to this 90-day window that they give transitioning service members to reenroll, you can submit claims that were paid out-of-pocket for reimbursement. So, if you end up going to the doctor and finding out that your TRICARE has been denied because you did not know you needed to reenroll, you can potentially be reimbursed for that appointment. If you are like me at all, you probably won’t trust them. I didn’t and neither did my wife.
Your Answer
Transitioning service members, here is what you need to do as soon as possible to avoid these pitfalls and keep your coverage going. Go to your calendar and look at your final out date, look back 90 days, and mark it. On that day, you need to start looking for DEERS offices that have appointments the day after you final out. You need to be able to pick up your final orders, DD-214, etc., walk over and get your new ID card, and ensure your status is changed in DEERS. That way, within the next 24-48 hours you can call TRICARE or wherever you are getting coverage, and start your service with no gap or fears.
I wish you the best of luck and short lines at the DEERS walk-in hours. You will need it.
