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Qualifying Life Events (QLEs)

A change in your or a family member’s life may affect your TRICARE enrollment options. This is known as a qualifying life event (QLE). In most cases, when a QLE occurs, a request to change your enrollment must be made within 90 days (see "Retiring" for exception). For TRICARE Prime and TRICARE Select beneficiaries, if this 90-day window is missed, enrollment changes cannot be made until the next TRICARE Open Season or when the next QLE occurs. 

To Do List Following a QLE

  1. Add or remove a family member in the Defense Enrollment Eligibility Reporting System (DEERS) by visiting your local ID card office (RAPIDS site). Note: Only sponsors can add or remove family members. 
  2. Update your or your family’s information on milConnect. Once a family member is added to DEERS, that family member can make changes to their information in milConnect.
  3. Make necessary enrollment changes with Health Net Federal Services, LLC (HNFS) online, by mail or by phone. The effective date will be the date the QLE occurred and it must be requested within 90 days. 

Eligible Qualifying Life Events

Visit TRICARE’s Qualifying Life Events page for additional information. 

Adding a Family Member (Except Newborn or Adopted Child)

Active Duty Service Members and Their Family Members

  1. Register the active duty family member (ADFM) in DEERS. 
  2. Once registered in DEERS, your family member's enrollment in a TRICARE plan (TRICARE Prime or TRICARE Select) is automatic. The effective date will be the first day of the QLE.
    • In most circumstances, ADFMs who reside in a Prime Service Area (PSA) are automatically enrolled in TRICARE Prime.
    • In most circumstances, ADFMs who reside outside of a PSA are automatically enrolled in TRICARE Select.
  3. Important! Use the self-service tools on this website or milConnect to confirm your family member's TRICARE plan enrollment within 90 days of the QLE to make sure they are covered under the right plan. Any changes to enrollment must be made within 90 days of the QLE.

Retirees and Their Family Members

  1. Register the family member in DEERS. 
  2. Enroll in a TRICARE plan within 90 days of the QLE. The effective date will be the first day of the QLE.

Note: You must submit a full quarterly payment for your application to be processed. Your next billing statement will be adjusted to the quarterly amount. Also, if you have an automatic payment option, it will be updated to the monthly amount after the quarterly payment applies to your account. 

TRICARE Reserve Select (TRS)/TRICARE Retired Reserve (TRR)

  1. Register the family member in DEERS. 
  2. Enroll within 90 days of the QLE. The effective date will be the first day of the QLE. Requests received outside of the 90-day window will be effective the day the request is received.

Note: If you are adding a family member without a QLE, the family member’s enrollment is considered a new enrollment and will be effective the date the request is received or up to 90 days in the future.

 

Adding a Newborn or Adopted Child

Active Duty Service Members and Their Family Members

  1. Register the child in DEERS. 
  2. Once registered in DEERS, your child's enrollment in a TRICARE plan (TRICARE Prime or TRICARE Select) is automatic. The effective date will be the first day of the QLE.
    • In most circumstances, ADFMs who reside in a Prime Service Area (PSA) are automatically enrolled in TRICARE Prime.
    • In most circumstances, ADFMs who reside outside of a PSA are automatically enrolled in TRICARE Select.
  3. Important! Use the self-service tools on this website or milConnect to confirm your child's TRICARE plan enrollment within 90 days of the birth or adoption. Any changes to enrollment must be made within 90 days of the QLE.

Retirees and Their Family Members

  1. Register the child in DEERS. 
  2. Enroll in a TRICARE plan with HNFS within 90 days of the birth or adoption. The effective date will be the first day of the QLE. 

TRICARE Reserve Select (TRS)/TRICARE Retired Reserve (TRR)

  1. Register the child in DEERS. 
  2. Enroll in a TRICARE plan with HNFS within 90 days of the birth or adoption. The effective date will be the first day of the QLE. Requests received outside of the 90-day window will be effective the day the request is received.

All newborn and adopted child claims will be held until the TRS enrollment request is processed. If enrolled within 90 days of the QLE, claims for services on or after the effective date of enrollment will be processed. Any claims for services prior to the effective date of enrollment will be denied.

 

Moving

There are important steps to consider when moving. Visit our Moving with TRICARE page for tips on how to make your move a smooth transition. 

 

Separating from Active Duty

Benefits end the last day of the sponsor's military service. Log in to milConnect to determine when your benefits end. You may be eligible to enroll in Transitional Assistance Management Program (TAMP) or Continued Health Benefits Program (CHCBP). TRICARE Reserve Select is available for select members of the National Guard and Reserve and their family members and TRICARE Retired Reserve is available to retired reservists and their family members. 

 

Retiring

In order to qualify for continuous TRICARE coverage, retiring service members and their eligible family members must submit an enrollment request within 12 months of the sponsor's retirement (or turning age 60 for retired Reserve members).

  • The effective date must be the date of the retirement.
  • All applicable TRICARE enrollment fees must be paid in full retroactive to the retirement date.

Retirees and their family members (including those enrolled in TRICARE Young Adult) who don't enroll in a TRICARE plan will only be eligible for health care in a military hospital or clinic under direct care if space is available. 

HNFS can accept enrollment requests up to 90 days prior to the retirement date through 12 months from the retirement date.

Learn more on TRICARE's Retiring page.

 

Children Becoming Adults

Biological and adopted children may be eligible for TRICARE beyond the age of 21 (or 23 if a full-time student). Enrollment must be submitted within 90 days after your child turns 21 (or 23) to maintain continuous coverage. Additional eligibility requirements apply. Visit our TRICARE Young Adult page for additional information.

 

Death in the Family

Sponsor Death (Survivor Coverage)

For more information, visit TRICARE’s Survivor page.

Active Duty Service Members and Their Family Members

Surviving spouses remain eligible for TRICARE as long as they do not remarry. For the first three years following the death of their sponsor, they fall under transitional survivor status with active duty family member TRICARE benefits and costs. After three years, spouses convert to survivor status with TRICARE retiree benefits and costs.

Children up to the age of 21, or 23 if a full-time student, are eligible under transitional survivor status with active duty family member TRICARE benefits and costs until TRICARE eligibility ends due to age limits or another reason, such as marriage.

Retirees and Their Family Members

Benefits do not change if your retired sponsor passes away. Surviving spouses remain eligible for TRICARE retiree benefits as long as they do not remarry and enrollment rules are followed (for example, payments are submitted timely).

Children up to age 21, or 23 if a full-time student, are eligible for TRICARE retiree benefits and costs until TRICARE eligibility ends due to age limits or another reason, such as marriage.

TRICARE Reserve Select (TRS)/TRICARE Retired Reserve (TRR)

If your sponsor passes away you may qualify for survivor coverage. Under TRS, coverage is up to six months after the sponsor’s passing. Under TRR, coverage is available until the day your sponsor would have turned 60. To qualify, you must be registered in DEERS and your sponsor must have been enrolled in TRS/TRR on the date of passing. If your sponsor was not enrolled in TRS/TRR, you do not qualify for survivor coverage. 

  • If you were not enrolled in TRS/TRR on the date of your sponsor’s passing, you can enroll by submitting the request through BWE. Your request must be received within 90 days of the sponsor’s passing in order for your coverage to begin on the date your sponsor passed away.  If not received within 90 days, coverage will begin the first of the month after the application is received.
  • If you were enrolled in TRS/TRR on the date of your sponsor’s passing, your benefits will automatically transition without a break in coverage. You will receive a letter from the Defense Manpower Data Center (DMDC) with instructions on updating or ending your coverage.

Your survivor benefits remain the same as your TRS/TRR benefits and payments are still due the first of each month. However, your monthly premium payments may change. If there is only one person enrolled in TRS/TRR, you will pay the member only rate. If two or more people remain enrolled in the plan, you will continue to pay the member and family rate.

On the date your sponsor would have turned 60 years old, you become eligible for TRICARE with the same health plan options and costs as survivors of retired service members.

TRICARE Young Adult

If your sponsor passes away, your TYA eligibility depends upon your sponsor’s status.

  • Active duty service member: You are eligible for enrollment in TYA with active duty family member benefits and cost shares.
  • Retired service member: You are eligible for enrollment in TYA with retired family member benefits and cost shares.
  • TRICARE Reserve Select: If your sponsor was enrolled in TRS at the time he or she passed away, you are eligible for enrollment in TYA for up to six months after your sponsor passed away or until your 26th birthday, whichever is first. 
  • TRICARE Retired Reserve: If your sponsor was enrolled in TRR at the time he or she passed away, you are eligible for enrollment in TYA until your sponsor would have turned 60 or until your 26th birthday, whichever is first. 

 

Other Family Member Dies

You must contact your local DEERS office to find out the necessary steps to report their death. Visit TRICARE’s Death in the Family page to learn more. 

 

Divorce or Annulment

The sponsor must update DEERS with a certified copy of the divorce decree as soon as possible. Eligibility won’t change for the sponsor or biological/adopted children. If you would like to change health plans, you have 90 days to make those changes. Former spouses may be eligible for continuous TRICARE coverage if certain criteria are met. Visit TRICARE’s Getting Divorced page to learn more. 

 

Activating/Deactivating

Activating

  • If you are activated for more than 30 days, you will be disenrolled from TRS and unused monthly payment premiums will be refunded automatically.
  • If you live in a PSA, you and your family members will automatically be enrolled in TRICARE Prime on the date the TRS member becomes activated. Family members who would like to switch from TRICARE Prime to TRICARE Select must submit an enrollment request within 90 days of the QLE in order for enrollment to be backdated to the date the service member was activated. 
  • If you live outside of a PSA, you and your family members will automatically be enrolled in TRICARE Select. 
  • Visit our Pre-Activation/Early Benefits page to learn more.

It’s imperative to confirm your enrollment to ensure you are covered under the right TRICARE plan.

Deactivating

  • When you leave active duty after serving more than 30 days, you deactivate. Your coverage depends on whether your time was for a preplanned mission or in support of a contingency operation. 

Visit TRICARE’s Activation/Deactivation Coverage Scenarios page for more information.

 

Government Directed Primary Care Manager or Health Plan Change

TRICARE Prime beneficiaries directed by the government to change their primary care manager (PCM) must do so within 90 days. You can either accept the PCM change or change your enrollment to TRICARE Select. 

If your TRICARE health plan is no longer available in your area, you will be notified to enroll in another qualified TRICARE health plan within 90 days.  

 

Losing/Gaining Other Health Care Coverage

If you lose or gain other health coverage such as other health insurance (OHI), or Medicaid or Medicare entitlement, you can make changes to your TRICARE coverage within 90 days.

  • If you are gaining OHI, in most cases, TRICARE will become your secondary payer for TRICARE covered services. If you are losing OHI, TRICARE will become your primary payer. Visit our How TRICARE Works with Other Health Insurance page to learn more. 
  • A loss of Medicare coverage due to failing to sign up for Medicare on time or failing to pay Medicare premiums not considered a QLE.