Every couple’s divorce situation is as unique as their relationship, and some are more difficult to navigate than others. Some spouses find that separating their assets, lives and benefits is not as easy as it was to combine them. With so much at stake, it is important for military couplings to understand how the rules of divorce apply to their TRICARE benefits so they can plan accordingly and minimize the likelihood of coverage issues, out-of-pocket expenses and confusion.
Filing for divorce does not immediately or automatically exclude the nonpolicy holder spouse from military health care benefits. There are rules and certain criteria in place that govern eligibility. Here is a brief overview of how divorce impacts military health benefits.
What is a qualifying event?
The government recognizes divorce as a qualifying event for military personnel to update their TRICARE coverage. Until the courts issue a divorce decree, the non-sponsor spouse and children in some circumstances continue receiving and using benefits.
For benefits to cease for the non-sponsor spouse and unqualified children, the partner sponsor must provide TRICARE with an official copy of her or his divorce decree. A motion for divorce is not enough. It is possible for children and the non-sponsor spouse to retain TRICARE eligibility after divorce.
What affects children eligibility?
TRICARE allows for the biological and adopted children of a sponsor divorcee to continue receiving health benefits until they reach the age of 23, if going to college. Covered dependents who are not in school lose coverage once they reach the age of 21. Stepchildren do not qualify unless they were formally adopted prior to the divorce.
How does divorce affect the benefits of former spouses?
TRICARE also provides coverage for non-sponsor ex-spouses if their marriage meets the 20/20/20 regulation. The divorce must occur after 20 years, the covered spouse served for at least 20 years and the overlap is 20 years. Military marriages that last at least 15 years and meet the 20 years served and overlap criteria qualify the non-sponsor spouse to retain military health benefits for a period of one year after the date on the divorce decree. There are exceptions. After that time, the nonmilitary divorcee loses coverage and assumes responsibility for his or her health care expenses.
Benefits for the nonpolicy holder spouse end on the same date on the divorce decree. Because processing times can vary, some couples do not learn they no longer have military health benefits through their ex-spouse. Sometimes, processing delays result in the payment of healthcare expenses after the disqualification date. To avoid unexpected healthcare costs and issues and delays in treatments after the divorce is over, military partners who stand to lose their spouses’ health benefits should make alternative arrangements and consider investing in a personal health insurance policy to cover the gap.