After experiencing a qualifying life event, beneficiaries must take action to ensure uninterrupted TRICARE coverage. Even if you don't want to make any changes to your health plan, you must update your information in the Defense Enrollment Eligibility Reporting System. Follow these steps after your QLE:
1. Update the Defense Enrollment Eligibility Reporting System
DEERS is a database of active duty and retired service members, their family members, and others who are eligible for TRICARE. Keeping DEERS updated is essential to getting uninterrupted care.
After a QLE, a beneficiary may need to enter a new address, add a spouse or child, indicate other health insurance, etc. Some of these actions may need to take place in person with documentation. Learn more at www.tricare.mil/deers.
2. Choose from three options, based on eligibility
- Stay in the same plan. If a beneficiary wants to stay in the same plan, they don't need to take further action after updating DEERS.
- Change plans. Beneficiaries who want to learn more about plan options can use the TRICARE Plan Finder at www.tricare.mil/planfinder.
- Enroll in a plan. If a beneficiary isn't already enrolled in a plan and chooses not to enroll, they'll only be able to get care and pharmacy service at a military hospital or clinic if space is available. learn more about how to enroll at www.tricare.mil/enroll.
Changes and enrollment must be made within 90 calendar days of the date of the QLE, in most cases. Coverage starts on the date of the QLE and runs for as long as the beneficiary remains eligible.
Frequently Asked Questions
TRICARE QLE Questions and Answers
Q2:
What if I don’t experience a QLE? Do I have any other option?
A:
You may. If you’re eligible for TRICARE, but don’t enroll in a plan during open season or within 90 days of a QLE, you’ll only be eligible for care and pharmacy services at a military hospital or clinic if space is available.
If you’re a qualified member of the Select Reserve or Retired Reserve and you aren’t in an active status, you may be eligible to purchase a premium-based plan for you and your family. The same is true if you have an eligibility change. Available options include TRICARE Reserve Select, TRICARE Retired Reserve, TRICARE Young Adult, and the Continued Health Care Benefit Program. You can purchase a premium-based plan at any time, except for the Continued Health Care Benefit Program (CHCBP). You can only purchase CHCBP coverage within 60 days of loss of eligibility for TRICARE.
You also may be eligible for TRICARE For Life. Coverage is automatic if you have Medicare Part A and Part B.
Q3:
What is a qualifying life event (QLE)?
A:
A QLE is a certain change in your life that would make you eligible to enroll in a TRICARE Prime option or TRICARE Select outside of open season. These life events may open up TRICARE health plan options for you and your family. If you want to make any eligible changes, you’ll have 90 calendar days from the date of the QLE to do so.
Q4:
When Does Coverage Start?
A:
Your coverage will start on the date of the QLE and continue until you lose eligibility or disenroll.