TRICARE Young Adult

TRICARE Young Adult Prime is a new program offered by TRICARE and the Martin’s Point US Family Health Plan to eligible dependents up to age 26. Please see the information below. To enroll in the TRICARE Young Adult program, see our enrollment page.

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Q:

What is TRICARE Young Adult?

A:

The TRICARE Young Adult (TYA) program is a premium-based health care plan available for purchase by qualified dependents. TRICARE Young Adult Prime coverage is available for purchase from Martin’s Point through the US Family Health Plan. TYA includes medical and pharmacy benefits, but excludes dental coverage.

Q:

Who Is Eligible?

A:

If you are an adult-age dependent, you may purchase TYA coverage based on the eligibility established by your uniformed service sponsor and where you live.
Note: Special eligibility conditions may exist.

You may purchase TYA coverage if you are all of the following:

  • A dependent of an eligible uniformed service sponsor
  • Unmarried
  • At least age 21 (or age 23 if enrolled in a full-time course of study at an approved institution of higher learning and if the sponsor provides at least 50 percent of the financial support), but have not yet reached age 26
  • Not eligible to enroll in an employer-sponsored health plan as defined in TYA regulations
  • Not otherwise eligible for TRICARE program coverage

Q:

Enrollment in TRICARE Young Adult

A:

After enrolling in TYA, you and your sponsor will need to visit a facility that issues uniformed services identification (ID) cards to

obtain an ID card for you. You must bring two forms of ID—one must be an unexpired government-issued ID card containing a picture. Coverage will begin the day Martin’s Point receives your completed application. You may request your start date to be up to 90 days in the future.

Q:

Purchasing TRICARE Young Adult

A:

TYA offers open enrollment, so if you qualify, you may purchase coverage at any time. The TRICARE Young Adult Application is available at www.tricare.mil/tya. When applying, you must verify that you are not married and not eligible to enroll in an employer-sponsored health plan.
Your completed application must include the first two months of premium payments, paid by personal check, cashier’s check, money order, or credit/debit card. After the initial two-month payment, premiums must be paid in advance by monthly automated payment. The monthly premium is $324.
Send your completed application and initial premium payment to Martin’s Point Health Care, Attn: Enrollment, PO Box 9746, Portland, ME 04104. To enroll, please call us at 1-888-241-4556.
Note: If you are not already in the Defense Enrollment Eligibility Reporting System (DEERS), your sponsor must add you to the system before starting the application process.

Q:

Covered Services

A:

TYA coverage includes medical and pharmacy, but excludes dental. TYA is only available for individuals and is not offered as a family plan. For more information review the Benefits and Services or call 1-888-241-4556.

Q:

Ending TRICARE Young Adult Coverage
Choosing to End Coverage

A:

You may choose to end TYA coverage at any time by completing the fields related to terminating coverage on the TRICARE Young Adult Application and submitting it to Martin’s Point. If you decide to end TYA coverage, you will be locked out from purchasing TYA coverage for one year from the date of termination.
There will be no lockout if the coverage is terminated because you gain access to employer-sponsored coverage.

Nonpayment
Your premium payment is due no later than the last day of the month for the next month’s coverage. Failure to pay total premium amounts due and any insufficient fund fees owed will result in a termination of coverage. A 12-month TYA purchase lockout will go into effect.

Change in Status
Your sponsor must always report all family and status changes to DEERS.
Your TYA coverage ends when any of the following occurs:

  • You reach age 26
  • You get married
  • You become eligible for an employer-sponsored health plan as defined in TYA regulations
  • You gain other TRICARE coverage
  • You lose eligibility because your sponsor ends TRICARE coverage