Qualifying Life Event Resources

 Am I Moving Out of the Service Area?

The USFHP service area covers specific regions. If your new address is outside this area, here’s what you need to know:

• Check Your Options: Use the USFHP Service Locator or TRICARE.mil to confirm if TRICARE Prime or Select is available in your new ZIP code.
• Porting Coverage: If TRICARE coverage is available, contact the new TRICARE contractor to request a PORT. Once completed, Martins Point will automatically receive notification to disenroll you—no additional action is needed.
• DEERS Update: If you report your new address to DEERS and it is out of the service area, this will trigger an automatic disenrollment. No application is required.
• Request Voluntary Disenrollment: You may also choose to disenroll from USFHP by completing a disenrollment application. Members with Medicare Part B will automatically transition to TRICARE for Life (TFL).

Note: Address updates can take 24–48 hours to reflect across all systems. Mail sent before the update may use your previous address.

We’re Here to Help—Every Step of the Way

Moving doesn’t have to be stressful. Call Member Services at 1-800-574-8494 for guidance and personalized support.

Complete the Transition of Care Form

• Ensure seamless access to ongoing care by providing details about your current treatments, specialists, and referrals.
• Download the form: Transition of Care Form (PDF)

 

  Provide Key Details

• Share important information about your care, such as:
• Specialist names and contact details.
• Ongoing treatments (e.g., chemotherapy, physical therapy).
• Durable medical equipment needs (e.g., CPAP machines, insulin pumps).

 

  Return the Completed Form

• Send the completed form to ensure our team can coordinate your care effectively.
• Mail To:
Health Management Department, Martin’s Point Health Care
PO Box 9746, Portland, ME 04104

Managing Changes to Other Health Insurance

Report Other Health Insurance Changes:

• Adding a New Insurance Policy: Notify Martin's Point US Family Health Plan Member Services of any new OHI. You’ll need to provide:
  • Name of Insurance
  • Subscriber
  • ID Number
  • Effective Date
  • Phone Number
  • Names of Covered Family Members
• Removing or Updating an Existing Policy: Share details of any changes, including policy termination dates and updated coverage information.

How to Report Changes:
Call Member Services: 1-888-674-8734 (TTY: 711)
Provide the insurer’s name, policy number, effective dates, and any necessary updates.

Annual Updates in DEERS

TRICARE requires members to confirm and update their information in DEERS annually to maintain eligibility and ensure proper coordination of benefits.

How to Update DEERS:

• Visit MilConnect to update your information online.
• Visit a local ID card office for in-person updates.

Coordination of Benefits

• When Other Health Insurance is Primary:
  • Your OHI (e.g., an employer-sponsored health plan, Medicare, or private insurance purchased through a marketplace) processes claims first.
  • Martin's Point US Family Health Plan covers remaining eligible costs, such as copays or deductibles, once an Explanation of Benefits (EOB) from your primary insurance is received.

  Example: If you have health insurance through your employer in addition to Martin's Point US Family Health Plan, your employer-sponsored insurance would process claims first. Martin's Point would then cover eligible remaining costs.

• When Martin's Point US Family Health Plan is Primary:
  • Martin's Point US Family Health Plan processes claims first.
  • If your OHI (e.g., a supplemental policy or a plan that only covers specific services like dental or vision) denies a claim (e.g., for non-covered services), submit the denial notice to Martin's Point US Family Health Plan for secondary processing.

  Example: If your other insurance is a supplemental plan, like one that only covers vision or dental services, Martin's Point would process claims first for all medical services. Your supplemental plan would only apply to vision or dental care, and any non-covered claims would be handled by Martin's Point.

Notification of Divorce

• Disenrollment Date: Coverage ends based on when DEERS receives notification of the divorce. Ensure timely updates to avoid disruptions.
• Submit Divorce Decree to DEERS: If not already submitted, you must provide the divorce decree to DEERS to update your eligibility status. Visit MilConnect or contact a local ID card office.

Eligibility for Former Spouses

Former spouses may retain eligibility under certain conditions, as determined by DEERS, provided they do not remarry or obtain Other Health Insurance (OHI):

• 20/20/20 Rule:
  • Full benefits are provided if all the following criteria are met:
  • Married to the service member for at least 20 years.
  • The service member completed at least 20 years of creditable service.
  • There was at least 20 years overlap between the marriage and the military service.
• 20/20/15 Rule:
  • Transitional benefits for one year are provided if all the following criteria are met:
  • Married to the service member for at least 20 years.
  • The service member completed at least 20 years of creditable service.
  • There was at least 15 years overlap between the marriage and the military service.
• Ineligibility:
  • If neither rule applies, coverage ends immediately. Former spouses may:
  • Enroll in the Continued Health Care Benefit Program (CHCBP) for up to 36 months.
  • Explore private or employer-sponsored insurance options.

Update Dependents in DEERS

• Ensure dependents’ information is accurate and up-to-date in DEERS:
• Eligibility for Children:
  • Covered until age 21, or 23 if enrolled full-time in college.
  • After aging out, dependents may qualify for the TRICARE Young Adult (TYA) Program.
• Stepchildren:
  • Retain coverage only if legally adopted by the sponsor.
• How to Update DEERS:
  • Visit MilConnect or a local ID card office.

Notify Martin's Point US Family Health Plan of Changes

Let US Family Health Plan know of changes promptly to avoid care disruptions. If you have questions or need assistance, contact Member Services at:

1-888-674-8734