US Family Health Plan and TYA Eligibility

Eligibility and enrollment requirements for the Martin’s Point US Family Health Plan (TRICARE Prime®) and TRICARE® Young Adult (TYA) Prime.

US Family Health Plan

The Martin’s Point US Family Health Plan is a highly rated TRICARE Prime plan for active-duty family members and military retirees (to age 65) and their dependents. 

  • Active-duty family members, including spouses and unmarried dependent children. Dependent children are eligible until their 21st birthday, or, if they are a full-time student, their 23rd birthday
  • Military retirees from the active component, their spouses, and unmarried dependent children
  • Military retirees from the reserve component upon reaching age 60, their spouses, and unmarried dependent children
  • Family members survivors of a deceased active-duty military member or military retiree
  • Former spouses of military sponsors who meet TRICARE eligibility rules
  • Enrollee must reside in the service area of the US Family Health Plan
  • Acceptance for enrollment depends on confirmation of TRICARE eligibility through the DEERS (Defense Enrollment Eligibility Reporting System) and payment of enrollment fees, if applicable

    Note: Beneficiaries who are eligible for Medicare because of age (65 or older) may not enroll.
 
  • If you are coming from another TRICARE Prime program, you may enroll anytime during the year. Your coverage will start the day Martin's Point receives your application.
  • If you currently have TRICARE Select, you may enroll:
    • During TRICARE’s Open Season. Open Season is an annual period when you can switch or enroll in a health plan for the next calendar year. It occurs each fall, beginning on the Monday of the second full week in November to the Monday of the second full week in December. Your coverage will start on January 1.
    • As a result of a Qualifying Life Event (QLE). Your coverage will start on the date of your QLE.
  • What are Qualifying Life Events (QLE)?
    • QLEs are certain changes in your or a family member’s life, such as marriage, birth of a child, or retirement from active duty, which allow you to make some changes to your TRICARE enrollment or coverage. QLEs open a 90-day period for you to make eligible changes. A QLE for one family member allows all family members to make these changes.
  • If you have recently become eligible for TRICARE due to a QLE. Your coverage will start on the date of your QLE. Note: You must enroll within 90 days of your QLE. If you do not enroll within 90 days of your QLE, you will have to wait until the next TRICARE Open Season or another QLE.

You can find more information on our Qualifying Life Events page.

If you enrolled in the US Family Health Plan on or after October 1, 2012, you will have to disenroll from the Plan once you become eligible for Medicare because of age. Martin's Point will ensure you have a smooth transition to TRICARE For Life. You may also be eligible for extra benefits if you add a Medicare Advantage plan to your TRICARE for Life coverage.

TRICARE Young Adult (TYA) Prime

TYA Prime is a premium-based health care plan available for purchase by qualified dependents through the US Family Health Plan.

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 until 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
  • Residing in the service area of the US Family Health Plan
  • Note: Special eligibility conditions may exist

Tricare Young Adult offers open enrollment, so if you qualify, you may purchase coverage at any time. 

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.

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.

You can find more information on our Qualifying Life Events page.

If you are not already in the Defense Enrollment Eligibility Reporting System (DEERS), your sponsor must add you to the system before starting the TYA application process.

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 2020 TYA monthly premium is $376.

Send your completed application and initial premium payment to:
Martin’s Point Health Care
Attn: Enrollment
PO Box 9746
Portland, ME 04104 
 
Download the TRICARE Young Adult application. (PDF)

 
Request Information
Have questions? We’re here to help.
Enroll:
1-888-241-4556

Current members:
1-888-674-8734
Join Us for a Seminar
Connect with a Health Benefits Specialist one-on-one or at an info seminar to discuss your options and enroll.Find out More
Plan Benefits and Details