Eligibility & Enrollment

Are you eligible for the US Family Health Plan?

Explore eligibility and enrollment information pertaining to the US Family Health Plan and TRICARE Young Adult Prime®.

First, confirm your eligibility:

Service Area

Do you live within the US Family Health Plan service area?

The area we serve includes Maine, New Hampshire, Vermont, upstate/western New York, northern/western Pennsylvania, and northeast/central Ohio.

DEERS Registration

Are you (or your sponsor) currently registered in the Defense Enrollment Eligibility Reporting System (DEERS)?

Learn more about DEERS registration

Am I eligible for the US Family Health Plan?

Individuals eligible for the US Family Health Plan include:

Active-duty family members, including spouses and unmarried dependent children. Dependent children are eligible until their 21^st birthday, or, if they are a full-time student, their 23^rd birthday

National Guard and reserve members, including their spouses and unmarried dependent children

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.

Am I eligible for TRICARE Young Adult Prime?

You may purchase TRICARE Young Adult Prime 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

Acceptance for enrollment depends on confirmation of TRICARE eligibility through the DEERS (Defense Enrollment Eligibility Reporting System) and payment of enrollment fees

Note: Special eligibility conditions may exist

When can I enroll in the US Family Health Plan and when does my coverage begin?

If you currently have TRICARE Prime, 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 (QLEs)?

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 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. 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.

Qualifying Life Events Enrolling Your Newborn

When can I enroll in TRICARE Young Adult Prime and when does my coverage begin?

TRICARE Young Adult (TYA) 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.

Information Needed	What to Include
Sponsor's ID	Social Security Number (SSN) or DoD Benefit Number
Sponsor's Details	Date of birth; branch of service; active-duty/retired status
Dependents	For each family member: full name, SSN, date of birth
Other Coverage	Policy and group number(s) for any existing medical or prescription plan
Home Address	Physical residence (street, city, state, zip code)
Mailing Address	If different from your physical residence (street or PO Box, city, state, zip code)
Contact Information	Phone number and email address
Primary Care Manger	Name and location of your preferred PCP(s). If unknown, we'll assign one—you can change it online anytime.
Qualifying Life Event Docs (if not Open Season)	E.g. PCS orders, marriage certificate, retirement paperwork

What happens when I turn 65?

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.

Learn More

Ready to enroll? Let’s get started

Get details on how to enroll by phone or online—it’s fast and easy.

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