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TRICARE Transitional Survivor and Survivor benefits

Family members are entitled to TRICARE benefits as transitional survivors or survivors if their active duty service sponsor who died while serving on active duty for a period of more than 30 days. TRICARE pays transitional survivor claims at the active duty family member payment rate and pays survivor claims at the retiree payment rate. Transitional survivors pay no enrollment fees or copayments to use TRICARE Prime. They will, however, pay cost shares and deductibles at the active duty family member rate to use TRICARE Standard or TRICARE Extra.

National Defense Authorization Act for Fiscal Year 2006
Section 715 of the National Defense Authorization Act for fiscal year 2006 extends transitional survivor status for surviving minor children and unmarried dependent children of service members who died while serving on active duty for a period of more than 30 days. The law also enhances TRICARE benefits for surviving children and spouses of deceased active duty service members. Survivor family members are eligible for this provision if their sponsorís date of death occurred on or after Oct. 7, 2001

Transitional Survivor and Survivor: Active Duty Spouse
For a surviving active duty spouse, transitional survivor status ends three years from the active duty service memberís date of death. During the transitional survivor period, the out-of-pocket expense for a surviving active duty spouse is limited to $1,000 per fiscal year for TRICARE-covered services. At the end of three years, the spouseís status is changed in the Defense Enrollment Eligibility Reporting System (DEERS) to survivor status at the retiree payment rate. As a retiree, a surviving spouse is no longer entitled to active duty family members benefits. The out-of-pocket expense also increases to $3,000 per year for TRICARE-covered services.

Transitional Survivors: Minor Children and Unmarried Dependent Children
Surviving children are in transitional survivor status from the date of the sponsorís death until they reach the eligibility age limit, marry, or otherwise become ineligible for TRICARE.

Surviving children remain eligible up to age 21, or up to age 23 if they are full-time students at an institution of higher learning (and if, at the time of the death, relied on the sponsor for more than 50% of their financial support).

Transitional Survivors_Incapacitated Children and Unmarried Dependent Children
Incapacitation (physical or mental disability) is determined by the sponsorís Service, and it is a special circumstance that must be verified and recorded in DEERS. TRICARE does not determine incapacitation. In order to be eligible as an incapacitated child, the child must be incapable of self-support because of a mental or physical incapacity that occurs while a dependent of a member, and was at the time of the memberís death, dependent on the deceased member for over one-half of their support.

An incapacitated family member is eligible for transitional survivor status for the longer of:

- 3 years from their sponsorís death, or
- age 21, or
- age 23 if a full-time student at an institution of higher learning (and if, at the time of the death, relied on the sponsor for more than 50% of their financial support).

New Benefits for Transitional Survivors and Survivors
TRICARE Prime, TRICARE Prime Remote for Active Duty Family Members program, Overseas Prime, Global Remote and the Extended Care Health Option (ECHO) programs are available to those in transitional survivor status (spouses, minor children, eligible unmarried dependent children, and incapacitated children). Transitional survivors who choose to live overseas should check with their overseas TRICARE Service Center, as the availability of certain benefits may vary between the United States and locations overseas.

At the end of the transitional survivor period, the status for surviving spouses and incapacitated dependent children changes to survivor status at the retiree payment rate. As survivors, they are no longer eligible for active-duty specific programs and benefits such as ECHO and hearing aids because these programs are not available to retirees. They remain, however, eligible for TRICARE Prime, Extra and Standard benefits at the retiree family member payment rate.

Transitional Survivors Who Become Medicare Eligible
Transitional survivors who become dual-eligible for TRICARE and Medicare Part A benefits do not have to purchase Medicare Part B coverage to maintain TRICARE eligibility. However, Medicare considers transitional survivors the same as survivors and will charge a late penalty surcharge if transitional survivors do not purchase Medicare Part B coverage within eight months of their sponsorís death (or eight months from the date that they themselves become eligible for Medicare Part A).

Survivors Who Become Medicare Eligible
After the transitional survivor period ends, surviving spouses and incapacitated dependent children who become entitled to Medicare Part A due to age (65), disability or end-stage renal disease, must purchase Medicare Part B in order to remain TRICARE eligible. To avoid the Medicare surcharge for late enrollment, survivors must purchase Medicare Part B coverage when they first become eligible.

Dental Coverage for Transitional Survivors and Survivors
Active duty family members enrolled in the TRICARE Dental Program (TDP) before their sponsorís death remain eligible for dental care as transitional survivors for three years from the sponsorís death. During the three-year period, the government pays 100 percent of the dental premiums. Transitional survivors not enrolled in the TDP before their sponsorís death may enroll in the TRICARE Retiree Dental Program (TRDP) at any time. Enrollees in this program pay 100 percent of the dental premium cost. After the transitional survivor period ends, surviving spouses, minor children, eligible unmarried dependent children, and incapacitated dependent children whose status has changed to survivors, may also purchase dental coverage under the TRDP. To enroll, surviving active duty family members may contact Delta Dental, the TRICARE Retiree Dental Program contractor, for help.

DEERS
Surviving family members must ensure eligibility information listed in DEERS is up-to-date by visiting the nearest uniformed services identification card-facility. To locate the nearest facility, survivors may visit the Defense Manpower Data Center Support Office Telephone Center Web site at www.dmdc.osd.mil, or call 1-(800) 538-9552.
More information on TRICARE benefits for transitional survivors and survivors is available on the TRICARE Survivor Web page. A chart with TRICARE costs (premiums, copayments, deductibles, etc.) is also available.


 

 
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