Young adults are typically allowed to stay on their family’s health insurance plan until they turn 26, but the military’s TRICARE plan doesn’t have the same policy.
ST. PETERSBURG, Fla. —
As the cost of living continues to rise, paying for one crucial expense becomes a bigger burden.
High health insurance premiums and out-of-pocket payments have left many Americans “sicker and poorer,” according to a 2023 study conducted by the Commonwealth Fund Foundation.
More than half of the adults surveyed said they put off getting care because it was too expensive for them, causing their health problems to worsen.
In a recent report from the non-profit KFF, 18 to 29-year-olds reported the highest rates of struggling to pay for health care, postponing care due to cost and not being able to afford prescription medication.
For many of those young adults starting to become financially independent, staying on a parent’s health insurance plan until the cutoff at 26 years old is the most affordable option.
But Julie K. from Tampa heard from a military family that their health insurance policy doesn’t follow those same guidelines, and wanted to know if it was true.
THE QUESTION
Do kids in military families get kicked off their parents’ health insurance when they turn 21, while other young adults can stay on their parent’s plan until turning 26?
THE ANSWER
Yes, young adults are not allowed to be on their family’s military health insurance plan once they turn 21 or graduate from college.
OUR SOURCES
WHAT WE FOUND
The U.S. military’s health insurance provider is called TRICARE. It’s offered to active-duty service members and their families, National Guard and Reserve members and their families, retirees and their families, survivors and certain former military spouses, according to TRICARE’s website.
Its resources include the “Military Health System,” which encapsulates things like military hospitals and clinics, and a network of civilian health care services.
According to its website, “biological and adopted children can get TRICARE until their 21st birthday in most cases.”
Certain things can extend that cutoff date. If the young adult is enrolled full-time at a qualifying college or university, TRICARE coverage expires on their 23rd birthday or their graduation date, depending on which comes first.
To get the extension, parents must still be financially supporting at least half of the child’s expenses – an increasingly common scenario. A recent report from Savings.com found that 47% of parents with adult children give them some sort of financial support, averaging $1,384 a month.
Another exception is if the child has a disability that impacts their ability to support themselves financially.
After turning 21, and if they don’t qualify for one of the exceptions, parents can enroll their children into TRICARE Young Adult (TYA), which the provider calls “an option for unmarried, adult children who have ‘aged out’ of regular TRICARE coverage.”
TRICARE Young Adult coverage expires once the child turns 26 years old.
While this is meant to ease the burden of losing health insurance for young adult children, some advocates have called for an end to TYA and the cutoff of 21-year-olds from family policies, bringing TRICARE in line with other providers.
Advocates argue the plan’s premiums defeat its purpose.
“For 2024, the monthly premium for TRICARE Young Adult Select is $311. TRICARE Young Adult Prime costs $637 per month,” The National Military Family Association (NMFA) said. “Unlike other TRICARE plans, TYA beneficiaries cover the full cost of the program.”
A subsidy from the Department of Defense (DoD) makes it so military families don’t have to pay monthly TRICARE premiums out-of-pocket. TRICARE Young Adult premiums are not covered, so the family is responsible for paying them.
In 2021, the Health Care Fairness for Military Families Act was introduced to Congress. It was referred to the House and Senate committees on Armed Services and later died because it was never pushed through.
That bill was once again filed in the current session of Congress and has been referred to the Armed Services committees of the House and Senate.
The legislation “modifies the extension of dependent coverage under TRICARE by allowing a dependent under the age of 26 to be covered without an additional premium,” according to the summary on Congress’s website.
Both Democrat and Republican lawmakers were or are co-sponsors on both the former and current bills.
Four of Tampa Bay’s congressional representatives signed onto the bill in 2021:
- Kathy Castor (D): represents Tampa and downtown St. Pete
- Gus Bilirakis (R): represents parts of Citrus, Hernando and Pasco counties
- Scott Franklin (R): represents parts of Pasco and Hillsborough counties
- Charlie Crist (D): represented most of Pinellas County
One member of Congress from Tampa Bay is currently a co-sponsor of the latest version of the bill:
Senators Rick Scott and Marco Rubio have not co-sponsored the Senate versions of the bill.
The current congressional session will end in January 2025, so there is still time for other representatives to sign on to the current bill. Just because a member of Congress doesn’t co-sponsor a bill, it doesn’t mean they don’t support it. They still have the opportunity to vote in support of the bill on the floor of each chamber.
U.S. Representative Gus Bilirakis, R-Florida, said he hopes to get the measure passed by making it an amendment to the National Defense Authorization Act, which is a bill passed each fiscal year to fund various military efforts.
“If we’re going to be allowing lay people to keep their children on their health care policies up to the age of 26, then why should our veterans be cheated out of this?” he said. “These are our heroes, and they should be allowed.”
When the Affordable Care Act was signed into law in 2010, it extended dependent coverage in health care policies from 23 to 26 years old. It applied to most employer and individual market plans, but it did not apply to TRICARE.
The Congressional Budget Office never submitted cost estimates on the Health Care Fairness for Military Families Act, but Bilirakis said he believed the bill likely died in 2021 because appropriators felt the change would be too expensive for the government to pay.
The Military Health System’s website shows the number of beneficiaries enrolled in different TRICARE plans at the end of each fiscal year, with the most recent numbers being from 2022. It reports that 31,823 people used TRICARE Young Adult’s basic plan, while 4,052 people used TYA Prime.
The monthly premiums for TYA beneficiaries total $149,736,924 a year.
If those beneficiaries were to remain on their family plan with no additional premium, the federal government would have to subsidize the premiums along with covering services like doctor visits, screenings and treatments.
“We should be able to find the money to cover these kids. That’s the bottom line,” Bilirakis said. “It is under DoD and, the funds should be available for our heroes. It’s a recruitment and retention issue, but it’s a fairness issue as well.”
Bilirakis and groups like the NMFA encourage constituents to contact their members of Congress, both representatives and senators, to voice their support for the current bills, H.R.1045 and S.956, or any amendment to a bill that carries out the same policy. Bilirakis also said residents could encourage their members of Congress to sign onto the bills as co-sponsors.
You can find the members of Congress who represent you using the search tool linked here.
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