Active duty military receive medical and healthcare services through the Military Health System’s TRICARE program. Ordinarily, non-active duty National Guard and reserve component have health insurance coverage through their private employers just as their civilian counterparts do. But when one’s unit is mobilized, the military employee’s insurance coverage could be substantially affected.
With divorce pending or final, activated reserve and National Guard have several options to protect healthcare coverage for themselves and their dependents, including former spouses.
Understand that civilian employers are not required to provide healthcare coverage to military employees, men or women, while those employees serve on active duty. Private companies may do so but on a voluntary basis only. Any civilian employer may provide health insurance coverage to its mobilized military-employees called to active duty. What happens to the service member’s dependents if the employer does not extend coverage to its active duty workers? Other alternatives are available to the service member. Take a look.
Health Insurance Choices for National Guard and Reserve Component
What health insurance alternatives do National Guard and reserve component have should they be mobilized? Here are four healthcare programs available to eligible service members and their dependents:
- TRICARE
- COBRA
- USERRA
- CHCBP
Does the service member have health insurance through his or her civilian employer? Is that service member now active duty? The conversation begins with TRICARE.
TRICARE
Any service member in the National Guard or reserves who is called to active duty for more than 30 days is TRICARE eligible. The service member and his or her dependents (spouse, former spouse, step-children, adopted children, biological children) have full coverage under the military’s own TRICARE program.
Because TRICARE is based on military status, health coverage changes with deactivation. In separating from active duty under certain circumstances, the Transitional Assistance Management Program (TAMP) allows coverage for another 180 days after the service member’s deactivation.
Continued health insurance coverage is integral to spousal maintenance and child support negotiations during divorce proceedings. Consult an experienced military divorce attorney about the rights service members and their dependents have to uninterrupted health coverage. Start with COBRA continued coverage. And be sure to inquire into resuming coverage after a lapse in premiums because of active duty.
Omnibus Budget Reconciliation Act (COBRA)
The first option to consider is whether to continue employment-based group healthcare coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA). By continuing to pay the insurance premiums out-of-pocket, employer-based group coverage may be continued for at least 18 months. Notably, COBRA cannot be terminated when a reserve component starts TRICARE on the 31st day of active duty.
Under COBRA, a qualifying individual (or qualifying spouse, former spouse, or dependent child) receiving employer-provided medical, dental, or vision insurance may elect to pay the requisite premiums and continue with the same level of coverage for the full 18 months. An additional 18-month COBRA extension is possible with certain qualifying events. The absolute maximum period allowed for COBRA continued health coverage is 36 months. Three years may seem like a long time. But if the dependent child is very young when the parents separate, some other form of health insurance coverage will be needed.
Uniformed Services Employment and Reemployment Rights Act (USERRA)
Another federal statute directly affecting National Guard and reservists along with their civilian employers is the Uniformed Services Employment and Reemployment Rights Act (USERRA). Unlike COBRA, the USERRA is enforceable against all employers without regard to the number of people they employ.
Among the protections provided those in the uniformed services under the USERRA, reservists who must leave their civilian jobs to perform assigned military duties have the right to elect continuing employer-based health insurance coverage for up to two years (24 months). The election is both for themselves and for their dependents.
Upon return to civilian life from military duty, the non-active duty service member has the right to full reinstatement with the employer’s health insurance. Setting service-related illness or injury aside, upon returning to the job the military-employee is freed from insurance waiting periods and pre-existing condition exclusions. At least with regard to health insurance coverage, the military-employee picks up in private life where things left off when the reserve unit mobilized.
Continued Health Care Benefit Program (CHCBP)
Once released from military service, the Continued Health Care Benefit Program (CHCBP) provides transitional health care coverage for military families. Intended to bridge coverage so there is no lapse or significant change in scope or cost, the CHCBP begins where TRICARE eligibility ends.
Who is eligible for CHCBP? To be eligible for post-duty continued coverage through the military health system, the former active duty service member must have separated from military service under “other than adverse conditions.” CHCBP is extended to eligible family members as well.
The 60-day CHCBP enrollment period begins immediately after separation from active duty or termination of military health care. A still-unmarried divorced spouse, plus any non-eligible children, may apply for CHCBP coverage, too. (Because their relationship with the service member is somewhat tenuous, they must pay the CHCBP premiums.) A civilian who is an “unremarried former spouse” of the service member can obtain temporary health coverage for 18 to 36 months. The scope of that coverage being similar to what was provided through TRICARE Standard care.
In 1996, the TRICARE program through the DoD replaced so-called CHAMPUS which stood for Civilian Health & Medical Program of the Uniformed Services. A similar-sounding program does exist, but not through the DoD. Does continued insurance coverage involve a veteran? Then the Civilian Health and Medical Program of the Department of Veteran’s Affairs (CHAMPVA) is another key program worth investigating. CHAMPVA is a cost-sharing benefits program available through the Department of Veteran’s Affairs. Talk to a lawyer.