TRICARE Young Adult: Continuing Coverage for Dependents Over 21/23

Last updated 1 week ago. Our resources are updated regularly but please keep in mind that links, programs, policies, and contact information do change.

For many young adult dependents of military service members, turning 21 (or 23 for eligible full-time students) marks a significant transition in healthcare coverage. Regular TRICARE eligibility often ends, creating a potential gap in health benefits.

The TRICARE Young Adult (TYA) program offers a health plan option that qualified individuals can purchase to maintain coverage. TYA is not an automatic entitlement—it’s a premium-based plan requiring enrollment and monthly payments.

TYA provides a bridge for eligible young adults to continue receiving comprehensive medical and pharmacy benefits under the TRICARE system until they reach age 26. The program offers worldwide coverage options, ensuring continuity of care regardless of location.

TYA targets unmarried adult children of eligible uniformed service sponsors who meet specific age and other criteria. Beneficiaries can choose between two main plan options—TYA-Prime and TYA-Select—which differ in how care is accessed, provider networks, and associated costs.

Are You Eligible for TRICARE Young Adult?

Determining eligibility is the first step in accessing the TYA program.

Core Requirements

To qualify for TYA coverage, you must satisfy all of these conditions:

• Relationship to Sponsor: Be an unmarried adult child (including biological, adopted, or stepchild) of an eligible uniformed service sponsor. Eligible sponsors include active duty service members, retired service members, activated Guard/Reserve members, non-activated Guard/Reserve members enrolled in TRICARE Reserve Select (TRS), retired Guard/Reserve members enrolled in TRICARE Retired Reserve (TRR), and certain unremarried former spouses registered in DEERS under their own Social Security number.
• Age: Be at least 21 years old but not yet 26 years old. (The eligibility start date might be delayed to age 23 for certain full-time students).
• Marital Status: Be unmarried. Getting married results in immediate loss of TYA eligibility.
• Employer-Sponsored Health Insurance: Not be eligible to enroll in an employer-sponsored health plan based on your own employment. If TYA coverage ends because you gain eligibility for employer insurance, the standard 12-month lockout period for repurchasing TYA does not apply.
• Other TRICARE Coverage: Not be eligible for any other TRICARE program coverage. This includes coverage through your own military service or extended eligibility due to disability.

Eligibility Checklist

Understanding the 21 vs. 23 Cutoff (Student Status)

While standard TRICARE coverage for dependent children usually ends on their 21st birthday, a significant exception exists for full-time students.

Coverage can be extended until the student’s 23rd birthday or graduation, whichever occurs first, provided these conditions are met:

• Full-Time Enrollment: The child must be enrolled full-time at an approved institution of higher learning, pursuing at least an associate’s degree.
• Sponsor Support: The TRICARE sponsor must provide more than 50% of the child’s financial support during their college enrollment.

This extension is not automatic. The sponsor must proactively update the dependent’s eligibility status within the Defense Enrollment Eligibility Reporting System (DEERS) before the child’s 21st birthday to prevent a coverage lapse. Sponsors must contact a Uniformed Services ID card office to provide documentation, typically a letter from the school’s registrar confirming full-time enrollment and certifying the required financial support.

For those who qualify for the student extension, eligibility to purchase TYA begins only when this extended coverage ends—either upon turning 23 or graduating, whichever comes first.

Special Sponsor Considerations

Eligibility for TYA can also depend on the sponsor’s specific TRICARE plan, particularly for Guard and Reserve families. If the sponsor is a non-activated member of the Selected Reserve or the Retired Reserve, they must be actively enrolled in TRICARE Reserve Select (TRS) or TRICARE Retired Reserve (TRR), respectively, for their dependent child to qualify to purchase TYA.

This means that even if a Guard/Reserve sponsor is eligible for TRS or TRR but chooses not to enroll, their otherwise eligible young adult dependent cannot purchase TYA coverage.

Confirming Your Status in DEERS

Accurate information in the Defense Enrollment Eligibility Reporting System (DEERS) is fundamental for all TRICARE benefits, including TYA. If a young adult is not registered in DEERS, their sponsor must add them before the TYA application process can start.

Information on updating DEERS can be found at TRICARE DEERS. Beneficiaries can verify their eligibility status by logging into their account on the milConnect website or by contacting their regional TRICARE contractor.

Choosing Your TYA Plan: Prime vs. Select

Once confirmed eligible, young adults must select one of two TYA plan options: TYA-Prime or TYA-Select. The best choice depends on individual circumstances, including the sponsor’s status, geographic location, healthcare needs, and preference for managed care versus provider flexibility.

TYA-Prime: The Managed Care Option

TYA-Prime functions similarly to the standard TRICARE Prime plan, operating as a health maintenance organization (HMO)-style managed care plan.

• Primary Care Manager (PCM): Enrollees are assigned a PCM, who can be either a military or civilian network provider. The PCM delivers most routine care and coordinates referrals for specialty services.
• Referrals: A referral from the PCM is generally required to see specialists. Exceptions include preventive services and outpatient mental health care visits. Seeking care outside the network without a referral typically results in significantly higher out-of-pocket costs under the Point-of-Service (POS) option.
• Provider Network: Care is primarily delivered through the assigned PCM and the network of TRICARE providers to keep costs low.
• Availability: TYA-Prime eligibility varies by sponsor status and location:
  • Dependents of active duty sponsors can enroll in TYA-Prime anywhere in the U.S. and in overseas locations if command-sponsored.
  • Dependents of retired sponsors can only enroll in TYA-Prime if they reside within a designated Prime Service Area (PSA) in the United States. They cannot enroll in TRICARE Prime Overseas.
  • TYA-Prime is not an option if the sponsor is enrolled in TRICARE Reserve Select or TRICARE Retired Reserve.
• US Family Health Plan (USFHP): In specific geographic service areas, eligible individuals can choose USFHP as their TYA-Prime option.
• Claims: PCMs and network providers typically handle claim filing.

TYA-Select: The Flexible PPO Option

TYA-Select mirrors the standard TRICARE Select plan, functioning as a preferred provider organization (PPO) that offers greater flexibility.

• Provider Choice: Enrollees have the freedom to visit any TRICARE-authorized provider, whether they are in the network or not.
• Network Incentives: While provider choice is broad, using TRICARE network providers results in lower out-of-pocket expenses (deductibles and cost-shares). Non-network providers may charge more than the TRICARE-allowable amount, potentially leaving the beneficiary responsible for the difference.
• Referrals: Referrals are generally not required for visits to primary care providers or specialists.
• Pre-authorization: Despite the lack of referral requirements, pre-authorization from the regional contractor is still necessary for certain services and treatments, such as Applied Behavioral Analysis.
• Availability: TYA-Select is available worldwide to all young adults who meet the core TYA eligibility criteria. This includes dependents whose sponsors are enrolled in TRICARE Reserve Select or TRICARE Retired Reserve.
• Military Facility Access: Access to care at military hospitals and clinics is limited to a space-available basis.
• Claims: Network providers file claims directly. When using non-network providers, beneficiaries may need to submit their own claims for reimbursement.

TYA Prime vs. TYA Select at a Glance

Understanding TYA Costs for 2025

Understanding the costs associated with TYA is essential, as it is a premium-based program. Costs include monthly premiums plus out-of-pocket expenses like deductibles and copayments/cost-shares, which vary between the Prime and Select options.

Monthly Premiums

A non-negotiable component of TYA is the monthly premium that must be paid to maintain coverage. These premiums are set annually.

2025 TYA Monthly Premiums (Effective January 1 – December 31, 2025)

These 2025 rates reflect significant increases from the previous year, particularly for the TYA-Prime option. This substantial fixed monthly cost makes careful budgeting and comparison with other potential coverage options crucial.

When first enrolling via mail or fax, applicants must submit payment for the initial two months of premiums. Acceptable payment methods for this initial payment include personal check, cashier’s check, money order, or credit/debit card.

Following this initial payment, ongoing premiums must be paid automatically each month through either an electronic funds transfer (EFT) from a bank account or a recurring charge to a credit or debit card. Setting up and maintaining this automatic payment is critical, as failure to pay premiums leads to coverage termination and a 12-month lockout from repurchasing TYA.

Monthly premiums do not count toward the plan’s annual deductible or the catastrophic cap.

Out-of-Pocket Expenses

Beyond the monthly premium, TYA enrollees are responsible for out-of-pocket costs when they receive covered services. These costs differ significantly between TYA-Prime and TYA-Select and are based on the cost structures established for TRICARE Group B beneficiaries.

Group B generally includes beneficiaries whose sponsors entered the military on or after January 1, 2018. For TYA enrollees, these Group B cost rules apply regardless of their sponsor’s actual entry date.

TYA-Prime Out-of-Pocket Costs (Based on Group B Retiree/Other Rules):

• Annual Deductible: $0. A deductible only applies if the Point-of-Service (POS) option is used (i.e., seeing a non-network provider without a referral).
• Copayments: Fixed dollar amounts paid for services received from network providers. For 2025, these include:
  • $25 for a primary care visit
  • $38 for a specialty care visit
  • $77 for an emergency room visit
  • $193 per inpatient hospital admission
• Using the POS option incurs a separate deductible ($300 individual/$600 family for 2025) and then 50% cost-sharing for allowable charges.

TYA-Select Out-of-Pocket Costs (Based on Group B Retiree/Other Rules):

• Annual Deductible: An amount that must be paid out-of-pocket for covered services each calendar year before TRICARE begins to share costs. The 2025 deductible for TYA Select (based on Group B Retiree/Other rules) is:
  • Network Providers: $193 per individual / $386 per family
  • Out-of-Network Providers: $386 per individual / $772 per family
• Cost-Shares: After the annual deductible is met, the beneficiary pays a percentage of the TRICARE-allowable charge for covered services. For 2025 (based on Group B Retiree/Other rules), examples include:
  • Network Primary Care Visit: $32
  • Network Specialty Care Visit: $51
  • Out-of-Network Visits: 25% of the allowable charge
  • Network Inpatient Admission: $225 per admission
  • Out-of-Network Inpatient Admission: 25% of the allowable charge

The Catastrophic Cap

TRICARE plans feature an annual catastrophic cap (CC), which limits the maximum amount a beneficiary or family pays out-of-pocket for TRICARE-covered services each calendar year (January 1 – December 31). Once this cap is reached, TRICARE covers 100% of the allowable charges for most covered services for the remainder of that year.

2025 TYA Catastrophic Cap: Because TYA plans follow Group B cost rules (specifically, the Retiree/Other Group B category for cost-sharing purposes), the 2025 catastrophic cap for both TYA-Prime and TYA-Select enrollees is $4,509 per family.

What Counts Towards the Cap: Annual deductibles (for TYA-Select), copayments (for TYA-Prime), and cost-shares (for TYA-Select) applied to covered services accumulate towards reaching the catastrophic cap.

What Does NOT Count Towards the Cap: Monthly TYA premiums do not count towards the catastrophic cap. Additionally, costs incurred under the Point-of-Service option for TYA-Prime generally do not apply to the cap.

Find Your Specific Costs

Given the variables involved (plan choice, type of service, network vs. non-network provider), the most reliable way to determine specific costs is by using the official TRICARE Compare Cost Tool.

This online tool allows users to select their plan (TYA-Prime or TYA-Select), input relevant details like sponsor status, and view applicable premiums, deductibles, the catastrophic cap, and estimated costs for various healthcare services and prescriptions.

Enrolling in TYA: Step-by-Step Guide

Purchasing TYA coverage involves several steps, from confirming eligibility to setting up payments.

Before You Start: Check DEERS!

The absolute first step is ensuring the young adult dependent is correctly listed and showing as eligible for TYA in the Defense Enrollment Eligibility Reporting System (DEERS).

If the dependent is not in DEERS or their information (like student status or address) is outdated, the sponsor must update the record before proceeding with the TYA application. Updates can typically be made through an ID card office or sometimes via milConnect.

Enrollment Timing

A key feature of TYA is its enrollment flexibility compared to other TRICARE plans like Prime and Select, which often restrict enrollment changes to the annual Open Season or following a Qualifying Life Event (QLE).

• Enroll Anytime: Eligible individuals can purchase TYA coverage at any point during the year once they meet the criteria. The TRICARE Open Season does not apply to TYA enrollment.
• Seamless Transition: For those losing other TRICARE coverage (e.g., aging out at 21/23, ending CHCBP coverage), prompt action is needed for uninterrupted coverage. The TYA application must be received by the contractor within 30 days of the loss of the previous coverage to request a start date immediately following the end date.
• Future Start Date (TYA-Select Only): When purchasing TYA-Select, applicants can request a coverage start date up to 90 days in the future. If no specific date is requested, coverage typically begins when the contractor receives the completed application.
• Changing Plans: While initial enrollment is flexible, switching between TYA-Prime and TYA-Select, or making changes due to life events like moving, generally requires a Qualifying Life Event (QLE). A move resulting in a new region, country, or significant address change (ZIP+4) qualifies as a QLE, providing a 90-day window to change TYA plan options if desired.

How to Apply

There are four primary methods to purchase TYA coverage:

1. Online:

• Log in to the milConnect portal
• Navigate to the “Benefits” tab
• Select “Beneficiary Web Enrollment”

2. Phone:

• Contact the regional contractor directly:
  • East Region (Humana Military): 1-800-444-5445
  • West Region (TriWest Healthcare Alliance): 1-888-TRIWEST (1-888-874-9378)
  • Overseas: Call the appropriate TRICARE Overseas Program Regional Call Center and select option 4
  • US Family Health Plan (for TYA-Prime option in USFHP areas): 1-800-748-7347

3. Mail or Fax:

• Download the region-specific TRICARE Young Adult Application (DD Form 2947) from the TRICARE Forms page or use these direct links:
  • East
  • West
  • Overseas
• Complete the form, ensuring verification of unmarried status and lack of eligibility for employer-sponsored health insurance
• Mail or fax the form, along with the initial two-month premium payment, to the contractor address or fax number listed on the form

Making the Payment

Payment procedures require careful attention to avoid delays or loss of coverage.

• Initial Payment: Applications submitted by mail or fax must be accompanied by payment for the first two months of TYA premiums. Payment can be made via personal check, cashier’s check, money order (payable to the regional contractor/USFHP provider), or credit/debit card.
• Ongoing Payments: After the initial payment is processed, subsequent monthly premiums must be paid via an automatic method. Enrollees must set up either an Electronic Funds Transfer (EFT) from a checking or savings account or an automatic recurring charge to a debit or credit card.

Maintaining this autopay arrangement is crucial, as non-payment will lead to coverage termination and a 12-month lockout period.

After Enrollment: Next Steps

Once the application and initial payment are processed:

• Confirmation: The regional contractor will send notification confirming enrollment.
• Enrollment Card: Enrollees can log in to milConnect to view and download their TYA enrollment card. Physical cards are not typically mailed for TYA Select.
• ID Card: The young adult beneficiary, accompanied by their sponsor if possible, should visit a Uniformed Services ID card issuing facility to obtain an updated ID card reflecting TYA enrollment. Generally, two forms of identification are needed, one of which must be an unexpired government-issued photo ID.

It is advisable to call the ID card office beforehand to verify required documentation, especially if the sponsor cannot be present. While a valid ID card is needed to access services, it is not required to initially purchase TYA coverage.

What’s Covered Under TYA?

TYA provides robust health coverage, but it’s important to understand the scope and limitations, particularly regarding dental and vision care.

Comprehensive Medical Coverage

TYA offers comprehensive coverage for medically necessary services, mirroring the benefits of either TRICARE Prime or TRICARE Select, depending on the chosen TYA option. This generally includes:

• Preventive care services
• Primary care visits
• Specialty care consultations and treatments
• Urgent and emergency care
• Hospitalization (inpatient care)
• Mental health services (both outpatient and inpatient). Outpatient mental health visits do not require a PCM referral under TYA-Prime.

For definitive confirmation on whether a specific medical service or procedure is covered, beneficiaries should consult the official TRICARE Covered Services page. Information on services explicitly excluded from coverage can be found on the TRICARE Exclusions page.

Prescription Drug Coverage

Prescription drug benefits are included as part of the TYA program through the TRICARE Pharmacy Program. Costs for prescriptions vary depending on the drug’s formulary status (generic, brand-name, non-formulary) and the type of pharmacy used (military pharmacy, retail network pharmacy, or TRICARE Pharmacy Home Delivery).

Beneficiaries can check drug coverage and costs using the TRICARE Formulary Search Tool. Current pharmacy cost-shares are scheduled to remain unchanged through December 31, 2025.

Vision and Dental Benefits

This is a critical area where TYA coverage differs significantly from comprehensive health insurance.

• Vision: TYA provides only limited vision benefits. Coverage for services like routine eye exams may be available, but the specifics depend heavily on the TYA plan option (Prime vs. Select), the sponsor’s status, and the type of care required. TYA does not include benefits for eyeglasses or contact lenses. Young adults needing comprehensive vision coverage may be eligible to purchase separate insurance through the Federal Employees Dental and Vision Insurance Program (FEDVIP) via the BENEFEDS website.
• Dental: TYA explicitly excludes dental coverage. Young adults requiring dental benefits must purchase separate dental insurance. FEDVIP may also be an option for purchasing dental coverage.

While TYA effectively fills the gap for medical and pharmacy needs after regular TRICARE ends, it leaves significant gaps in dental and comprehensive vision care. Beneficiaries must plan and budget separately for these needs if required.

When TYA Ends: Next Steps

TYA coverage is temporary, designed to bridge a specific period. Understanding when coverage ends and what options are available afterward is crucial for maintaining continuous health insurance.

Common Reasons for Losing TYA Coverage

Eligibility for TYA automatically terminates upon the occurrence of any of the following events:

• Reaching Age 26: This is the maximum age limit for the program.
• Marriage: Getting married immediately ends TYA eligibility.
• Gaining Employer-Sponsored Health Insurance (ESHI): Becoming eligible to enroll in an ESHI plan based on one’s own employment terminates TYA. (This does not trigger the 12-month purchase lockout).
• Gaining Other TRICARE Coverage: Becoming eligible for another TRICARE plan (e.g., through enlistment, activation) ends TYA eligibility.
• Loss of Sponsor Eligibility: If the sponsor loses their TRICARE eligibility or can no longer establish the dependent’s eligibility for TYA, the TYA coverage ends.
• Voluntary Termination: An enrollee can choose to end TYA coverage at any time. However, doing so generally results in a 12-month lockout period before TYA can be purchased again, unless the termination is due to gaining ESHI or other TRICARE coverage.
• Non-Payment of Premiums: Failure to pay the required monthly premiums will result in termination of coverage and a 12-month purchase lockout.

Coverage Options After TYA

When TYA coverage ends, several alternative paths exist for obtaining health insurance. Proactive planning is essential, as some options have strict enrollment deadlines.

Continued Health Care Benefit Program (CHCBP):

• Overview: CHCBP is a premium-based health plan that provides temporary coverage (typically 18-36 months) after TRICARE eligibility, including TYA eligibility, ends. It’s administered by Humana Military and offers benefits comparable to TRICARE Select Group B, meeting minimum essential coverage requirements.
• Eligibility & Timing: Young adults losing TYA coverage are generally eligible to purchase CHCBP. Enrollment is not automatic; individuals must apply and purchase coverage within 60 days of losing TYA eligibility. Missing this deadline results in permanent loss of eligibility for CHCBP.
• Enrollment & Cost: Enrollment requires submitting the CHCBP Enrollment Application (DD Form 2837) to Humana Military, along with the first 90-day premium payment. For 2025, the quarterly premium for individual coverage is $1,849. Enrollees also pay annual deductibles and cost-shares similar to TRICARE Select Group B.
• Duration: For children losing eligibility due to age, CHCBP coverage can typically last up to 36 months.

More information is available on the TRICARE CHCBP page or by calling Humana Military at 1-800-444-5445.

Health Insurance Marketplace:

• Special Enrollment Period: Losing TYA (or other qualifying health coverage like regular TRICARE) triggers a Special Enrollment Period (SEP) on the Health Insurance Marketplace. This SEP typically lasts 60 days from the date of coverage loss, allowing enrollment in a private health plan outside the standard annual Open Enrollment Period.
• Potential Advantages: The Marketplace offers a variety of plans from different insurance companies. Depending on the individual’s income and household size, they may qualify for significant financial assistance, such as Advance Premium Tax Credits (APTCs) to lower monthly premiums and Cost-Sharing Reductions (CSRs) to lower deductibles and copays. This assistance could potentially make Marketplace coverage more affordable than CHCBP or even TYA.
• Comparison Needed: Individuals leaving TYA should actively compare Marketplace plan options, coverage details, provider networks, and potential subsidies against the cost and benefits of CHCBP to determine the best fit.

Visit healthcare.gov or call 1-800-318-2596 for more information.

Employer-Sponsored Health Insurance (ESHI): Securing employment that offers health benefits is often the most common long-term solution. Enrollment typically occurs during a new hire period. As noted earlier, gaining eligibility for ESHI terminates TYA coverage.

Medicaid: Depending on the individual’s income level and state of residence, they might qualify for low-cost or free coverage through Medicaid. Eligibility rules vary significantly by state. Information can often be found via the state’s health department or the Health Insurance Marketplace.

Post-TYA Coverage Options Overview

The transition away from TYA requires foresight and timely action. Because options like CHCBP and the Marketplace Special Enrollment Period have strict 60-day deadlines triggered by the loss of TYA coverage, individuals should begin researching these alternatives well before their TYA plan is scheduled to end.

Official TRICARE Young Adult Resources

Navigating TRICARE programs requires access to accurate, official information. The following resources provide definitive details about the TYA program and related benefits.

Key TRICARE Websites

• Main TRICARE Young Adult Page
• TYA Eligibility (Children/Aging Out):
  • TRICARE Eligibility for Children
  • TRICARE Life Events: Child to Adult
• TYA Enrollment Information
• TYA Costs (Compare Cost Tool)
• TRICARE Forms Page (for DD Form 2947)
• TYA Fact Sheet (Direct PDF)
• Covered Services Search
• TRICARE Pharmacy Program
• DEERS Information / milConnect Login
• ID Card Office Locator
• Continued Health Care Benefit Program (CHCBP)
• Health Insurance Marketplace
• FEDVIP (Separate Dental/Vision)

Getting Help: Contact Information

For specific questions regarding enrollment, eligibility, claims, or benefits, contact the appropriate entity:

TRICARE Regional Contractors:

• East Region (Humana Military): 1-800-444-5445 | Website
• West Region (TriWest Healthcare Alliance): 1-888-TRIWEST (1-888-874-9378) | Website
• TRICARE Overseas Program (International SOS): Contact via website

CHCBP Contractor (Nationwide):

• Humana Military: 1-800-444-5445

Beneficiary Counseling and Assistance Coordinators (BCACs): Located at most military hospitals and clinics, BCACs can provide personalized assistance in understanding and navigating TRICARE benefits.

Our articles make government information more accessible. Please consult a qualified professional for financial, legal, or health advice specific to your circumstances.