TRICARE Young Adult Program Questions and Answers

First verify that you are still in the DEERS database. If you are, then you may complete an application for the TRICARE Young Adult Program at US Family Health Plan. You can download the application from this website. Mail your completed form to:

US Family Health Plan
PO Box 84985
Seattle, WA 98124

The monthly premium for US Family Health Plan’s TRICARE Young Adult Program coverage is $201.

You can join US Family Health Plan at any time. When you lose your TRICARE Prime coverage you have 30 days to apply to USFHP to avoid a break in coverage. Just send in your application and a pro-rated monthly payment that is equal to $6.70 multiplied by the number of days left in the month, plus two months’ premiums: $402.

If you wait more than thirty days after you have lost your TRICARE Prime coverage, your coverage will start the 1st of the month if we receive your application and three-month payment ($603) in our office by the 20th of the previous month. If you are unsure about how much you should send in, please contact USFHP Enrollment Management at 1(888) 958-7347.

In either case, your initial payment may be made by check, money order, credit card or debit card. After the initial three-month payment, automated monthly debit payments are required from a savings or checking account or credit card.

No. The application must be signed by you—the young adult dependent. As part of the application process, you must attest that you do not have employer-sponsored health care, that you are not married and that you otherwise are qualified to purchase coverage.

Yes. Shortly after you enroll, you will receive a USFHP member identification card that will have your unique member number. This card is your proof of US Family Health Plan coverage.

The US Family Health Plan network offers you more than 50 primary care physicians (PCPs). As a USFHP member, you can choose your own PCP from the provider network. Your PCP will arrange and coordinate all of your care and ensure your providers work together as a team to keep you healthy.

USFHP members can receive care at military treatment facilities only for life-threatening emergencies.

Your US Family Health Plan coverage provides you with two options. You can order your prescriptions by mail or get them from a retail pharmacy:

• The mail-order benefit is administered by Maxor and provides you with a 90-day supply. Generic prescriptions filled by mail order are free.
• The retail benefit provides you with a 30-day supply. Prescriptions can be filled at most Pacific Medical Centers clinics or at select Bartell Drugs pharmacies in Snohomish County.

Your eligibility depends on the status of your sponsor. If your sponsor is eligible for TRICARE Retired Reserve or Reserve Select, he or she is not eligible for US Family Health Plan. And so you are not eligible for US Family Health Plan. The only TRICARE Young Adult coverage you are eligible for is TRICARE Standard or TRICARE Extra.

You can switch your coverage from the TRICARE Standard Young Adult Program to US Family Health Plan at any time. All you need to do is submit the enrollment form.

Your automatic payments must also be switched to US Family Health Plan. Please note that there is a difference in premiums between the two programs.

You may enroll in US Family Health Plan if you are not eligible for health insurance from your own employer. If you remain covered under your parent’s insurance as a dependent, your USFHP coverage will be secondary coverage. That means that USFHP will help you pay any deductibles and cost shares that you are responsible for under your parent’s insurance.

Your eligibility for coverage ends when one of the following events takes place:

• You have your 26th birthday.
• You get married.
• You become eligible for insurance through your employment.
• You become eligible for another TRICARE program.
• You fail to pay your monthly premium when it is due.
• You voluntarily submit a request to terminate USFHP.
• Your sponsor loses eligibility for TRICARE coverage.

If you voluntarily terminate your coverage, you will be locked out of the program for 12 months. If you fail to pay your premium when due, you will be locked out of the program for 12 months. (Your premium payment is due no later than the last day of the current month for the next month’s coverage.) If you fail to pay the total premium amounts due and any fees due for insufficient funds, your coverage will be terminated. If you become eligible for or enroll in another TRICARE plan or employer-sponsored health insurance, the lock-out provision will not apply.