There are more than 20 different life events that count as TRICARE QLEs. Rules and restrictions apply to each. Download the TRICARE Qualifying Events Fact Sheet at www.tricare.mil/publications or visit www.tricare.mil/lifeevents to learn more.
| Qualifying Life Event |
Examples |
| Change in sponsor status that results in ineligibility to continue existing coverage |
- Retiring from active duty
- Separating from active duty
- Activating
- Deactivating
|
| Change in family composition |
- Marriage
- Divorce or annulment
- Adoption of a child
- Placement of a child by a court in member's home
- Children becoming adults (turning either age 21 or age 23 if a full-time student
- Death in family
|
| Moving (change of address) |
- Child moving away to college
- Relocation to a new country, city, region, or ZIP +4 code
|
| Government-directed changes |
- Government-directed primary care manager change
- Government-directed health plan change
|
| Change in command sponsorship (overseas only) |
- Gaining or losing permission to have family members accompany the military member, with full military benefits, during an assignment overseas
|
| Losing sponsor or family member eligibility that results in ineligibility to continue existing coverage |
- Turning age 60 (Retired Reserve member)
- Turning age 65 (Becoming entitled to Medicare)
|
| Change in eligibility status of any single family member in another family |
- In case where both parents are sponsors, change in eligibility status for either member of a joint service family*
|
| Gaining or losing other health insurance |
- Gaining or losing employer-sponsored health insurance
- Gaining or losing Medicare entitlement
- Gaining or losing Medicaid entitlement
|
Frequently Asked Questions
TRICARE QLE Questions and Answers
Q2:
What if I don’t experience a QLE? Do I have any other option?
A:
You may. If you’re eligible for TRICARE, but don’t enroll in a plan during open season or within 90 days of a QLE, you’ll only be eligible for care and pharmacy services at a military hospital or clinic if space is available.
If you’re a qualified member of the Select Reserve or Retired Reserve and you aren’t in an active status, you may be eligible to purchase a premium-based plan for you and your family. The same is true if you have an eligibility change. Available options include TRICARE Reserve SelectA premium-based plan for qualified Selected Reserve members and their families.TRICARE Reserve Select, TRICARE Retired Reserve, TRICARE Young Adult, and the Continued Health Care Benefit Program. You can purchase a premium-based plan at any time, except for the Continued Health Care Benefit Program (CHCBP). You can only purchase CHCBP coverage within 60 days of loss of eligibility for TRICARE.
You also may be eligible for TRICARE For LifeMedicare-wraparound coverage for TRICARE-eligible beneficiaires who have both Medicare Part A and B.TRICARE For Life. Coverage is automatic if you have Medicare Part A and Part B.
Q3:
What is a qualifying life event (QLE)?
A:
A QLE is a certain change in your life that would make you eligible to enroll in a TRICARE Prime option or TRICARE SelectTRICARE Select is a self-managed, preferred provider network plan. TRICARE Select is a fee-for-service option in the United States that allows you to get care from any TRICARE-authorized provider. Enrollment is required to participate.TRICARE Select outside of open season. These life events may open up TRICARE health plan options for you and your family. If you want to make any eligible changes, you’ll have 90 calendar days from the date of the QLE to do so.
Q4:
When Does Coverage Start?
A:
Your coverage will start on the date of the QLE and continue until you lose eligibility or disenroll.