MCRD/ERR PARRIS ISLAND, S.C. -- As of Feb. 1, the Department of Defense Military Health System began automatically issuing a Certificate of Creditable Coverage to any former uniformed services sponsor or any family member who loses eligibility for health care benefits under TRICARE.
Who will receive a Certificate of Creditable Coverage?
Any former military sponsor or family member whose eligibility for TRICARE ends as a result of the sponsor's separation from active duty status, divorce, demobilization if the sponsor is a member of the National Guard or Reserves, or a dependent child reaching age 21 (or 23 for a full-time college student).
What is a Certificate of Creditable Coverage?
According to Mr. Paul Marcinko, Naval Hospital Beaufort Health Insurance Portability and Accountability Act of 1996 Privacy Officer, "The certificate is written
proof of prior healthcare coverage. When you leave the military and accept a job offer and choose to purchase other insurance, the other insurance plan may ask for a Certificate of Creditable Coverage to show that you had prior healthcare coverage.
The certificate provides proof of TRICARE coverage for the period of time noted on the certificate.
Health plans use the certificate to show prior coverage and to reduce the period of time that you might otherwise be excluded from coverage for a pre-existing condition."
Why would I need a Certificate of Creditable Coverage?
A healthcare plan can refuse to pay for healthcare for conditions you had prior to being covered by that plan. Plans may refuse to cover you for these pre-existing conditions for a set period of time (for instance, they may say they will not cover you for your high blood pressure for six months), unless you can prove that you had coverage for your condition prior to enrolling in their plan.
A Certificate of Creditable Coverage is the document that proves you had previous healthcare coverage.
How do I get a Certificate of Creditable Coverage?
The Defense Manpower Data Center Support Office, as custodian of the Defense Enrollment Eligibility Reporting System, will mail a certificate for the sponsor or family member within five to 10 days after eligibility expires.
The certificate will be mailed to the address on file in DEERS, which is why it is important for everyone to ensure their DEERS information is updated.
Sponsors or family members, who need their certificate sooner, may mail or fax a request to the DSO.
The request should include the sponsor's name and Social Security number, name of family member(s) for whom the certificate is needed, reason for the urgent request, name and address of the person or organization where the certificate should be sent, and the signature of the requester.
Where do I send my request?
The DSO fax number is: (831) 655-8317; the address is: Defense Manpower Data Center Support Office (DSO), Attn: Certificate of Creditable Coverage, 400 Gigling Road, Seaside, CA 93955-6771.
Where can I get assistance with this?
Sponsors or family members who have questions regarding the certificate may contact the DSO at (800) 538-9552, or TTY/TDD at (866) 363-2883.
Additional information is also available on the TRICARE Web site located at www.tricare.osd.mil/certifi cate/index.cfm.