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I am not sure what difficulty there would be. If you are talking about getting on/off base or medical attention and stuff think that... You will have your MIL ID so there really is no question. It says right on there that you are the spouse of so and so..
I don't have experience with the military. But I kept my name throughout the whole 20 years of my first marriage. The worst inconvenience I faced was sometimes ending up in the A-L line while the rest of my family was in M-Z. But I had my husband and children on my health insurance with no issues, even though they all had a different last name.
A friend of mine is a "new" military wife-- well she is doing ROTC and this is her last year and her husband has been serving abroad-- and she kept her name. As far as I know, no issues.
I am glad you brought this up, I don't plan on changing my last name and as far as I know as long as it is on the mil ID you should be okay. I am going to ask my SO/FI about this right now.
I got married to a Marine in October, haven't changed my name yet (and won't until after the religious ceremony in July'13) and we haven't run into any issues. I think the other posters are right, as long as you have your ID on you, it says who you're married to. There shouldn't be any issues 
I didn't change my name legally before we went to DEERS. My military ID lists me as his name and me as his spouse with my maiden name. It shouldn't matter unless, like @2dbride and myself, your maiden name and married name are in different halves of the alphabet. That's not a problem, per se, just more of an inconvenience.
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I don't want to change my name when I get married, and my FI is totally fine with that. But, I keep hearing from everyone I know that there are so many things that become more difficult if I don't change my name especially because my FI is in the military.
Does anyone have experience with this? Being married to a service member but not changing your last name? Or being a service member who is not changing their name?