Military health insurance, mainly through TRICARE, covers active-duty troops, National Guard, Reserve, retirees, and their families. It’s not always free, though. Knowing the TRICARE plans is key for service members to choose the right health care.
TRICARE: The Military’s Health Insurance Program
TRICARE is the DoD’s health insurance, covering millions. It has plans for different needs, including hospital stays, doctor visits, and prescriptions.
TRICARE for Active-Duty Service Members
Active-duty troops get free health care through TRICARE. They must pick a TRICARE Prime plan based on where they are. The plans include:
- TRICARE Prime: Managed care with a Primary Care Manager. No costs for medical services at Military Treatment Facilities (MTFs).
- TRICARE Prime Remote: For remote locations, it allows care outside MTFs.
- TRICARE Select: More flexibility in choosing providers but may have costs and deductibles.
Coverage for Active-Duty Family Members
Dependents of active-duty members also get TRICARE coverage. They can choose Prime plans or TRICARE Select for more provider options. Costs vary by plan:
- TRICARE Prime for Family Members: No costs unless using the point-of-service option.
- TRICARE Select: Allows civilian providers without referrals but has costs like deductibles and copays.
TRICARE Coverage for National Guard and Reserve Personnel
The National Guard and Reserves get TRICARE, but coverage varies by service status.
Coverage for Activated Guard/Reserve Personnel
Activated Guard or Reserve members and their families get TRICARE Prime, like active-duty troops.
Coverage for Non-Activated Guard/Reserve Personnel
Non-activated Selected Reserve members get TRICARE Reserve Select (TRS). It’s a PPO-style plan with flexibility but requires premiums, copays, and deductibles.
TRICARE Coverage for Retired Service Members
Retirees stay eligible for TRICARE but benefits change. They must choose a TRICARE plan within 90 days of retirement to keep coverage:
- TRICARE Prime: Available in some U.S. areas, it offers managed care with lower costs.
- TRICARE Select: Allows provider choice but has higher copays and deductibles.
- US Family Health Plan: An option in specific U.S. regions, providing enhanced care at civilian facilities.
For retirees who are eligible for Medicare, TRICARE For Life (TFL) offers secondary coverage. It helps cover costs not paid by Medicare.
TRICARE Retired Reserve (TRR)
Retired members of the Reserve component who are under 60 can enroll in TRICARE Retired Reserve. This plan is similar to TRICARE Reserve Select but has higher premiums. Yet, it might be cheaper than civilian plans.
Supplemental Coverage Through the Military Benefit Association (MBA)
Many TRICARE beneficiaries choose to get extra coverage through the Military Benefit Association (MBA). MBA offers more coverage to help with costs like copays and deductibles. There are two main options:
- TRICARE Supplemental Insurance: This helps reduce or eliminate costs like copays and deductibles.
- Hospital Indemnity Insurance: It gives cash payments during unexpected hospital stays. It covers non-medical expenses like transportation or child care.
Health Insurance Options for Separated Personnel
When leaving active service, it’s important to plan for health care coverage. Luckily, there are programs to help service members and their families keep coverage as they move to civilian life.
Transitional Assistance Management Program (TAMP)
TAMP gives 180 days of TRICARE coverage after service ends. It helps those leaving active duty and their dependents keep health care benefits as they adjust to civilian life.
Continued Health Care Benefit Program (CHCBP)
CHCBP offers 18 to 36 months of health care coverage for those losing TRICARE or TAMP eligibility. It’s a premium-based program but offers the same coverage as TRICARE Select.
Civilian Health Insurance Options
After leaving the military, veterans might get health insurance from employers or buy private coverage through the Health Insurance Marketplace ®. Depending on income and household size, subsidies can help lower premium costs.
Health Care for Veterans Through the VA
The Veterans Administration (VA) provides health care for veterans. Coverage varies based on service-connected disabilities, income, and priority group. The VA offers medical treatment but is not insurance. Veterans with service-connected disabilities often get priority care and may not pay out-of-pocket.
Frequently Asked Questions (FAQs)
Is health insurance free in the military? TRICARE covers active-duty service members at no cost. But, family members, retirees, reservists, and others may pay premiums, deductibles, copays, and enrollment fees.
Does TRICARE cover dependents? Yes, TRICARE covers dependents, but costs and coverage vary by plan. Active-duty family members can choose between TRICARE Prime and TRICARE Select, each with different costs.
What is TRICARE Prime? TRICARE Prime is a managed care option. It assigns beneficiaries to a Primary Care Manager (PCM) and requires treatment at a Military Treatment Facility (MTF). It has lower costs but limits provider choices.
Does TRICARE cover retirees? Yes, military retirees can get TRICARE. They must enroll in a plan like TRICARE Prime, TRICARE Select, or TRICARE For Life (if eligible for Medicare).
Conclusion
Military health insurance through TRICARE covers active-duty service members, reservists, retirees, and their families. While TRICARE covers many services at little or no cost for active-duty members, others may face costs. Supplemental coverage, transitional programs, and civilian options ensure health care access throughout life. Knowing your TRICARE benefits and making informed choices about extra and transitional coverage is key for the well-being of military personnel and their families.
TRICARE Plans Overview
| TRICARE Plan | Eligibility | Cost for Members | Coverage Type |
|---|---|---|---|
| TRICARE Prime | Active-duty and eligible family | No cost for active-duty | Managed care through PCM |
| TRICARE Select | Active-duty family and retirees | Costs vary (deductibles, copays) | Fee-for-service, more provider flexibility |
| TRICARE For Life | Retirees with Medicare | No enrollment fee | Secondary coverage to Medicare |
| TRICARE Reserve Select | National Guard/Reserve personnel | Premium-based | PPO-style, referral not required |
TRICARE Costs Comparison (2025)
| Plan | Annual Deductible (Individual/Family) | Cost-Share/Co-pay (%) | Enrollment Fee (if applicable) |
|---|---|---|---|
| TRICARE Prime | $0 / $0 | $0 (unless point-of-service) | None for active-duty members |
| TRICARE Select | $150 / $300 | 20-25% | Varies based on sponsor status |
| TRICARE Reserve Select | $109 / $218 | 15-20% | $50-200 (premium-based) |
| TRICARE Retired Reserve | $400+ / $800+ | 20-25% | Higher premiums for retired members |
