TRICARE is the health insurance for military families. It covers medical, dental, and vision care. It helps those who serve or have served in the U.S. military get the care they need, both in the U.S. and abroad.
What Does TRICARE Cover?
TRICARE offers a wide range of medical services. This includes:
- Preventive care (e.g., annual physicals, vaccinations)
- Primary care (e.g., doctor visits, specialist consultations)
- Hospital stays (e.g., inpatient and outpatient services)
- Prescriptions (e.g., medication coverage at pharmacies)
- Mental health care (e.g., counseling, therapy)
- Vision and dental care (depending on the plan)
TRICARE also has special programs for health needs like maternity care and substance abuse treatment. It ensures military families get top-notch care.
Who Is Eligible for TRICARE?
TRICARE is for active-duty members, National Guard and Reserve, retirees, and their families. Here’s who can get it:
- Active Duty Service Members (ADSMs): Full-time military personnel on active duty.
- Active Duty Family Members (ADFMs): Spouses and children of ADSMs.
- National Guard and Reserve Members: Those who serve part-time but are activated for federal service.
- Retirees and Their Families: Former service members who qualify for retirement benefits.
- Medal of Honor Recipients: Special coverage is offered for these honorees and their families.
- Surviving Family Members: Spouses and children of service members who died while on active duty or after retirement.
Types of TRICARE Plans
TRICARE has different plans based on your military status and location. Here are the main ones:
| TRICARE Plan | Who It Covers | Features |
|---|---|---|
| TRICARE Prime | Active-duty service members, retirees under 65, families | Low or no cost for care, managed care option, available in certain areas |
| TRICARE Select | Active-duty family members, retirees, Guard/Reserve | Freedom to choose any TRICARE-authorized provider, fee-for-service option |
| TRICARE For Life (TFL) | Retirees and family members 65+ with Medicare | Acts as secondary insurance with Medicare, covering most costs not paid by Medicare |
| TRICARE Reserve Select | National Guard and Reserve members | Premium-based plan similar to civilian insurance, designed for reservists |
| TRICARE Retired Reserve | Retired Guard and Reserve members | Similar to TRICARE Reserve Select but for retirees |
1. TRICARE Prime
TRICARE Prime is a managed care option for active-duty members, their families, and retirees under 65. It requires enrollment but has no out-of-pocket costs for active-duty members. Family members may have small copayments for some services. It offers full coverage at low costs but requires using a network of providers.
2. TRICARE Select
TRICARE Select lets you pick your own doctors. It’s for active-duty families, retirees, and Guard/Reserve members. You get more freedom but might pay more, like copays and deductibles.
3. TRICARE For Life
TRICARE For Life is for military retirees 65 and older with Medicare. It covers what Medicare doesn’t, like copays and deductibles.
4. TRICARE Reserve Select
This plan is for National Guard and Reserve members not on active duty. It works like civilian insurance, with monthly fees, copays, and deductibles. It’s affordable for reservists and their families.
5. TRICARE Retired Reserve
Similar to TRICARE Reserve Select, this plan is for retired Guard and Reserve members under 60. It offers coverage with access to military and civilian providers.
Costs of TRICARE Plans
TRICARE costs vary by plan and military status. Here’s a look at common costs:
| TRICARE Plan | Annual Enrollment Fees | Copayments | Deductibles |
|---|---|---|---|
| TRICARE Prime | $0 for active duty; $365 individual/$730 family for retirees | $0 to low copayments for active duty | None for active duty |
| TRICARE Select | No enrollment fee for active duty families; $150 individual/$300 family for retirees | Varies depending on service | $150 individual/$300 family for retirees |
| TRICARE For Life | None (must have Medicare Part B) | No copayments with Medicare | No deductibles |
| TRICARE Reserve Select | $42.83 monthly for individuals; $218.01 for families | Varies depending on service | $50 to $150 depending on rank and status |
Knowing your costs helps manage your health care budget. TRICARE is often cheaper than civilian plans, great for active-duty and their families.
How To Enroll in TRICARE
Enrolling in TRICARE varies by eligibility and plan. Here’s how to do it:
- Create a DS Logon Account: Use milConnect to manage your TRICARE benefits.
- Select Your Plan: Pick the best TRICARE plan for you.
- Complete Enrollment: Apply online through milConnect or mail forms.
- Update Your DEERS Information: Keep DEERS up to date for enrollment.
- Pay Enrollment Fees: Pay premiums or fees on time.
TRICARE Pharmacy Program
TRICARE offers prescription drug coverage through the TRICARE Pharmacy Program. This program covers prescription medications at:
- Military Treatment Facility Pharmacies
- Retail Network Pharmacies
- Home Delivery
- Non-Network Pharmacies
Using military or network pharmacies will reduce costs. The Home Delivery option is convenient for long-term medications.
Special Programs Under TRICARE
TRICARE also offers several special programs to meet the needs of its beneficiaries:
- TRICARE Dental Program (TDP): Available to active-duty families, National Guard/Reserve members, and retirees. The TDP provides dental care, including cleanings, fillings, and orthodontics.
- TRICARE Young Adult: For dependents aged 21-26 who are no longer eligible for regular TRICARE but can enroll in a premium-based plan.
- Extended Care Health Option (ECHO): This program offers additional services for family members with special needs, covering therapies, assistive technology, and more.
Frequently Asked Questions (FAQs)
Is TRICARE Free for Active Duty Members?
Yes, TRICARE is free for active-duty service members. Family members may have small copayments depending on the plan they choose.
Can I Use TRICARE If I Live Overseas?
Yes, TRICARE offers coverage for beneficiaries living abroad through TRICARE Overseas. It provides the same benefits as domestic plans but includes additional support for international health care needs.
What Is the Difference Between TRICARE Prime and TRICARE Select?
TRICARE Prime is a managed care option that requires using network providers. TRICARE Select offers more freedom to choose any provider but may come with higher out-of-pocket costs.
How Do I Know Which TRICARE Plan Is Right for Me?
Your plan choice depends on your military status, location, and health care needs. Active-duty members usually enroll in TRICARE Prime. Retirees and those preferring more flexibility often choose TRICARE Select.
Conclusion
TRICARE is a health care program for U.S. military service members, retirees, and their families. It offers various plans to ensure affordable, quality care, no matter where you are. Understanding your options, costs, and coverage will help you make the best decision for your family’s health care needs.
TRICARE continues to evolve, providing a vital lifeline for those who serve our country and their loved ones. Whether you’re on active duty, a retiree, or a reservist, TRICARE has a plan to suit your needs.
