TRICARE

About This Program

TRICARE is the healthcare program for the U.S. uniformed services, covering active-duty members, National Guard and Reserve members in qualifying statuses, retirees, and the dependents of all these groups. Several plan options exist with different cost and access tradeoffs. TRICARE Prime is an HMO-style plan requiring enrollment and care through a primary care manager (PCM) at a Military Treatment Facility (MTF) or in-network provider. It has the lowest out-of-pocket costs but requires referrals for specialty care. Active-duty members and their families are automatically enrolled in Prime and pay no premiums. Retired members and their families pay modest premiums. TRICARE Select is a PPO-style plan with more flexibility — you can see any TRICARE-authorized provider without a referral, but with higher cost-sharing than Prime. TRICARE For Life is available to Medicare-eligible beneficiaries as a secondary payer to Medicare, effectively eliminating most Medicare cost-sharing for covered services. Coverage includes primary care, specialty care, hospitalization, surgery, mental health, pharmacy, and preventive care. TRICARE pharmacy benefits are particularly valuable — prescriptions filled at military pharmacies or through mail order are very low-cost or free. Dental coverage requires separate enrollment in TRICARE Dental. Eligibility and enrollment are managed through the Defense Enrollment Eligibility Reporting System (DEERS). Service members must ensure their dependents are enrolled in DEERS to access TRICARE coverage.

Eligibility Requirements

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