What is Tricare? Who Can Receive Benefits from Tricare?

What is Tricare – Overview

Tricare is the health care program for uniformed service members, retirees, and their families, managed by the Defense Health Agency under the Department of Defense.

Tricare provides a range of health care plans and services to active duty service members, National Guard and Reserve members, retirees, and their families.

Who Can Receive Services from Tricare

Tricare delivers uniformed healthcare services for the following people –

What is Tricare – Who Can Receive Services

Active duty service members (ADSMs)
Active duty family members (ADFMs)
National guards and their family members
Reserve members and their family members
Retired individuals and their family members
Survivors
Certain former spouses

Tricare can connect healthcare resources, such as a network of civilian healthcare professionals, pharmacies, institutions, and supplies, with the Military Health System, military hospitals, and clinics to promote and protect health.

All Tricare plans meet the minimum essential coverage requirements under the Affordable Care Act. Tricare offers comprehensive coverage for –

Health plans
Prescriptions
Special programs
Dental plans

The Primary Mission of Tricare

The primary goal of Tricare is to offer health care for military operations and enhance the military department and national security. Their mission is to sustain the health of the individuals entrusted to the care of the entire country.

Tricare’s vision is to become the best healthcare system to foster, sustain, protect, and restore health and support the military’s mission.

Who Can Receive Benefits from Tricare

Here is a list of the individuals who can receive benefits from Tricare and its services –

Uniformed service members and their families
Army National Guard and their families
Army reserve and their families
Navy reserve and their families
Marine Corps Reserve and their families
Air National Guard and their families
Air Force Reserve and their families
US Coast Guard Reserve and their families
Survivors
Former spouses
Medal of Honor recipients and their families
Individuals registered in the Defense Enrollment Eligibility Reporting System or DEERS

12 Different Tricare Plans

There are different Tricare plans available on the market.

1. Tricare Plus

Tricare Plus is a primary care enrollment program at some military hospitals and clinics. It offers additional access to care for beneficiaries enrolled in a Tricare health plan but does not extend coverage for specialty care.

You can book an online appointment or visit your primary care provider at a nearby military hospital or clinic by calling the hospital or clinic.

The Tricare Plus program does not offer any specialty care services to anyone.

2. Tricare Prime

Tricare Prime works like a civilian health maintenance organization. One primary care manager is always assigned to every user.

Every user must receive a referral from someone to apply for specialty care services.

3. Tricare Prime Remote

Tricare Prime Remote provides managed care to active duty service members and their families living in remote areas within the U.S., ensuring they receive Tricare Prime benefits even when far from military hospitals or clinics.

However, one can only use Tricare Prime Remote if their work address and sponsor’s house are more than fifty miles from the military hospital or clinic.

Individuals who are eligible for Tricare Prime Remote –

Active duty service members
Activated National Guard or reserve members who are ordered to active duty for more than thirty days in a row
Active duty families if they live with their TRP enrolled sponsor
Activated National Guard or reserve family members when living in a remote location

4. Tricare Prime Overseas

Tricare Prime Overseas offers managed care in overseas areas near military hospitals and clinics. One must enroll here first to receive the services. The enrollment process is free for eligible individuals.

Every person has an assigned primary care manager who offers all the required services at a military hospital or clinic. The manager can also refer you to a specialist for services they cannot provide.

5. Tricare Prime Remote Overseas

Tricare Prime Remote Overseas provides managed care to active duty service members and their families stationed in specific remote overseas locations, ensuring access to comprehensive healthcare services.

Tricare Prime Remote Overseas can fulfill and exceed the requirements for basic essential coverage.

Your Primary Care Manager can refer you to specialists when needed. They can also sometimes work with international SOS for authorization.

6. Tricare Select

Tricare Select works like a civilian-preferred provider organization. Eligible individuals can choose their primary care manager and refer themselves to specialists when required.

The enrollment fees or payment structure depends on the service status of the users.

7. Tricare Select Overseas

Tricare Select Overseas delivers comprehensive coverage for different overseas areas. You must fulfill all the eligibility criteria in the Defense Enrollment Eligibility Reporting System and enroll yourself.

You do not need a referral to become eligible for these services. You can schedule an appointment with overseas providers. However, certain services may require pre-authorization.

8. Tricare For Life

Tricare For Life is a Medicare-wraparound coverage for Tricare beneficiaries with Medicare Parts A and B, primarily serving retired service members and their families over 65.

9. Tricare Reserve Select

Tricare Reserve Select provides comprehensive health care coverage to eligible members of the Selected Reserve and their families. Users must pay a monthly premium to receive those benefits.

10. Tricare Retired Reserve

Tricare Retired Reserve is a premium-based plan that is available worldwide. If you are eligible to receive the benefits, you can schedule an appointment with any of their authorized providers.

11. Tricare Young Adult

Tricare Young Adult is a premium-based health care plan available in both Prime and Select versions for qualified adult children of Tricare eligible sponsors.

Military dependents aged between 21 and 25 who are full-time students can apply for benefits. The Tricare young adult program users must pay specific enrollment fees, which are often determined by law.

12. US Family Health Plan

It is an additional prime option that offers multiple healthcare services through a community-based non-profit healthcare system. It is available in six different areas of the US.

Your primary care physician can provide all necessary medical and prescription drug coverage. However, you can select your primary care provider from their private physician network.

Depending on your requirements, they can guide you in fixing appointments with specialty care providers. However, if you are enrolled in the US family health plan, you will not be eligible to receive any care from military hospitals and clinics.

Tricare Dental Plan

The Tricare dental plan is available for guard and reserve members, their families, and active-duty family members. Most of their plans are managed by a contractor.

Retired service members and their families can enroll in dental and vision plans through the Federal Employees Dental and Vision Insurance Program (FEDVIP), not under Tricare Dental.

Conclusion

Tricare is a healthcare program that benefits the US military and their families. Their primary mission is to promote healthcare in the military department.

They offer multiple plans for their users, each with different eligibility criteria and benefits. However, you can contact your nearest military hospitals or clinics to learn more about your plans.

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