What is Tricare? Who Can Receive Benefits from Tricare?

What is Tricare – Overview

Tricare is the health care program of the US military. It also works as a health insurance program managed by the government. The Pentagon’s Defense Health Agency often manages all the programs of Tricare.

Tricare delivers multiple healthcare programs with various coverages for millions of former and current service members and their families.

Who Can Receive Services from Tricare?

Tricare delivers uniformed healthcare services for the following people –

• 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 like a network of civilian healthcare professionals, pharmacies, institutions, and supplies with the Military Health System, military hospitals, and clinics to promote and protect health.

Most Tricare programs can fulfill the requirements for minimum essential coverage 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 who are 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 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 health care program you can receive from some military hospitals and clinics. You must enroll yourself first to receive all the benefits they offer.

You can book an online appointment or call your nearby military hospital or clinic to visit your primary care provider.

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 or TPR, offers managed care in different remote areas of the US.

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. They can refer you to a specialist for services they cannot provide.

5. Tricare Prime Remote Overseas

Tricare Prime Remote Overseas offers managed care in remote overseas locations, including –

• Pacific
• Eurasia-Africa
• Latin America
• Canada

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 also can work with international SOS for authorization at times.

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 depend 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.

Any referral is not required 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

The name ‘Tricare For Life’ is assigned by the law. It is a program that offers supplemental health services for retired people and their families who are over 65 years old.

9. Tricare Reserve Select

Tricare reserve selection offers benefits for both traditional guards and reservists. 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

Depending on your requirements, you can receive Tricare young adult benefits in both select or prime versions.

Military dependents aged somewhat between 21 and 25 who are full-time students can apply for the benefits. The users of the Tricare young adult program must pay specific enrollment fees. These enrollment fees 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 you with all the 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 to fix 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.

However, retired military persons can buy dental plans through the Federal Employee Dental and Vision Insurance Program (FEDVIP).

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 have multiple plans for their users. Every plan has different eligibility criteria and benefits. However, you can always contact your nearest military hospitals or clinics to learn more about your plans.

See Also

IVF Grants for Military Families

Free Dental Implants for Veterans

Veteran Business Grants

Grants for Disabled Veterans

VA Disability Rates

Can You Have Medicare and Medicaid at the Same Time?

Does Medicaid Cover Hearing Aids?