HomeFinancial WellnessUnderstanding TRICARE: Types and Eligibility

Understanding TRICARE: Types and Eligibility

TRICARE is a healthcare program providing comprehensive coverage for military personnel, retirees, and their families. The program offers several types of plans, each designed to meet the needs of different beneficiaries. Here’s an in-depth look at the various TRICARE options:

  1. TRICARE Prime

Description: TRICARE Prime is a managed care plan similar to an HMO (Health Maintenance Organization). It requires beneficiaries to use a network of military and civilian providers.

Eligibility: Available to active-duty service members and their families. Certain retirees and their families may also be eligible.

Coverage: Includes comprehensive medical services such as preventive care, specialist visits, and hospitalizations. Beneficiaries must choose a primary care manager (PCM) and obtain referrals for specialty care.

 

  1. TRICARE Select

Description: TRICARE Select is a fee-for-service plan that offers more flexibility in choosing healthcare providers. It is similar to a PPO (Preferred Provider Organization) plan.

Eligibility: Available to active-duty family members, retirees, and others. Beneficiaries can see any provider but will pay less if they use network providers.

Coverage: Offers broad coverage for medical services, including hospital stays, physician visits, and prescription drugs. Referrals are not required for most specialist visits.

 

  1. TRICARE for Life

Description: TRICARE for Life is a supplemental health insurance plan that works alongside Medicare. It provides additional coverage for expenses not covered by Medicare.

Eligibility: Available to retirees and their families who are eligible for Medicare Part A and B. It covers medical services both domestically and internationally.

Coverage: Includes comprehensive coverage for most healthcare needs, including hospital and outpatient care, and prescription drugs. It helps cover costs like deductibles and co-pays that Medicare does not cover.

 

  1. TRICARE Reserve Select

Description: TRICARE Reserve Select is a health plan for National Guard and Reserve members who are not on active duty.

Eligibility: Available to qualified members of the National Guard and Reserves who meet specific criteria, including maintaining their reserve status.

Coverage: Provides similar benefits to TRICARE Select, including access to a network of providers and flexible care options.

 

  1. TRICARE Young Adult

Description: TRICARE Young Adult provides coverage for young adults who are no longer eligible for other TRICARE options but are under 26 years old.

Eligibility: Available to unmarried children of service members or retirees who are under age 26 and not eligible for employer-sponsored insurance.

Coverage: Offers comprehensive medical coverage, including preventive care, hospitalization, and prescription drugs.

 

These TRICARE options ensure that military families have access to quality healthcare coverage tailored to their unique needs and circumstances.

 

Resources:

  1. TRICARE. (n.d.). TRICARE Plans and Benefits. Retrieved August 4, 2024, from https://www.tricare.mil
  2. Defense Health Agency. (n.d.). TRICARE Eligibility and Benefits. Retrieved August 4, 2024, from  https://www.health.mil