TRICARE 101 | TRICARE (2024)

What is TRICARE?

TRICARE is the uniformed services health care program for active duty service members (ADSMs), active duty family members (ADFMs), National Guard and Reserve members and their family members, retirees and retiree family members, survivors, and certain former spouses worldwide.

TRICARE brings together the health care resources of the Military Health System—such as military hospitals and clinics—with a network of civilian health care professionals, institutions, pharmacies, and suppliers to foster, protect, sustain, and restore health for those entrusted to their care.

TRICARE 101 | TRICARE (1)

Your service personnel office determines your TRICARE eligibility. Those eligible for TRICARE include:

  • Active duty service members and families
  • National Guard/Reserve members and families
  • Retired service members and families
  • Retired Reserve members and families
  • Beneficiaries eligible for TRICARE and Medicare
  • Survivors
  • Children
  • Former spouses
  • Medal of Honor recipients and families
  • Dependent parents and parents-in-law
  • Foreign Force members and families

To check your eligibility, first make sure your information isfully updated in DEERS. Then, you can log intomilConnectand check whether you are eligible for TRICARE.>>Learn more

Where can I get care?

The Military Health System (MHS) is a global, comprehensive, integrated system. You may be able to get care from a military hospital or clinic, a civilian network of providers, or TRICARE-authorized non-network providers.

Military Hospitals and Clinics

The Department of Defense (DoD) operates many military hospitals and clinics. You may be able to seek care there, depending on where you are, what plan you have, and your beneficiary category.>>Learn More

Civilian Network

You can also seek care from a civilian network of TRICARE-authorized providers. This network depends on what region you are in.>>Learn More
To search for a provider in one of our provider directories, visit the Find a Doctor tool to get you to the right directory for you.>>Learn More
Note: You may be able to see a non-network TRICARE-authorized providerAn authorized provider is any individual, institution/organization, or supplier that is licensed by a state, accredited by national organization, or meets other standards of the medical community, and is certified to provide benefits under TRICARE. There are two types of TRICARE-authorized providers: Network and Non-Network. DS, depending on your TRICARE plan. But you may have higher costs and you may have to file your own claims.>>Learn More

TRICARE 101 | TRICARE (2)

There are different plan options depending on who you are. If you're new to TRICARE, select the option below that best describes you for more information:

  • New Active Duty Service Members
  • New Spouse
  • National Guard and Reserve Members
  • Family Members of National Guard or Reserve Members
  • Foreign Force Members and Families

What plans can I choose from?

There are a number of TRICARE plans available. Remember that your eligibility for these plans depends on who you and your sponsor are.Plan FinderandCompare Plansare useful tools on our website. To learn more about each plan, select from the list below:

  • TRICARE Prime
  • TRICARE Prime Remote
  • TRICARE Prime Overseas
  • TRICARE Prime Remote Overseas
  • TRICARE Select
  • TRICARE Select Overseas
  • TRICARE For Life
  • TRICARE Reserve Select
  • TRICARE Retired Reserve
  • TRICARE Young Adult
  • TRICARE Plus
  • US Family Health Plan

To see what TRICARE plans you may be eligible for, use theTRICARE Plan Findertool.

TRICARE 101 | TRICARE (3)

How do I enroll in TRICARE?

Once you know your plan, visit theTRICARE Enrollment pagefor steps on how to enroll or purchase a plan.

How much does TRICARE cost?

Each TRICARE plan has different costs for care and coverage. You can use theTRICARE Compare Costtool to view and compare costs for covered services, enrollment, and plan premiums.

Where can I get care?

Depending on your plan, you’ll get care from either a military hospital or clinic, or a civilian provider. For more information, visit theProvider Typespage or use theFind a Doctor tool.

What does TRICARE cover?

You can use theTRICARE Covered Servicestool to see if something is covered or not by searching keywords, or browsing common categories. To check if your prescription drugs are covered, visit theTRICARE Formulary.

Can I get TRICARE worldwide?TRICARE 101 | TRICARE (4)

Yes, TRICARE is available worldwide.

There are two TRICARE regions in the U.S.:

  • TRICARE East
  • TRICARE West

And there’s one overseas region with three areas:

  • TRICARE Eurasia-Africa
  • TRICARE Latin America and Canada
  • TRICARE Pacific

Ourcontract partnershelp deliver the benefit around the world. Your benefits are the same no matter where you live. There are different customer service contacts for each of our partners.

TRICARE 101 | TRICARE (5)

TRICARE offersprescription drug coverageand many options for filling your prescriptions. You have the same pharmacy coverage with any TRICARE health plan. But, if you're enrolled in theUS Family Health Plan, you have separate pharmacy coverage.

Dental coverage is separate from TRICARE’s medical coverage. Your dental coverage is based on who you are.

Vision coverage, including eye exams, depends on:

  • Who you are
  • Your TRICARE plan
  • Your age

Getting Started is Easy

  1. Confirm your eligibilityonlineor call 1-800-538-9552
  2. Explore yourhealth plan options
  3. Decide which is right for you andenroll(if required)

Where can I find more information on TRICARE?

You can find a number of helpful resources on TRICARE.mil, including:

  • TRICARE Newsroom
  • TRICARE Publications
  • TRICARE Newsletters
  • TRICARE Resources
  • Frequently Asked Questions
  • Military Hospitals and Clinics
  • TRICARE Podcast
  • Find a Phone Number

You cansign upto receive TRICARE updates and news releases via email. You can also follow TRICARE onFacebookandTwitter.

Last Updated 8/24/2023

TRICARE 101 | TRICARE (2024)

FAQs

What is the 20 20 20 rule for TRICARE? ›

20/20/20: Under the 20/20/20 rule, you keep TRICARE health care benefits for as long as you remain eligible if: You were married to the service member for at least 20 years, The service member served in the armed forces for at least 20 years, and. The marriage and the period of service overlapped for at least 20 years.

Why does no one accept TRICARE? ›

Among the most common reasons provided by both physicians and mental health providers for not accepting either insurance type are insufficient reimbursem*nt or their specialty not being covered; lack of awareness of TRICARE is also frequently cited, particularly among mental health providers.

What is TRICARE 101? ›

TRICARE is the health care program for active duty service members, National Guard and Reserve members, retirees, and their eligible family members. Your service personnel office determines your eligibility.

Can 100% veterans get TRICARE? ›

To receive TRICARE coverage, you must have a health condition that prevents you from performing military duties, and must have a disability rating of 30% or more from the Department of Veteran's Affairs.

At what age do you lose TRICARE? ›

What happens to their TRICARE coverage? If they're under 21, TRICARE coverage continues until age 21. If they're 21 or over, TRICARE coverage ends when they graduate or turn 23, whichever comes first. When they lose eligibility, they may qualify to buy TRICARE Young Adult (TYA).

What is the 10 10 rule for TRICARE? ›

If you were married for at least 10 years in a period that overlapped with your spouse's active-duty service for at least 10 years (known as the 10-10 rule), then the Defense Finance and Accounting Service (DFAS) will usually pay your portion of the pension directly to you.

Why are doctors dropping TRICARE? ›

The problem stems from the fact that most Tricare managed care support contractors have negotiated physician reimbursem*nt rates that are even lower than those paid by Medicare. Unhappy with their fees, some major health care provider groups have simply dropped out of the system.

What are the downfalls of TRICARE? ›

TRICARE Standard disadvantages: Most expensive option. Must pay a deductible and cost share. No PCM to guide patient care.

Why is Walmart not accepting TRICARE? ›

Walmart declined several opportunities to offer more highly competitive discounts to continue to serve Tricare beneficiaries,” said Express Scripts officials, in a statement to Military Times.

What does TRICARE not cover? ›

In general, TRICARE excludes services and supplies that are not medically or psychologically necessary for the diagnosis or treatment of a covered illness (including mental disorder), injury, or for the diagnosis and treatment of pregnancy or well-child care.

What are the two most common TRICARE options? ›

Available TRICARE plans. There are many different TRICARE plans, but TRICARE Prime and TRICARE Select are the two primary options for active-duty service members and their families.

Is TRICARE worth it? ›

Is TRICARE good health insurance? While there can be occasional issues, generally speaking, TRICARE plans offer generous coverage for treatments, tests, services, and prescriptions with relatively low out-of-pocket costs compared to many civilian health plans.

Does the VA accept TRICARE for Life? ›

Yes, since 1995, all VA health care facilities have participated as TRICARE Network Providers. VA can provide care for Active Duty Service Members, military retirees, & family members under their TRICARE benefit - on a space available basis.

Who is not eligible for TRICARE? ›

TRICARE does not cover every veteran: While retirees, Medal of Honor recipients, and their families are typically eligible for TRICARE health insurance, other separated service personnel are generally not. Veterans who don't qualify for TRICARE are typically eligible for medical services through the VA health system.

Can you be 100 VA disabled and still be in the military? ›

Provided you have been medically cleared to serve, simply having a VA disability rating isn't enough to prohibit you from serving on active duty.

What is the 20/20/20 rule in the military? ›

An un-remarried former spouse may retain the military ID card if he or she meets the 20/20/20 rule. The 20/20/20 rule requires at least twenty years of marriage, at least twenty years of military service, and at least twenty years of overlap of the marriage and the military service.

What benefits does the 20 20 20 military spouse get? ›

Full benefits (medical, commissary, exchange, theater, etc.) are extended to a former spouse if: ➢ The parties were married for at least 20 years; ➢ The military member performed at least 20 years of service creditable for retirement; and ➢ There was at least a 20-year overlap of the marriage and the military service.

What happens to TRICARE after 65? ›

TRICARE and Medicare beneficiaries who are age 65 must have Medicare Part A and Part B to remain TRICARE-eligible and be able to use TFL. TRICARE beneficiaries who aren't eligible for premium-free Medicare Part A at age 65 on their own work history or their spouse's work history remain eligible to enroll in USFHP.

What is a military spouse entitled to in a divorce? ›

The amount of money the former spouse becomes entitled to will be determined by the judge rendering the final divorce decree. The maximum amount that can be paid to a former spouse is 50 percent of the Servicemember's disposable retired pay (gross retired pay less allowable deductions, including VA disability pay).

References

Top Articles
Latest Posts
Article information

Author: Francesca Jacobs Ret

Last Updated:

Views: 5782

Rating: 4.8 / 5 (68 voted)

Reviews: 91% of readers found this page helpful

Author information

Name: Francesca Jacobs Ret

Birthday: 1996-12-09

Address: Apt. 141 1406 Mitch Summit, New Teganshire, UT 82655-0699

Phone: +2296092334654

Job: Technology Architect

Hobby: Snowboarding, Scouting, Foreign language learning, Dowsing, Baton twirling, Sculpting, Cabaret

Introduction: My name is Francesca Jacobs Ret, I am a innocent, super, beautiful, charming, lucky, gentle, clever person who loves writing and wants to share my knowledge and understanding with you.