Who is eligible for TRICARE? (2024)

FAQs

Who is eligible for TRICARE? ›

TRICARE is a health program for: Uniformed Service members and their families, National Guard/Reserve members.

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.

Providers must verify patient eligibility online (log in to the Secure Portal), through the self-service tools at 1-844-866-WEST (1-844-866-9378), or via electronic data interchange (EDI).

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.

TRICARE is managed by the Defense Health Agency under leadership of the Assistant Secretary of Defense (Health Affairs).

Conditional eligibility notices will be sent to affected Covered California consumers who have not resolved their inconsistency and submitted documents 45 days after their eligibility determination.

When you register with the Defense Enrollment Eligibility Reporting System (DEERS), you will receive a Uniformed Services Identification (ID) Card that you should use as your TRICARE For Life card. Use this ID card when visiting a provider or filling a prescription.

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.

Are you enrolled in a plan, but not sure which one? If so, you can find out which plan you're enrolled in: By logging into your account in Defense Enrollment Eligibility Reporting System (DEERS) via milConnect, or. By calling your regional contractor.

Why are doctors dropping TRICARE? ›

The second most cited specific reason given by doctors for rejecting Tricare users is that they don't like the reimbursem*nt rate given by Tricare. That reason was particularly high among specialized doctors, according to the report.

No. The VA and TRICARE are two different government programs. Getting a disability rating from the VA doesn't mean you get TRICARE. To learn about your VA benefits, visit the U.S. Department of Veterans Affairs page.

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.

WHO IS ELIGIBLE FOR ENROLLMENT IN THE TRICARE SUPPLEMENT PLAN? Eligibility in the TRICARE Supplement Plan includes the following: Military retirees entitled to retired pay and their spouses/surviving spouses who are ineligible for Medicare and enrolled in TRICARE.

Government health program serving dependents of active-duty service members, military retirees and their families, some former spouses, and survivors of deceased military members.

Active duty service members and their families (spouses and children registered in DEERS) are eligible for TRICARE.