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TRICARE for Active Duty Service Members

TRICARE for active duty

TRICARE is the United States military healthcare program for active duty military members and their families. When you start your career in the Armed Forces, you are covered by TRICARE from the moment you ship out to boot camp, and you will later formally enroll in TRICARE on behalf of yourself and your family.

Military members have basic coverage options, but family members have expanded options and may, depending on the plan, have the option to apply for TRICARE coverage to supplement the options they have with civilian or federal employers.

The programs below are all approved for active duty troops. This article does not cover the TRICARE options for those retiring or separating from the military; these are options for those who are currently serving on active duty status. Terms and conditions for Guard and Reserve troops who are activated may be similar, but conditions may apply.

TRICARE for Active Duty Service Members and Families

Active duty service members and eligible family members registered in DEERS have options for TRICARE including the following:

  • TRICARE Prime is a managed care health insurance plan all active duty military members use when assigned to a stateside base.
  • TRICARE Prime Remote is for servicemembers and their families stationed in remote locations in the United States.
  • TRICARE Prime Overseas is similar to Prime but is a “managed care” plan for those assigned to overseas areas near military hospitals and clinics.
  • TRICARE Prime Remote Overseas is also a managed care option but this is for those stationed overseas in remote locations.

TRICARE Prime

TRICARE Prime is offered to those assigned stateside, located in “Prime Service Areas”. This plan is offered to active duty service members and their families, who will use a Primary Care Manager or PCM who is either a military care provider or an in-network provider. You get referrals for services your PCM cannot offer and you make your copays to the PCM. Active duty troops pay no fees out of pocket, and family members likewise unless they select a “point-of-service” option. Point-of-service plans cost more but allow the following:

  • Care available from any TRICARE-authorized provider
  • Options for routine care
  • No referrals required

Active duty troops are covered by Prime when they ship out to basic training. Enrollment is required but it typically does not happen immediately in spite of being covered. TRICARE Prime is the only option you can have as an active duty service member–you cannot carry other health insurance when stationed in the United States. Family members are not restricted in this way (see below).

TRICARE Prime Remote

TRICARE Prime Remote is a managed care plan similar to Prime but offered only in remote areas in the United States. According to the TRICARE official site, you may only enroll in Prime Remote when the service member’s home and work addresses are more than 50 miles (or one hour’s drive time) from a military hospital or clinic. Enrollment is required but there are no fees for active duty troops.

“Most care” comes from a primary care manager (PCM) or a network PCM where applicable. The PCM will offer referrals for services they cannot provide and you may be offered help finding specialists and filing claims. Prime Remote is not offered overseas as there is a different plan for those assignments.

TRICARE Prime Overseas

Like its stateside equivalent, TRICARE Prime Overseas is a managed care option for those assigned to bases outside the United States. Enrollment is required, there are no enrollment fees, and TRICARE Prime is available to both the service member and “command sponsored: dependents.

“Command sponsored” means the family members are listed on the service member’s orders and are approved to accompany the service member to the overseas location. Those who are not command sponsored may not be eligible for care under TRICARE Prime Overseas. Likewise for spouses and/or dependents who were originally command sponsored but lost that command sponsorship for some reason.

Like TRICARE Prime for stateside assignments, most care is offered via a PCM. For Prime Overseas your care is likely to start at a military clinic or hospital. The PCM offers referrals when specialist care is needed. There are no copays as long as your care comes from the PCM or via a referral.

TRICARE Prime Remote Overseas

Prime Remote Overseas is for those who are stationed at remote assignments. This plan is offered to both service members and families, but in many cases a soldier, sailor, airman, Marine, or Guardian may be sent to such an assignment without dependents. In order for dependents and spouses to qualify for Prime Remote Overseas, they must be command sponsored.

There are three coverage areas for Prime Remote:

  • Eurasia-Africa
  • Latin America and Canada
  • Pacific

Most healthcare under Prime Remote comes via an assigned primary care manager who will refer you to specialists for care the PCM cannot offer. There are no enrollment fees, and no copays as long as your care is from the PCM or by referral.

TRICARE for Active Duty Family Members

Active duty family members can enroll in the Prime plans above along with the service member but they are not restricted from seeking other TRICARE options which may include:

TRICARE Select is a plan described as a preferred provider organization plan (PPO) offered to those in the United States. This option is described as a self-managed, preferred provider organization (PPO) plan available, and is offered to those living in the United States. Family members who are registered in DEERS may apply for this option.

TRICARE Select Overseas provides comprehensive coverage for family members living at overseas duty locations. This is offered for command-sponsored family members only and works in a similar fashion to TRICARE Select.

US Family Health Plan is a TRICARE Prime option available through networks of community-based health care systems. This plan is not offered to all and is available only in “designated US Family Health Plan” areas. It’s an “additional TRICARE Prime option” offered to those living in qualifying regions. Care is offered via networks of community-based healthcare providers in six regions in the USA.

TRICARE For Life is for family members who are TRICARE-eligible and have Medicare Part A and B. Enrollment for this program is automatic if you meet the requirements. Under this program, you can use any care provider who accepts Medicare, which is the “first payer” with TRICARE For Life paying the remainder for approved services.

TRICARE Young Adult is for qualifying adult children after their eligibility for “regular” TRICARE coverage ends at age 21 (or 23 if enrolled in college according to the official site). This option is for those who are unmarried adult children of an eligible TRICARE sponsor or active duty service member.

You must be between 21 and 26 years old. In cases where you are enrolled full-time at “an approved institution of higher learning” and the service member is responsible for at least half of your financial support eligibility may not begin “until age 23 or upon graduation, whichever comes first” according to the TRICARE official site.

What to Know About TRICARE Options

It is a very good idea to compare TRICARE plans to see which options are best for your family. Active duty troops don’t have a choice, they must enroll in TRICARE Prime, TRICARE Prime Remote, TRICARE Prime Overseas, or TRICARE Prime Remote Overseas, depending on where they have been assigned.

Comparing these plans with other family options under TRICARE can help you select the most appropriate coverage depending on duty station, your next scheduled permanent change of station move, or other career changes.

Not all plans are appropriate for all family members; some may be offered health insurance through an employer and coverage options should be selected carefully on that basis. An active duty military member should expect to have to change TRICARE plans every few years or so depending on where they are reassigned–stateside or overseas.

Compare plans at the TRICARE official site using the TRICARE comparison tool.