TRICARE: Guide to TRICARE

TRICARE: Overview

TRICARE: All About the TRICARE Program

Answering the call for our nation’s military, provides numerous benefits to the individuals who serve within its branches. In addition to serving the nation with selfless and honorable service, also comes valuable training, pay, retirement and healthcare benefits. However, a lot of military benefits can be overwhelming and sometimes overlooked, which leads to a service member not knowing exactly what benefits are available. One of the many benefits that is often misunderstood is the insurance the military provides to its members and their families, known as TRICARE.

What Is TRICARE?

TRICARE is a health care program of the United States Department of Defense Military Health System. TRICARE provides civilian health benefits for U.S Armed Forces military personnel, military retirees, and their dependents, including some Members of the Reserve Component. TRICARE is the civilian care component of the Military Health System, although historically it also included health care delivered in military medical treatment facilities. However, like most insurance policies, there can be some difficulty in navigating using the TRICARE system. Below are 3 key areas that Service Members, both current and retired, need to understand to effectively use the healthcare benefit.

Who is Eligible?

TRICARE is a health program for:

  • Uniformed Service Members and their families
  • National Guard/Reserve Members and their families
  • Survivors
  • Former spouses
  • Medal of Honor recipients and their families
  • Others registered in the Defense Enrollment Eligibility Reporting System (DEERS). This is critical, considering most of the issues with enrollment come from Service Members not having the proper documentation on their dependents loaded into DEERS.

What Options are Available

TRICARE offers numerous health plans. The availability of those plans depends on who you are and where you live. Although there are 11 healthcare plans that cover everything from overseas locations to retirees, the three major plans that effect Service Members are TRICARE Prime, TRICARE Prime Remote and TRICARE Select.

TRICARE Prime

TRICARE Prime is a health maintenance organization (HMO) style plan available to Active Duty personnel, retirees from the Active Component, retirees from the Reserve Component age 60 or older, and their eligible family Members. Most TRICARE Prime enrollees must exclusively use the MTF (Military Treatment Facility) to receive their care, if the MTF has the resources available. If the MTF does not have the resources to support the patient, then the MTF notifies the region’s contractor and the contractor’s provider network is used to supplement the MTF’s capacity.

TRICARE Prime Remote

(TPR) is a managed care option available in remote areas in the United States. By law, you can only use TPR if both your sponsor’s home and work addresses are more than 50 miles (or one hour’s drive time) from a military hospital or clinic. TPR is only available to Active Duty Service Members (including activated Guard/Reserve Members) and their families who live and work in designated remote locations.

TRICARE Select

is a premium-based health plan that active status qualified National Guard and Reserve Members may purchase. It requires a monthly premium and offers coverage comparable to TRICARE Prime and TRICARE Prime Remote for the military Member and eligible family Members. It has a partial premium cost sharing arrangement with Department of Defense (DoD) like civilian private or public sector employer plans, although typically at a lower cost than civilian plans. Note: If a Service Member is on Active Duty (including Activated Guard/Reserve Members), they cannot use TRICARE Select.

TRICARE covers Dental

TRICARE offers three different dental plans, Active Duty Dental Program, TRICARE Dental Program and FEDVIP Dental. Each plan has its own dental contractor.

Active Duty Dental Care

Service Members will receive most of their dental care at Military Dental Clinics, usually located in conjunction with Military Treatment Facilities. If a Service Member needs care outside of a military dental clinic, how they receive the care depends on the Service Member’s location.

TRICARE Dental Program

The TRICARE Dental Program is a voluntary dental plan. Sponsors can enroll through the Beneficiary Web Enrollment website. An individual can enroll if they are a Family Member of an Active Duty Service Member, Family Member of a National Guard/Reserve Member or National Guard/Reserve Member who is not on Active Duty or covered by the Transitional Assistance Management Program (TAMP). Note: Service Members will receive Active Duty dental benefits if they are on Active Duty or covered by TAMP.

FEDVIP Dental

FEDVIP Dental is a Voluntary dental insurance plan that covers Retired Service Members, Family Members of retired Service Members, Retired Guard and Reserve Members, Family Members of retired Guard and Reserve Members, Medal of Honor recipients, Family Members of Medal of Honor recipients and Survivors.

As you can see in the links provided above, TRICARE is a tremendous resource provided by the military to its Members, both past and present. Is it perfect? No, however, what insurance is? Most of the negative experiences that come from using TRICARE stem from the overall lack of knowledge on the system and its coverage plans. In a world of constant change, proper knowledge of your healthcare coverage options will turn uncertainty into confidence.

 

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About the author

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Justin Fisher is a currently serving with the Arkansas Army National Guard. His career has expanded two decades and has three deployments. He holds a Bachelor’s in Arts in Communications and hosts a weekly podcast featuring candid interviews with members of the military.