TRICARE provides military service members and their families with great health insurance options to meet the specific needs of the military. TRICARE has additional benefit programs that provide assistance when transitioning from TRICARE insurance to civilian health insurance. Some of these programs help with travel expenses for medical care, autism care costs, and cancer clinical trial expenses. TRICARE also provides Medicare insurance to eligible individuals that offers coverage throughout the world.
TRICARE offers 11 kinds of health insurance plans to meet the needs of military service members and their families:
With all four of the TRICARE Prime plans, members work with a Primary Care Manager (PCM) who coordinates their care. A Primary Care Manager has a similar function to a Primary Care Physician, which is a term used more commonly on other health insurance plans.
The cost specifics vary plan to plan. Most of the TRICARE Prime plans do not have premiums, annual enrollment fees, copays, or out-of-pocket costs for active duty or command sponsored military members as long as the care is from the member’s PCM or from a specialist referred by the PCM. Some of these same features apply to their family members depending on the eligibility rules of the specific plan.
With the two TRICARE Select plans there is an annual deductible and cost sharing for medical care received.
The TRICARE Select Overseas plan does not require referrals to specialists from a PCM. However, prior authorization is required for some kinds of medical care.
The TRICARE Reserve Select plan is designed for members of the Selected Reserves. It has premiums and an annual deductible. It is connected to a network of doctors. Using this network gives plan members access to larger discounts and coverage than visiting out-of-network doctors.
The TRICARE Retired Reserve Plan is similar to the TRICARE Reserve Select plan, but is intended for retired Reserve members under age 60 and their families.
TRICARE also offers Medicare parts A and B to TRICARE-eligible beneficiaries through its TRICARE For Life plan. Those enrolled pay monthly premiums and have medical coverage in the United States and abroad.
For unmarried children ages 21-26 of eligible sponsors, the TRICARE Young Adult plan offers medical insurance coverage if children are not eligible for any other kind of health insurance.
There are two options with the TRICARE Young Adult plan: Prime and Select. The Prime options works like the TRICARE Prime plans. The Select option works like the TRICARE Select plans.
The U.S. Family Health plan has no enrollment fees or out-of-pocket costs for care received from a U.S. Family Health Plan provider. This plan can be combined with Medicare coverage if individuals were enrolled in the U.S. Family Health plan before October 1, 2012.
TRICARE offers the following additional programs to benefit its members:
TRICARE only offers health insurance to individuals who are registered in the Defense Enrollment Eligibility Reporting System, including the following:
Because each of TRICARE’s health insurance plans are designed with specific groups in mind, each plan has its own eligibility requirements. Details about plan-specific requirements can be viewed easily from TRICARE’s website.
TRICARE health insurance also has some exclusions. These exclusions can be viewed on TRICARE’s website.
Generally, we have had good experience with Tricare. We typically don't have issues with being able to find in network providers or having our insurance paid out. They are usually timely in their processing and taking care of payments. Unfortunately, we have had a couple of occasions when things have been miscommunicated and have had to jump through hoops for Tricare to pay their portion. Overall, we have had a good experience though.
I appreciate Tricare for the quickness of getting our family taken care of! I like everything about Tricare. The only issue that I think that they could improve on is taking care of meeting the deductible better and keep us in formed about our Catastrophic Cap.