Tricare is a health care program for military personnel and their families. It provides comprehensive coverage for medical and dental expenses, mental health care, and prescription drugs. In this article, we will discuss everything you need to know about Tricare insurance, including what it is, who is eligible, and what it covers.
What is Tricare Insurance?
Tricare is a health care program for active-duty and retired military personnel, as well as their eligible family members. It is managed by the Department of Defense and provides comprehensive coverage for medical and dental expenses, including hospitalization, surgery, and preventive care.
Tricare offers several plans, including Tricare Prime, Tricare Select, Tricare Reserve Select, and Tricare for Life. Each plan has its own benefits, costs, and eligibility requirements.
Tricare Prime
Tricare Prime is a managed care option that offers the lowest out-of-pocket costs for eligible beneficiaries. It requires enrollees to select a primary care provider, who will coordinate all their health care needs.
Tricare Prime is available to active-duty service members and their families, as well as retired service members and their families. To be eligible, you must live within the service area of a military treatment facility or a Tricare Prime network provider.
The cost of Tricare Prime varies depending on your status and the type of coverage you choose. Enrollees may be required to pay an annual enrollment fee and copayments for certain services.
Tricare Select
Tricare Select is a fee-for-service option that allows you to see any Tricare-authorized provider without a referral. It offers greater flexibility and choice than Tricare Prime, but also higher out-of-pocket costs.
Tricare Select is available to active-duty service members and their families, as well as retired service members and their families. To be eligible, you must have a valid military ID card and be registered in the Defense Enrollment Eligibility Reporting System (DEERS).
The cost of Tricare Select varies depending on your status and the type of coverage you choose. Enrollees may be required to pay an annual deductible and coinsurance for certain services.
Tricare Reserve Select
Tricare Reserve Select is a health care option for eligible members of the Selected Reserve and their families. It offers comprehensive coverage at a relatively low cost, but requires enrollees to pay monthly premiums.
To be eligible for Tricare Reserve Select, you must be a member of the Selected Reserve, have completed a period of initial active duty for training, and not be eligible for or enrolled in the Federal Employees Health Benefits (FEHB) program.
The cost of Tricare Reserve Select varies depending on your status and the type of coverage you choose. Enrollees may be required to pay monthly premiums, an annual deductible, and coinsurance for certain services.
Tricare for Life
Tricare for Life is a health care option for eligible Medicare-eligible beneficiaries. It provides supplemental coverage to Medicare and covers many of the costs that Medicare does not, including deductibles, copayments, and coinsurance.
To be eligible for Tricare for Life, you must be eligible for Medicare and have both Parts A and B. You must also be enrolled in DEERS and have paid your Medicare Part B premiums.
Tricare for Life is a secondary payer to Medicare, which means that Medicare pays first for your health care expenses and Tricare for Life pays second.
What Does Tricare Cover?
Tricare covers a wide range of health care services, including:
- Preventive care, such as health screenings and immunizations
- Primary care, such as office visits and routine check-ups
- Specialty care, such as mental health and behavioral health services
- Emergency care, including ambulance services and emergency room visits
- Inpatient care, such as hospitalization and surgery
- Prescription drugs
- Dental care (depending on your plan)
The specific benefits and coverage offered by Tricare vary depending on your plan, location, and eligibility status. You can check the Tricare website or contact the Tricare contractor in your region for more information.
Who is Eligible for Tricare?
Tricare eligibility varies depending on your status and relationship to a military sponsor. In general, Tricare is available to:
- Active-duty service members and their families
- Retired service members and their families
- Reserve and National Guard members and their families
- Survivors of military personnel who died in the line of duty
- Medal of Honor recipients and their families
Additionally, some extended family members may be eligible for certain Tricare plans, such as Tricare Young Adult (TYA). Eligibility requirements and coverage options may vary depending on your plan and region, so it’s important to check the Tricare website or contact the Tricare contractor in your area for more information.
FAQ
How do I enroll in Tricare?
To enroll in Tricare, you must first be registered in the Defense Enrollment Eligibility Reporting System (DEERS). You can enroll in DEERS online, by phone, or in person at a military ID card office. Once you are registered in DEERS, you can choose a Tricare plan and enroll online, by phone, or by mail.
How much does Tricare cost?
The cost of Tricare varies depending on your plan, status, and location. Some plans, such as Tricare Prime, may require an annual enrollment fee and copayments for certain services. Other plans, such as Tricare Reserve Select, may require monthly premiums, an annual deductible, and coinsurance.
You can check the Tricare website or contact the Tricare contractor in your region for more information about costs and coverage options.
Can I see any provider with Tricare?
The provider network for Tricare varies depending on your plan and location. Some plans, such as Tricare Prime, require you to select a primary care provider and obtain a referral for specialty care. Other plans, such as Tricare Select, allow you to see any Tricare-authorized provider without a referral.
You can check the Tricare website or contact the Tricare contractor in your region for more information about provider networks and referrals.
Does Tricare cover mental health care?
Yes, Tricare covers a wide range of mental health and behavioral health services, including psychotherapy, counseling, and medication management. Coverage options may vary depending on your plan and location, so it’s important to check the Tricare website or contact the Tricare contractor in your region for more information.
Does Tricare cover vision and hearing care?
Tricare covers some vision and hearing services, but the specific benefits and coverage options vary depending on your plan and location. Some plans, such as Tricare Prime, may offer routine vision and hearing exams at no cost, while others may require copayments or coinsurance.
You can check the Tricare website or contact the Tricare contractor in your region for more information about vision and hearing benefits.
Conclusion
Tricare is a comprehensive health care program for military personnel and their families. It offers several plans, including Tricare Prime, Tricare Select, Tricare Reserve Select, and Tricare for Life, each with its own benefits, costs, and eligibility requirements. Tricare covers a wide range of health care services, including preventive care, primary care, specialty care, emergency care, inpatient care, prescription drugs, and dental care (depending on your plan). Eligibility for Tricare varies depending on your status and relationship to a military sponsor. If you are considering enrolling in Tricare, it’s important to research your options carefully and choose a plan that best meets your needs and budget.