Military Health Insurance: Everything You Need to Know

As a member of the military, you and your family are entitled to health insurance through the TRICARE program. Understanding the details of your coverage can be confusing, but it’s important to know what’s covered and what’s not. In this article, we’ll break down everything you need to know about military health insurance.

What is TRICARE?

TRICARE is the health care program for members of the military and their families. It provides coverage for a wide range of medical services, including doctor visits, hospital stays, and prescription drugs.

There are several different plans within the TRICARE program, and the plan you’re eligible for will depend on your status and where you live. Some plans require enrollment fees and copayments, while others are free.

TRICARE Prime

TRICARE Prime is a managed care option that’s available to active duty members and their families. It’s similar to a health maintenance organization (HMO) and requires you to choose a primary care provider (PCP) who will manage your care. Prime enrollees typically have low or no out-of-pocket costs for covered services.

Enrollment

To enroll in TRICARE Prime, you’ll need to fill out an enrollment form and choose a PCM. You can do this online or by visiting a TRICARE Service Center. You can also call the TRICARE hotline to enroll over the phone.

TRICARE Select

TRICARE Select is a fee-for-service option that’s available to all eligible beneficiaries, including retirees and their families. You can see any TRICARE-authorized provider without a referral, but you’ll usually pay more out of pocket than you would with TRICARE Prime.

Enrollment

If you’re eligible for TRICARE Select, you’ll need to enroll during an open season or after a qualifying life event, such as a move or retirement. You’ll also need to pay monthly premiums and copayments for some services.

What’s Covered by TRICARE?

TRICARE covers a wide range of medical services, including:

• Doctor visits
• Hospital stays
• Prescription drugs
• Mental health services
• Dental services (for some beneficiaries)

There are some services that TRICARE doesn’t cover, such as elective cosmetic surgery and experimental treatments. Make sure you understand what’s covered by your plan so you don’t end up with unexpected bills.

How to Access TRICARE Benefits

To access your TRICARE benefits, you’ll need to find a TRICARE-authorized provider. You can search for providers online, by phone, or through the TRICARE mobile app.

When you visit a provider, make sure to bring your military ID and your TRICARE card. Your provider will submit a claim to TRICARE for payment, and you’ll usually only be responsible for any copayments or cost-shares required by your plan.

FAQ

How do I enroll in TRICARE?

You can enroll in TRICARE online, by phone, or by visiting a TRICARE Service Center. The enrollment process will vary depending on the plan you’re eligible for.

Can I use TRICARE when I’m traveling?

Yes, TRICARE provides coverage for medical services both in the U.S. and overseas. If you’re traveling outside of the U.S., make sure to check the coverage requirements for your specific plan.

What happens if I’m not satisfied with my care?

If you’re not satisfied with your care, you can file a complaint with TRICARE. You can also switch to a different provider or plan if you’re not happy with your current coverage.

Can I continue to use TRICARE after I leave the military?

Yes, you may be eligible for TRICARE coverage after you leave the military through the TRICARE Retired Reserve program or the Continued Health Care Benefit Program. Make sure to enroll within the required timelines to avoid any gaps in coverage.

Do I need to renew my TRICARE enrollment every year?

It depends on your specific plan. Some plans require annual re-enrollment, while others do not. Make sure to check the requirements for your plan so you don’t accidentally lose coverage.

Conclusion

TRICARE provides comprehensive health care coverage for members of the military and their families. Understanding the details of your coverage is key to making the most of your benefits and avoiding unexpected costs. If you have any questions about your TRICARE benefits, don’t hesitate to reach out to a TRICARE representative or visit the TRICARE website for more information.