Tricare is the U.S. military’s health care program and functions as government-managed health insurance. Tricare’s various coverage plans provide health care for millions of current and former service members and their families. Tricare is managed by the Pentagon’s Defense Health Agency.
Tricare offers a variety of plans to fit the needs of different beneficiaries.
These plans are divided into four main categories:
1. Tricare Prime:
This is the standard health plan for active duty family members and certain retirees and their family members. It provides comprehensive health care services through a network of military treatment facilities (MTFs) and civilian providers. For example, an active-duty family enrolled in Tricare Prime pays no fees so long as they follow referral rules, but retiree families do pay out of pocket.
2. Tricare Select:
This is a preferred provider organization (PPO) plan that allows beneficiaries to see civilian providers outside of the MTF network. It offers lower out-of-pocket costs than Tricare Prime, but beneficiaries may have to pay higher premiums. While some provider appointments, such as well-child visits, carry no fees, others do. How much users pay and whether they face an enrollment fee depends on their service status.
3. Tricare Extra:
This is a cost-sharing plan that allows beneficiaries to see civilian providers outside of the MTF network. It offers the lowest out-of-pocket costs, but beneficiaries may have to pay higher premiums and copays.
4. Tricare Standard:
Tricare Standard is a fee-for-service health insurance plan offered by the US Department of Defense (DoD) for active duty family members and certain retirees and their family members. It allows beneficiaries to see any provider they want, but they may have to pay higher out-of-pocket costs than other Tricare plans.
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Here are some of the key features of Tricare Standard:
1. Beneficiaries can see any provider they want, regardless of whether they are in-network or out-of-network.
2. Beneficiaries are responsible for paying a deductible and copays for most services.
3. Tricare Standard covers preventive care services at no cost to beneficiaries.
4. Tricare Standard offers a number of financial assistance programs for eligible beneficiaries.
In addition to these four main plans, Tricare also offers a number of other plans, such as Tricare for Life (TFL), which is a health insurance program for certain retired military personnel and their family members, and Tricare Reserve Select (TRS), which is a health insurance program for members of the National Guard and Reserve.
What is Tricare for Life :
Program that provides supplemental health coverage for retirees and their spouses who are over age 65. To use Tricare for Life, retirees also must be enrolled in Medicare Part B and pay Part B monthly premiums.
Confusion sometimes is caused when those leaving the military are told they will receive Tricare for life — meaning Tricare as a lifetime benefit, as opposed to being assigned to the Tricare for Life plan.
What is Tricare Reserve Select?
Tricare Reserve Select is a plan for traditional Guard and reservists and functions exactly like Tricare Select, with one significant difference: Users must pay a monthly premium.