FALLS CHURCH, Va. –
Have you recently enlisted in or received a commission to a uniformed service? Or, have you just married a uniformed service member? If you’re
new to TRICARE, you may have some questions about how to
enroll in a plan,
get care, and learn more about your
coverage. So, what exactly is TRICARE?
“TRICARE is the uniformed health care program for service members, retirees, their family members, and other eligible beneficiaries,” explained Malcolm Jones, a TRICARE subject matter expert at the Defense Health Agency. “It brings together the resources of military hospitals and clinics with a network of civilian health care providers and pharmacies.”
TRICARE covers:
Are you in one of these groups? Keep reading to learn more about the basics of using your TRICARE benefit.
Eligibility
Your uniformed service personnel office determines your TRICARE
eligibility.
To check your eligibility, first make sure your information is fully updated in the Defense Enrollment Eligibility Reporting System. Sponsors are automatically registered in DEERS, but they must register their eligible family members by going to a local ID card office. (Note: You should call first, or set up an appointment online, to check appointment availability.)
Then, log in to milConnect to check if you’re eligible for TRICARE. Once you’ve registered on the milConnect website, you can update your contact information in DEERS and view your TRICARE enrollment information.
Health plans
Choosing a plan
You have different TRICARE
health plan options depending on your sponsor’s status, your relationship to your sponsor, your age, and where you live.
To see which plans you may be eligible for, check out the Plan Finder Tool and answer a few simple questions. Then, you can use the Compare Plans Tool to figure out which plan is right for you. (Note: Families can have split enrollment, meaning some family members can enroll in one plan, while others enroll in a different one.)
Enrolling in a plan
Once you know your plan, visit
TRICARE Enrollment for steps on how to enroll or purchase a plan. These steps may differ depending on the plan you choose and where you live.
Are you a new active duty family member? Once you’re registered in DEERS, you'll be automatically enrolled in a TRICARE plan based on where you live and the plan selection of your other family members who aren’t active duty service members. You have 90 days from the automatic enrollment date to change to a different plan (TRICARE Prime, TRICARE Select, TRICARE Prime Remote, or the US Family Health Plan, if available).
Changing plans
Interested in switching your TRICARE plan? You may have the opportunity to do so during the annual
TRICARE Open Season in the fall each year. Changes you make during open season will take effect Jan. 1 of the following year.
You may also be able to change your plan when you experience a TRICARE Qualifying Life Event. QLEs are certain life changes that open a 90-day window for you and your family members to make eligible enrollment changes, as described in the TRICARE Qualifying Life Events Fact Sheet.
Common QLEs include, but aren’t limited to:
- Marriage, divorce, or annulment
- Birth or adoption of a child (or placement of a child by a court in a member’s home)
- Moving
- Activation or deactivation
- Retirement or separation
- Losing or gaining other health insurance
If you experience a QLE, make sure to update DEERS right away.
Getting care
Regions
TRICARE is available worldwide, and your benefits are the same no matter where you live. But different
regional contractors help deliver the benefit around the world. If you get civilian health care, this means you’ll reach out to different
customer service contacts depending on where you live.
There are two TRICARE regions in the U.S.:
And there is one Overseas Region.
To learn which region you’re in, visit Regions.
Military hospitals and clinics
The DHA operates
military hospitals and clinics. You may be able to seek care there, depending on where you are, what plan you have, and your
beneficiary group.
Civilian network
You can also seek care from a civilian network of TRICARE-authorized providers. This network depends on your region.
To search for a network provider, use the Find a Doctor Tool to get you to the right provider directory.
Note: You may be able to see a non-network TRICARE-authorized provider, depending on your TRICARE plan. But you may have higher out-of-pocket costs, and you may have to file your own claims.
ID cards
For most beneficiaries, you’ll need to show your Uniformed Services ID card to your provider as
proof of TRICARE coverage. If you’re an active duty service member, you’ll need to show your Common Access Card.
Coverage
TRICARE covers treatments, procedures, prescription drugs, or devices that are medically necessary and considered proven. Learn more about
how a service becomes a TRICARE-covered benefit.
You can use the Covered Services Tool to see if a service is covered by TRICARE or not. You can search by keyword or browse common categories.
Pharmacy, dental, and vision coverage
TRICARE offers
prescription drug coverage and several options for
filling your prescriptions. You have the same prescription coverage with almost any TRICARE health plan. (
Note: If you’re enrolled in
USFHP, you have separate pharmacy coverage.)
To check if your prescription drugs are covered, use the TRICARE Formulary Search Tool.
Dental coverage is separate from TRICARE’s medical coverage. Depending on your beneficiary group, you may get dental care through:
Vision coverage, including eye exams, depends on:
- Who you are
- Your TRICARE plan
- Your age
Costs
Each TRICARE plan has different costs for care and coverage. See
TRICARE Costs to view and compare costs for covered services, enrollment fees, and plan premiums.
Do you have more questions about plan options, enrollment, or getting care? Contact your regional contractor or visit www.tricare.mil for more information. Welcome to TRICARE!