TRICARE is the current health care program in place by the United States Department of Defense’s Military Health System. The DoD offers health insurance and benefits for U.S. soldiers, as well as civilian workers, retirees and their dependents, up to 26 years of age, through the TRICARE program.
Previously it was known as Civilian Health and Medical Program of the Uniformed Services, or CHAMPUS, but renamed in 1993. Today, it’s managed by the DHA, or Defense Health Agency, though prior to 2013 the program was run by Tricare Management Activity or TMA. The DHA was developed specifically to run TRICARE and its operations.
To date, TRICARE covers more than 9 million beneficiaries. Out of the DoD’s $50+ billion annual budget, the health care program accounts for 8% of that spend. (That does not include active duty members and TRICARE Prime.)
Types of TRICARE programs
TRICARE Prime is reserved for active duty service members and their dependents. It requires no out-of-pocket expenses. (Except for retirees and their dependents, who may have a small co-pay.) It’s also available for Active Component, Reserve retirees over 60 years of age and respective family members.
In most cases, TRICARE Prime members must utilize military treatment facilities, or MTFs in order to receive care.
Programs TRICARE Prime Remote, TRICARE Prime Overseas, and TRICARE Prime Remote Overseas also fall under this umbrella. Remote applies to rural areas where military treatment facilities may not exist, while the overseas program is available to members outside of the continental U.S.
TRICARE Select’s program is comparable to the pre-1993 health care plan, CHAMPUS. Select is available for active duty beneficiaries, Reserve retirees aged 60 or above, and Reserve members. Select allows military members and their families to visit civilian doctors. Users are responsible for a copay and they have an annual deductible. The program costs $12.50/month or $150/year for individuals, or $25/month or $300/year for families.
TRICARE Select also umbrellas TRICARE Select Overseas. Reserve Select is also similar, but with a higher monthly fee. Reserve members opting for this program can also trade their weekend work time in lieu of providing payments.
TRICARE For Life
TRICARE for Life is a program for retirees. It was introduced in 2001 when previous beneficiaries lost coverage once they became eligible for Medicare at 65 years of age. This program works in tandem with Medicare, where it pays the remaining balance after Medicare payments have been applied. TRICARE for life is available to retired active-duty soldiers and their spouses who have Medicare Part B.
TRICARE Reserve Retired is a health insurance plan available to retired soldiers of the National Guard and Reserve who are under the age of 60. It’s also available to their spouses and/or any eligible family members. This program does not cover premiums or administrative fees. It is one of the more expensive plans and is designed for those who do not have other options for health coverage.
After “aging out” at 21 years old (or 23 if a full-time college student), dependents can enroll in Young Adult. It covers single dependents, and only if they are not eligible for other health insurance. Dependents can use this coverage until they reach 27 years old. Additional benefits can be purchased on a monthly basis that includes pharmacy and medical benefits.
TRICARE has other branches, including programs that are available to certain civilian employees. Check with them to see what available coverage options are offered to you and your family members, or to learn more about what’s covered in each plan.