TRICARE Health Care Program

TRICARE is the comprehensive health care program offered by the military for soldiers and their family members. Other benefits include a robust pharmacy benefit and dental coverage options.

TRICARE Coverage

TRICARE provides comprehensive coverage for outpatient visits, hospitalization, preventative services, mental/behavioral health, immunizations, maternity care, etc. Put simply, most inpatient and outpatient care that is deemed medically necessary and proven is covered by TRICARE. For a complete list of covered services, visit the covered TRICARE services page at the official TRICARE website.

TRICARE Health Care Plans

There are several TRICARE health care plans available to choose from.

TRICARE Prime

Active duty service members as well as National Guard and Reserve soldiers called to active duty are enrolled in TRICARE Prime. TRICARE Prime is a managed care option offering the most comprehensive and affordable coverage. Those enrolled in TRICARE Prime are assigned a primary care manager (PCM) at a military treatment facility or from the TRICARE network. Your assigned PCM provides the majority of care and provides referrals to specialists when needed.

TRICARE Prime Costs

Active duty soldiers and their families have no enrollment fees or out-of-pocket costs with TRICARE Prime as long as all care is received via the PCM or a PCM referral.

TRICARE Standard

TRICARE Standard is a fee-for-service plan which is available to non-active duty beneficiaries. Standard provides more flexibility as you can visit any TRICARE-authorized provider (TRICARE network or non-network) and referrals are not required for care except for required authorizations needed for some health services.

TRICARE Standard Costs

Fees for TRICARE Standard coverage will vary based on military status. Members of TRICARE Standard also pay an annual deductible and a cost-share (percentage) for services rendered. Details on TRICARE Standard (http://tricare.mil/mybenefit/home/overview/Plans/LearnAboutPlansAndCosts/TRICAREStandardandExtra).

TRICARE Dental Plans

TRICARE provides three dental plans. Active duty soldiers are enrolled in the TRICARE Active Duty Dental Program which is basically a dental version of TRICARE Prime – no enrollment fees or costs but must receive care at a military dental treatment facility (No Primary Care Manager though). The other two dental programs are the TRICARE Dental Program and TRICARE Retiree Dental Program. See the below section to find additional information on the other TRICARE Dental insurance plans.

More on TRICARE

For an excellent summary of TRICARE benefits, coverages, available plans, etc., visit TRICARE’s official TRICARE Benefit At-a-Glance Page.

Article Last Modified: September 14, 2010

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