TRICARE is a health care plan that provides civil health benefits to uniformed service members, military retirees, and their dependents worldwide. This insurance provides comprehensive coverage to all beneficiaries, including health plans, special programs, prescription plans, and dental plans. TRICARE also covers a wide range of treatment programs to help those suffering from drug or alcohol abuse. As a world-class health care system, it fosters, protects, sustains, maintains, and restores health to support the military mission. The Defense Health Agency manages it under the direction of the Assistant Secretary of Defense for Health Affairs.
TRICARE REGIONS
The Tricare Management Activity reorganized twelve separate regions into three large regions in 2004, namely Tricare North, Tricare South, and Tricare West. Services in these regions are provided by:
- North – Health Net Federal Services, LLC
The North Region includes Ohio, Pennsylvania, Illinois, Indiana, Massachusetts, Michigan, New Hampshire, Rhode Island, Vermont, Delaware, the District of Columbia, Kentucky, Maine, Maryland, New Jersey, New York, Virginia, West Virginia, Connecticut, North Carolina, Wisconsin (Rock Island Arsenal area), Missouri (St. Louis area), and Tennessee (Ft. Campbell area).
- South – Humana Military Healthcare Services, Inc.
Louisiana, Mississippi, Alabama, Oklahoma, Arkansas, Tennessee (excluding the Ft. Campbell area), Florida, Georgia, South Carolina, and Texas (excluding the El Paso area) are included in the South Region.
- West – United Healthcare
Alaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa (excluding Rock Island Arsenal area), Kansas, Minnesota, Missouri (except the St. Louis area), Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Texas (the southwestern corner, including El Paso), Utah, Washington, and Wyoming are included in the West Region.
Changes In TRICARE Regions
As of January 2018, TRICARE regions have changed. Prior to the change, TRICARE was divided into three geographical regions: TRICARE East, TRICARE North, and TRICARE South. However, now, the TRICARE program is divided into two parts across the United States:
- TRICARE East
- TRICARE West
| TRICARE East | TRICARE West |
|---|---|
| Administered by Humana Military Healthcare | Administered by Healtnet Federal Services |
| Florida, Georgia, Alabama, Arkansas, Kentucky, Louisiana, South Carolina, Tennessee, Connecticut, Delaware, the District of Columbia, Illinois, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri (St. Louis area only), New Hampshire, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, Indiana, Iowa (Rock Island Arsenal area only), Texas (excluding the El Paso area), Virginia, West Virginia and Vermont, Wisconsin. | California, Colorado, Hawaii, Nebraska, Nevada, New Mexico, North Dakota, Alaska, Arizona, Kansas, Minnesota, Missouri (excluding the St. Louis area), Montana, Idaho, Iowa (excluding the Rock Island Arsenal area), Texas (the southwestern corner only, including El Paso), Oregon, South Dakota, Utah, Washington, and Wyoming. |
TRICARE PLANS
The TRICARE online program is divided into eight types of programs, which cover active-duty families, members of the National Guard, reservists, military retirees, and their dependents. The majority of TRICARE health plans meet the Affordable Care Act’s requirements for minimum essential coverage.
A detailed list of those programs is as follows:
- Tricare Select
- Tricare Prime
- Tricare Reserve Select
- Tricare Reserve Retired
- Tricare for Life
- Tricare Young Adult
- Tricare Supplement
- Tricare Dental Plan
Tricare Select
Tricare Select is an insurance plan available to military family members, retirees from the Active Component, Reserve Component, and their eligible family members. In Tricare Select, beneficiaries can seek medical care from any civilian provider who is covered by Tricare. The Tricare Select plan does not charge enrollment fees, and beneficiaries pay coinsurance and an annual deductible. Some out-of-pocket expenses might also apply.
Tricare Prime
The Tricare Prime program is similar to a Health Maintenance Organization (HMO) program where a provider acts as your primary care manager (PCM). Active-duty personnel, retirees from the Active Component, retirees from the Reserve Component, and their family members aged 60 or over are eligible for Tricare Prime. There are fewer out-of-pocket costs with TRICARE Prime than with TRICARE Select, but you have fewer choices of providers.
Tricare Reserve Select (TRS)
The Tricare Reserve Select (TRS) is a premium-based insurance program for Selected Reserve members that offers comprehensive health care coverage when you’re not on active duty. The plan runs similarly to a health insurance policy, where you make monthly payments in exchange for health care at a discounted or free rate. Choosing an in-network provider will result in you paying a lower copay than if you visit an out-of-network provider.
Tricare Reserve Retired (TRR)
Tricare Reserve Retired (TRR) is a premium-based insurance plan that eligible retired National Guard and Reserve members under 60 can purchase for themselves and their dependents. It is similar to Tricare Reserve Select (TRS), in that it has a monthly premium, an annual deductible, and applicable copays or cost-sharing. This plan is also available to retired Reserve members who do not qualify for or are not enrolled in Federal Employees Health Benefits (FEHB).
Tricare For Life (TFL)
Tricare For Life (TFL) is a program that supports retired military personnel and their families by paying for their medical expenses. People serving in the military can receive care at any military hospital and can choose to be treated by any Medicare-participating or nonparticipating provider through TFL. No enrollment is required to be eligible for Tricare for Life; however, eligible members must be Tricare and Medicare-eligible and have purchased Medicare Part B.
Tricare Young Adult (TYA)
Tricare Young Adult (TYA) offers a health insurance plan to students who are dependents of military personnel. To qualify for the coverage, you must either be a student aged 23 to 25 or a non-student aged 21 to 25 who is dependent on a military member. Unmarried and not eligible for employer-sponsored coverage or Tricare coverage or anyone whose sponsor is Tricare eligible can enroll in this plan.
Tricare Dental Plan (TDP)
The Tricare Dental Program (TDP) is available for active duty family members, Guards, Reserve members, and their families. A retiree can’t enroll in the Tricare Dental Program, so they must purchase coverage through the FEDVIP. This is a “pay-ahead” plan, which means you will receive coverage next month only after this month’s premiums are paid. In the event that you don’t pay a monthly premium, your coverage would end and you would not be eligible to re-enroll for another 12 months.
Tricare Supplement
Tricare Supplement plan is an option that retirees can choose over the Tricare options listed above. TRICARE supplement provides coverage for any expenses that Tricare is not going to cover. Specialists, surgeries, and hospital stays are examples of out-of-pocket expenses that can be covered via the Tricare supplement. Furthermore, those enrolled in this plan have access to additional TRICARE-authorized facilities or providers across the country.
The Bottom Line
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