Your TRICARE Benefits Explained

Do you understand your TRICARE benefits? Do you know if you are enrolled in the TRICARE coverage plan that best suits your family's needs? Are you completely confused by all the TRICARE coverage options, co-pays, deductibles, and acronyms?

If so you are not alone, our surveys have found that most servicemembers and their families are confused by TRICARE. The fact is, TRICARE is a enormous and very complex health care system.

We can help clarify many of your questions and concerns. You owe it to yourself and your family to find out as much as you can about TRICARE before making any decisions! The following provides a summary of this complex program:

• The Facts
• Three Main Coverage Plans
• Making the Choice
• Eligible Active Duty, Guard and Reserve Family Members
• Retirees (under 65), Their Family Members, and Others
• Other TRICARE Programs
• TRICARE Important Telephone Numbers
• TRICARE Enrollment and Forms
• TRICARE Claims Process and Forms

TRICARE Facts

TRICARE is a regionally managed health care program for Active Duty, Activated Guard and Reserves, Retired members of the uniformed services, their families, and survivors. TRICARE brings together the health care resources of the Army, Navy and Air Force and supplements them with networks of civilian health care professionals to provide better access and high quality service while maintaining the capability to support military operations.

Active Duty and Guard and Reserve servicemembers are automatically enrolled TRICARE Prime. However military dependents and retirees must choose the TRICARE option that best suits their needs.

TRICARE has three main coverage choices for health care:

• TRICARE Prime - where Military Treatment Facilities (MTFs) are the principal source of health care.
• TRICARE Extra - a preferred provider option that saves money; and
• TRICARE Standard - a fee-for-service option (the original CHAMPUS program);

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Making the Choice

Your main challenge will probably be deciding which TRICARE option, Prime, Extra or Standard, is best for you. The following tables provide examples of cost-shares or copayments for families who use civilian providers and facilities under each of the three TRICARE options. The listed fees are subject to change.

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Eligible Active Duty, Guard and Reserve Family Members:

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Retirees(under 65), Their Family Members, and Others

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Other TRICARE Programs

TRICARE has many other programs including TRICARE for Life, TRICARE Dental, etc... For more information see our TRICARE section, or click on the links below to learn more about:

• Defense Enrollment Eligibility Reporting System (DEERS)
• TRICARE Service Centers
• TRICARE Claims Process
• TRICARE Claims Forms 
• TRICARE Eligibility
• Family Care Authorized
• Priority of Care
• TRICARE and Medicare
• TRICARE Cost Co-Pay Schedule
• TRICARE Extra
• TRICARE for Life
• TRICARE Overseas
• TRICARE Pharmacy Options
• TRICARE Prime
• TRICARE Prime Remote
• TRICARE Reserve and Guard Overview
• TRICARE Senior Pharmacy Program
• TRICARE Standard
• TRICARE Dental Plan (TDP)
• TRICARE DTP - Overseas
• TRICARE Retiree Dental Program (TRDP)
• TRICARE ECHO (Formerly PFPWD)
• TRICARE Plus
• US Family Health Plan

If you aren't sure whether TRICARE covers a service or supply, contact your Beneficiary Counseling and Assistance Coordinator (BCAC), Health Benefits Advisor (HBA), TRICARE Support Center (TSC), or your TRICARE contractor. They can advise you about covered services, but they can't guarantee payment by TRICARE. If you're enrolled in TRICARE Prime, be sure to see your Primary Care Manger (PCM) for a referral before getting any type of civilian specialized medical care.

The applicable Federal laws and 32 CFR Part 199 are the final word on any TRICARE issue. If any difference exists among this handbook, what anybody tells you, and the law and regulation, it's the law and regulation that apply (32 CFR 199) is on the Military Health System/TRICARE website.

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TRICARE Important Telephone Numbers