One TRICARE Prime option, called US Family Health Plan (USFHP), is available to eligible persons – including those age 65 and over – who live near selected civilian medical facilities on the East, West and Gulf coasts. USFHP, sponsored by the DoD, has cared for military families for more than 25 years and has serves over 94,000 members. Its national member satisfaction ratings are 22 percent higher than the national average for satisfaction with health plans, as reported by the National Committee for Quality Assurance (NCQA) in its Quality Compass 2006 Public Report. The following is a summary of the US Family Health Plan:

US Family Health Plan Overview

USFHP is the only TRICARE Prime option that offers benefits to family members of active-duty military, including activated Reservists and National Guard members, as well as all military retirees and their eligible family members, including those age 65 and over, regardless of whether they participate in Medicare Plan B. Further, USFHP provides all the benefits of TRICARE Prime at the same cost structure – and enhances them by providing such extras as additional preventive care and screening programs, and discounts on hearing aids, dental care, lasik surgery, contact lens and eyeglasses. These enhancements vary by region, but all are aimed at improving the lives of military healthcare beneficiaries.

Enrollees in USFHP must live in specific, ZIP codes near one of the six not-for-profit healthcare networks through which the Plan delivers care. (See “Where You Can in Enroll in USFHP”, below.) Non-emergency care must be obtained through the USFHP hospital and doctor network in your area, but the Plan covers medical emergencies wherever you are. In an emergency, your costs for everything above your co-payment will be covered as long as you show your USFHP member ID card and have the bills sent to the plan. You may use a Military Treatment Facility (MTF) for medical emergencies only if it is the nearest emergency facility when you become acutely ill or severely injured, or if you are referred there by USFHP in certain other circumstances.

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Enrollment

You can enroll in USFHP anytime and coverage begins on the first day of the month following receipt of your application, when it is received by the 20th of the month. There’s no waiting period for benefits. As with any TRICARE Prime program, when you enroll in USFHP, you commit to remaining enrolled for 12 months. If you move within the area served by your USFHP plan, you simply provide the plan with your new address. If you move to another region served by USFHP, your enrollment can be transferred. If moving outside USFHP’s service area, you can transfer your enrollment to the regional TRICARE Prime program, and any enrollment fees paid will be transferred.


The USFHP enrollment fees are the same as for TRICARE Prime non-active enrollees: $230 for one person or $460 for a family. If you are 65 or older, you need not carry Medicare Part B to join USFHP, but the Plan recommends that you enroll in Part B when eligible. That’s because your USFHP enrollment fees and co-pays (except prescription drug co-pays) will be waived, and you’ll have coverage for end-stage renal disease.

Where You Can Enroll in the USFHP

Enrollment in USFHP is offered through the networks of community-based hospitals and physicians listed below. Contact the one in your area if you’d like to enroll in USFHP.

  • Johns Hopkins Medicine (1-800-801-9322) – serving central Maryland, Washington D.C., and parts of Pennsylvania, Virginia and West Virginia
  • Martin’s Point Healthcare (1-888-241-4556) – serving Maine, Vermont, New Hampshire and northeastern New York
  • Brighton Marine Health Center (1-800-818-8589) – serving Massachusetts, including Cape Cod, plus Rhode Island and northern Connecticut
  • St. Vincent Catholic Medical Centers (1-800-241-4848) – serving parts
    of New York, all of New Jersey, eastern Pennsylvania and southern Connecticut
  • CHRISTUS Health (1-800-678-7347) – serving southeast Texas and southwest Louisiana, and
  • Pacific Medical Centers (1-888-958-7347) – serving the Puget Sound area of Washington State.

For more information, call 1-800-748-7347, or visit the US Family Health Plan Web site at www.usfamilyhealthplan.org.

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