Haris Ashley
Military personnel and their families have access to TRICARE, a health insurance program that offers comprehensive coverage, including medical, dental, and vision plans, as well as life insurance and prescription drug coverage. TRICARE is the uniformed services healthcare program for active-duty service members, active-duty family members, retirees, and their families worldwide. It brings together the healthcare resources of the Military Health System, including military hospitals and clinics, with a network of civilian healthcare professionals, institutions, pharmacies, and suppliers. Military personnel can also benefit from other insurance options such as the Armed Forces death gratuity program and Service Members' Group Life Insurance (SGLI).
| Characteristics | Values |
|---|---|
| Name of Insurance | TRICARE |
| Who is it for? | Active-duty service members, active-duty family members, National Guard and Reserve members and their family members, retirees and retiree family members, survivors, and certain former spouses worldwide |
| What does it cover? | Medical, dental, vision, life insurance, and pharmacy prescription options |
| How does it work? | TRICARE brings together the healthcare resources of the Military Health System with a network of civilian healthcare professionals, institutions, pharmacies, and suppliers |
| Where can it be used? | Military hospitals and clinics, as well as civilian TRICARE-authorized providers depending on the region |
| Are there different plans? | Yes, there are different TRICARE plans available, such as Prime, Select, TYA, TRS, and TRR |
| Are prescriptions covered? | Yes, TRICARE offers prescription drug coverage and options for filling prescriptions, including military pharmacies, network pharmacies, home delivery, and reimbursement for non-network pharmacies |
| Are there additional benefits? | Yes, TRICARE offers special programs and services for those with special needs, including applied behavior analysis, cancer clinical trials, durable medical equipment, and hospice care |
| How do I enroll? | Enrollment can be done online through the milConnect website under the Benefits tab |
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What You'll Learn
- TRICARE: Comprehensive health insurance for military members and their families
- Military hospitals and clinics: Access to care at military medical facilities
- Civilian healthcare: Coverage for treatment by civilian providers
- Prescription coverage: Filling prescriptions at military or civilian pharmacies
- Life insurance: Low-cost group insurance options for military personnel
TRICARE: Comprehensive health insurance for military members and their families
TRICARE is a comprehensive health insurance program for military members and their families. It offers worldwide coverage for active-duty service members, retirees, and their families, as well as members and families of the National Guard and Reserve. TRICARE brings together the healthcare resources of the Military Health System, including military hospitals and clinics, with a network of civilian healthcare professionals, institutions, pharmacies, and suppliers.
TRICARE provides comprehensive coverage, including medical, dental, and vision plans, as well as life insurance and pharmacy prescription options. It offers several services for beneficiaries with special needs, such as applied behavior analysis, cancer clinical trials, durable medical equipment, home health care, hospice care, and mental health care.
TRICARE offers different health care plans to suit various situations, and beneficiaries can choose from a range of in-network and out-of-network providers to suit their needs. For those travelling, TRICARE fills prescriptions at military or network pharmacies, offers home delivery, or allows beneficiaries to visit a non-network pharmacy and file a claim for partial reimbursement.
TRICARE also provides a Military Treatment Facility Locator to help beneficiaries find the nearest facility by ZIP code or military installation. These facilities provide care for service members and their families. Additionally, TRICARE offers a Health Care Flexible Spending Account, allowing beneficiaries to set aside pre-tax earnings to help cover healthcare costs.
Overall, TRICARE is a comprehensive health insurance program that supports the military mission by fostering, protecting, sustaining, and restoring the health of its beneficiaries worldwide.
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Military hospitals and clinics: Access to care at military medical facilities
Military hospitals and clinics, sometimes called "military treatment facilities" or "MTFs", are located at military bases and posts worldwide. These facilities are operated by the Department of Defense and provide care for service members and their families. The care provided at these facilities is known as "direct care".
TRICARE, the health care program for service members, retirees, and their families, offers a number of programs and services by bringing together the healthcare resources of the Military Health System (MHS) with a network of civilian healthcare professionals, institutions, pharmacies, and suppliers. This includes military hospitals and clinics, which can be located using the TRICARE Military Treatment Facility Locator on the milConnect website.
The availability of care at military hospitals and clinics may depend on factors such as location, the specific TRICARE plan, and beneficiary category. Those seeking care may also have the option to utilise a civilian network of TRICARE-authorized providers, which can vary by region.
TRICARE provides comprehensive coverage, including prescription drug coverage, dental plans, and special programs such as applied behaviour analysis, cancer clinical trials, durable medical equipment, home health care, and mental health services. Additionally, TRICARE offers the convenience of meeting with your care team through secure live video via MHS Video Connect, enabling access to care at a time and location that suits the individual and their family.
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Civilian healthcare: Coverage for treatment by civilian providers
Civilian healthcare is provided by TRICARE, which brings together the healthcare resources of the Military Health System with a network of civilian healthcare professionals, institutions, pharmacies, and suppliers. TRICARE is operated by the Department of Defense, which also runs military hospitals and clinics.
TRICARE offers prescription drug coverage and several options for filling prescriptions. There are two types of TRICARE-authorized providers: Network and Non-Network. There are no additional costs for choosing a non-network provider, but you may have to file your own claims. There are a number of TRICARE plans available, and eligibility depends on the individual and their sponsor.
TRICARE may provide additional benefits beyond basic coverage to service members injured while on active duty, including reserve and guard members. These benefits do not require any out-of-pocket costs and have no benefit cap. They include coverage for a range of mental health and substance use disorders, as well as reproductive services.
Veterans who are not enrolled in VA benefits or other veterans health coverage can get coverage through the Health Insurance Marketplace. Depending on their household size and income, they may be able to get lower costs on monthly premiums and out-of-pocket expenses on private insurance. They may also qualify for free or low-cost coverage through Medicaid or the Children's Health Insurance Program (CHIP).
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Prescription coverage: Filling prescriptions at military or civilian pharmacies
Military personnel have access to prescription coverage through the TRICARE Pharmacy Program. This program offers beneficiaries several options for filling prescriptions, including military pharmacies, TRICARE Pharmacy Home Delivery, TRICARE retail network pharmacies, and non-network pharmacies.
Military pharmacies are typically located within military hospitals or clinics, but some are also free-standing pharmacies found elsewhere on the base. Military pharmacies stock drugs from the Basic Core Formulary and provide medications at no cost to beneficiaries, making this the most cost-effective option. Military pharmacies can fill prescriptions from both civilian and military providers and offer up to a 90-day supply of most medications.
For those who do not have access to a military pharmacy, the TRICARE Pharmacy Home Delivery option provides a convenient and cost-effective alternative. This service is free for active-duty service members, while copayments are required for other beneficiaries to receive up to a 90-day supply of medications. Home delivery is well-suited for maintenance medications taken regularly.
TRICARE retail network pharmacies, numbering over 60,000 in the United States and its territories, offer a fast and convenient option for filling prescriptions. Beneficiaries can fill prescriptions and pay one copayment for each 30-day supply.
Lastly, non-network pharmacies are also an option, but they represent the most expensive choice. Using retail and non-network pharmacies can result in higher costs for the Department of Defense (DoD) compared to military pharmacies, as the DoD incurs higher costs for drugs obtained through these channels.
It is important to note that certain drugs, such as refrigerated medications, may not be available through home delivery due to logistical constraints. Additionally, beneficiaries residing in certain countries, like Germany and the Philippines, may have restrictions on their prescription-filling options due to legal requirements.
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Life insurance: Low-cost group insurance options for military personnel
Military personnel have access to a range of insurance options, including health care, life insurance, and prescription drug coverage. One of the key life insurance programs available to them is the Servicemembers' Group Life Insurance (SGLI). SGLI is a low-cost term insurance program that offers coverage to eligible service members. Active-duty members of the Army, Navy, Air Force, Space Force, Marines, or Coast Guard are generally eligible for SGLI. Additionally, commissioned members of specific organizations, such as the National Oceanic and Atmospheric Administration (NOAA) and the U.S. Public Health Service (USPHS), are also eligible.
SGLI provides flexible coverage options, allowing service members to choose their level of coverage and beneficiaries. Those who qualify for SGLI are automatically enrolled, and they can manage their coverage through the SGLI Online Enrollment System (SOES). SGLI also offers a disability extension, providing free coverage for up to 2 years if a service member becomes totally disabled upon leaving the military. Part-time coverage is also available for Reserve members who don't qualify for full-time coverage.
When transitioning out of military service, individuals have the option to convert their SGLI coverage into a permanent, individual insurance policy within 120 days of their discharge date, without needing to provide proof of good health. This conversion allows them to maintain continuous life insurance coverage as they move into civilian life. Additionally, those who qualify can enroll in Veterans' Group Life Insurance (VGLI) to continue their life insurance coverage after leaving the military, as long as they continue paying the premiums.
VGLI enables individuals to maintain their life insurance benefits, with coverage amounts ranging from $10,000 to $500,000. The specific amount is based on the level of SGLI coverage they had when they left the military. To enroll in VGLI, individuals must apply within 1 year and 120 days of departing from military service. If they apply within 240 days, they are exempt from providing evidence of good health. Similar to SGLI, VGLI allows beneficiaries to be chosen and changed as needed.
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Frequently asked questions
TRICARE is the health insurance program for the military.
TRICARE offers comprehensive coverage, including medical, dental, vision, and life insurance, as well as prescription drug coverage. TRICARE also provides special programs for families with special needs, including autism care, hospice care, and cancer clinical trials.
TRICARE is available to active-duty service members, active-duty family members, National Guard and Reserve members, retirees, and certain former spouses worldwide.
