While we are not affiliated with the government in any way, our private company engaged writers to research the LIHEAP program and compiled a guide and the following answers to frequently asked questions. Our goal is to help you get the benefits that you need by providing useful information on the process.
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We are not affiliated with the government in any way. We are a private company that engaged writers to research the TRICARE insurance program and compiled a guide and the following answers to frequently asked questions. Our goal is to help you get the benefits that you need by providing useful information on the process. We are not providing legal or financial advice. If you need such advice please contact an attorney or a financial advisor.
TRICARE is a comprehensive health insurance program that benefits U.S. military service members, veterans, and their families. There are several different health insurance plans available through TRICARE, each with their own cost, coverage options, and eligibility requirements.
TRICARE is administered by the Defense Health Agency (DHA). Learn more about TRICARE on the Defense Health Agency website here.
TRICARE provides health insurance coverage to qualifying military personnel, veterans, and their families. Depending on your military status, age, and other eligibility factors, you may be eligible for one or more insurance plans. TRICARE insurance plans include:
TRICARE Prime is the primary health insurance plan for active duty service members and their families. Beneficiaries are assigned a Primary Care Manager (PCM), a healthcare professional who provides the majority of their care. This provider may be an in-network provider or associated with the military health care system.
TRICARE Prime is only available to qualifying service members and their families under 65 and who live within the Prime Service Area. Suppose a service member and their family qualify for TRICARE Prime, but do not live within the service area. In that case, they may be eligible for other Prime plans, including TRICARE Prime Remote, TRICARE Prime Overseas, and TRICARE Prime Remote Overseas. These plans include the same amount of coverage as TRICARE Prime.
TRICARE Prime Remote is available to qualifying service members and their families that live within remote areas of the United States. To qualify for the remote plan, the service member must either live:
TRICARE Prime Overseas is available to qualifying service members and their families stationed overseas.
TRICARE Prime Remote Overseas is available to qualifying service members and their families stationed in remote locations overseas in these regions:
TRICARE Select provides health insurance to veterans, non-active duty military personnel, their families, survivors, and qualifying former spouses. Beneficiaries who are enrolled in TRICARE Select but are called to active duty are transitioned to TRICARE Prime benefits while on active duty.
TRICARE Select lets beneficiaries select any TRICARE-authorized network provider. They can choose an out-of-network provider, but their out-of-pocket costs will increase like traditional forms of health insurance.
TRICARE Select Overseas offers the same coverage options and eligibility requirements as TRICARE Select but is available for those living outside of the United States.
TRICARE Reserved Select provides health insurance to members of the Selected Reserve and their qualifying family members. The Selected Reserve is a group of Army Reserve soldiers who are the first to be called to active duty should the need arise. To qualify for this type of health insurance plan, reserve members must not be on active duty and cannot be receiving Transitional Assistance Management Program (TAMP) benefits.
Beneficiaries may select any provider they choose. However, medical providers that are not in-network will increase beneficiaries' expected out-of-pocket costs. Some medical services may also require prior authorization from an in-network provider.
TRICARE Retired Reserved provides health insurance to retired members of the Reserve branches and their qualifying families. Beneficiaries can receive this type of health insurance as soon as they retire until they are 60 years old. Retired Select participants may choose to use in-network or out-of-network providers. Like other forms of TRICARE, some procedures may require prior authorization from an in-network provider.
TRICARE for Life provides coverage that is meant to supplement a Medicare plan, which means that it offers benefits and services not covered by Medicare. To qualify for TRICARE for LIFE, beneficiaries must:
TRICARE for Life provides benefits through authorized care providers around the world.
TRICARE Young Adult provides coverage to adult children of uniformed service members who have aged out of their other TRICARE coverage. Children will generally age out of most TRICARE plans when they turn 21, but coverage may be expended until they turn 23 if they are full-time students. TRICARE Young Adult provides additional coverage until the adult child turns 26, so long as they are not eligible to enroll in an employer-sponsored health insurance plan of their own.
TRICARE Young Adult is offered in two versions, Young Adult Prime and Young Adult Select, depending on their qualifications.
TRICARE Young Adult Prime is available to the adult children of active military members stationed anywhere globally and veterans residing within a Prime service area. TRICARE Young Adult Prime offers the same coverage level as TRICARE Prime, and beneficiaries will be assigned a primary care manager.
TRICARE Young Adult Select is available to all adult children who qualify for TRICARE Young Adult. This plan provides the same coverage as TRICARE Select and the same rules regarding in-network and out-of-network providers.
The U.S. Family Health Plan is only available in some regions of the U.S. This non-profit, community-based health care system offers coverage to those living in a Family Health Plan Area that meet one of the following categories:
The chart below provides information about these designated areas, corresponding care facilities, and contact information.
|Family Health Plan Area||Health Care Provider|
|● Maryland● Washington D.C.● Parts of Pennsylvania, Virginia, Delaware and West Virginia||Johns Hopkins Medicine1 (800) 808-7347|
|● Maine● New Hampshire● Vermont● Upstate and Western New York● Northern Tier of Pennsylvania||Martin's Point Health Care1 (888) 241-4556|
|● Massachusetts, including Cape Cod● Rhode Island● Northern Connecticut||Brighton Marine Health Center1 (800) 818-8589|
|● New York City● Long Island● Southern Connecticut● New Jersey● Philadelphia and area suburbs||St. Vincent Catholic Medical Centers1 (800) 241-4848|
|● Southeast Texas● Southwest Louisiana||CHRISTUS Health1 (800) 678-7347|
|● Puget Sound area of Washington state||Pacific Medical Centers (Pacmed Clinics)1 (888) 958-7347|
Learn more about TRICARE plans here.
TRICARE plans provide comprehensive health insurance, including coverage for necessary medical services, prescription drugs, dental, vision, and mental health.
TRICARE excludes services and supplies that are not deemed medically necessary to diagnose or treat a covered illness or injury. Services that are not covered by TRICARE include:
View a complete list of excluded services here.
TRICARE prescription drug coverage includes medications deemed medically necessary and approved by the United States Food and Drug Administration (FDA). This includes the brand-name and generic formulas of prescription drugs.
You can use the Formulary Search Tool here to determine if a medication is covered by TRICARE and the out-of-pocket cost associated with the prescription.
TRICARE provides dental coverage to qualifying military members, active Guard, Reserved members, and their families. There are three dental plans available through TRICARE:
The Active Duty Dental Program provides dental care at military dental clinics. There are no out-of-pocket costs associated with dental care received at these clinics. The Active Duty Dental Program also includes coverage for dental care at other locations when a participant lives in a remote area that is too far from military clinics and when they receive a referral from a military dental clinic for services that are not available at the clinic.
The Active Duty Dental Program is active duty service members, but other beneficiary groups may qualify, including:
The TRICARE Dental Program provides comprehensive dental coverage to:
The TRICARE Dental Program provides coverage for dental services through providers around the world. Covered services include orthodontics and braces, dentures, crowns, oral surgery, root canals, filling, cleanings, x-rays, and exams.
The Federal Employees Dental and Vision Insurance Program (FEDVIP) provides benefits to:
You can learn more about TRICARE dental coverage here.
TRICARE plans provide vision coverage services. The types of services that are available to beneficiaries and the frequency of their vision coverage vary by TRICARE plans but may include services such as:
Learn more about TRICARE vision coverage here.
TRICARE costs vary based on the TRICARE plan, military status of the beneficiary, and whether services are provided by an in-network or out-of-network provider. TRICARE services may include costs such as:
Active duty service members are exempt from all out-of-pocket costs shown above.
Additionally, TRICARE enrollees that receive medical services at a military treatment facility will not incur copayments, except for inpatient care and hospitalization.
TRICARE eligibility requirements vary by plan but are dependent on qualifications like age, military status, and location. To qualify for a TRICARE plan, you must be one of the following:
Learn more about TRICARE eligibility requirements here.
To apply for TRICARE, you will need to be able to provide the following information about the military sponsor on your enrollment application:
You must also provide the names, dates of births, addresses, and contact information for family members you wish to enroll.
You can apply for TRICARE online, by phone, or by mail. Review the chart below to learn more about each application method, including when and how to apply.
|Application Method||How to Apply||When to Apply|
|Online (only available to those living in a Prime Service Area)||Visit the milConnect website and log into your account here. If you do not have an account, register for one using your Common Access Card (CAC).Once logged in, click on the "Benefits" tab, and then click on "Beneficiary Web Enrollment (BWE)."||New enrollment or after a Qualifying Life Event (QLE). Find a list of QLEs here.|
|By Phone||Call your regional contractor:● East Region - Humana Military: 1 (800) 444-5445● West Region - Health Net: 1 (844) 866-9378● Overseas - call the regional call center in your area. Find a list of call center numbers hereIf enrolling in the U.S. Family Health Plan, call 1 (800) 748-7347||New enrollment, Open Season (November 9 - December 14) or after a QLE|
|By Mail||For TRICARE Prime and Select plans, download, complete, and print one of the following enrollment forms:● East Enrollment Form here.● West Enrollment Form here.● Overseas Enrollment Form here.For TRICARE Reserve or Retired Reserve, download the Reserve Component Health Coverage Request Form, sign it and return it by mail. This form is only available to those who qualify and will be available at the end of the qualification process. Log into your milConnect account here to determine if you are eligible to purchase these plans.For the U.S. Family Health Plan, download one of the enrollment forms found here and mail it to the address listed below:Mail the East Enrollment Form to:Humana MilitaryP.O. Box 105838Atlanta, GA 30348-5838Mail the West Enrollment Form to:Health Net, LLCP.O. Box 8458Virginia Beach, VA 23450-8458Mail the Overseas Enrollment Form to:International SOS AssistanceTOP Prime EnrollmentsP.O. Box 11520Philadelphia, PA 19116||New enrollment, Open Season (November 9 - December 14) or after a QLE|
Learn more about applying for TRICARE here.
You can check your application status by contacting your TRICARE regional contractor:
If you applied for TRICARE online, you may be able to check your application status by logging into your account here.
Your TRICARE application will be reviewed after you apply for benefits. Once your application has been processed, you will receive a letter detailing your coverage and benefits. Once approved, you can select a healthcare provider. If you are not approved for TRICARE benefits, your notice will inform you why you did not qualify for coverage. If you disagree with any decision made about your TRICARE application or benefits, you have the right to file an appeal.
If your TRICARE application is denied, you have the right to file an appeal. You must submit your request for an appeal within 90 days from the date on your denial notice. This notice will also include step-by-step instructions on how to submit an appeal. When submitting an appeal, you must include:
Appeals must be sent by mail using the form included with your decision letter or by writing a letter. You must submit your appeal to your contractor's address. You can find your contractor's address here.
Learn more about the TRICARE appeal process here.
After enrolling in TRICARE, you are required to report changes to your regional contractor. This includes changes to your military status, marital status, address, and contact information. You can report a change to your TRICARE regional contractor by phone. Click here to find your regional contractor provider.
For help with a TRICARE application or any further questions about the TRICARE program, contact the DMDC Support Office at 1 (800) 358-9552.
For questions regarding your benefits or coverage, contact your regional contractor. Click here to find your regional contractor provider.
While we are not affiliated with the government in any way, our private company engaged writers to research the TRICARE program and compiled a guide and these answers to frequently asked questions. Our goal is to help you get the benefits that you need by providing useful information on the process.
Our free TRICARE Guide is filled with helpful information about how to apply, program eligibility requirements, and how to get in touch with local offices. You can view or download our free guide here.