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Military Family

Health Care Benefits: An Overview

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If you are an active duty service member, you and your family are entitled to health care insurance through TRICARE. National Guard and Reserve service members who are mobilized/deployed for longer than thirty days also become eligible for TRICARE, along with their families. Availability for each of TRICARE’s plans depends on your military status and where you live. Prior to deployment, if you are already enrolled in TRICARE, you may want to check the enrollments of your family to ensure that they will be able to continue receiving care while you are deployed.

TRICARE Prime

This is a managed care option that provides service members and their families affordable, comprehensive coverage. If you are an active duty service member, you are required to enroll in TRICARE Prime or Prime Remote. Prime provides the lowest out-of-pocket costs compared to other TRICARE plans and does not require you to submit claims (they do that for you). With Prime, you will receive the majority of your health care through a primary care manager who can then refer you to specialists as needed.

Eligibility for TRICARE Prime is restricted to active duty service members and their families, retired service members and their families, surviving dependents, eligible former spouses, National Guard and Reserve service members and their families when activated for more than thirty consecutive days, retired National Guard and Reserve service members and their families, and Medal of Honor recipients and their families. If you are entitled to Medicare based on your age, you are not eligible for TRICARE Prime.

Eligible beneficiaries of TRICARE Prime must reside in a location near a military treatment facility, known as a prime service area. If you reside outside a prime service area, you may be eligible for TRICARE Prime Remote and your family may be able to enroll in TRICARE Standard and Extra.

TRICARE Prime Overseas

Active duty service members residing in overseas areas where the plan is available are eligible. Family members of active duty service members who accompany their sponsor overseas, are command-sponsored on their permanent change of station orders, or relocate on Service-sponsored/funded orders are also eligible for TRICARE Prime Overseas where it is available.

TRICARE Prime Remote

Prime remote is similar to Prime, but it is for active duty service members and their eligible family members when they are assigned to remote duty stations within theUnited States. If you reside and work outside of a prime service area, you are required to participate in TRICARE Prime Remote. Your family members have the option to either enroll in Prime Remote or use TRICARE Standard and Extra. Remote duty stations are those that are fifty miles (or an hour drive) from the nearest military treatment facility, designated by zip code.

TRICARE Prime Remote Overseas

This plan provides care through quality local providers and facilities to develop a network of licensed, qualified physicians in remote overseas areas. Permanently assigned active duty service members and their command-sponsored family members who are living with them are eligible for TRICARE Prime Remote Overseas when they are living in designated remote overseas locations. Activated National Guard and Reserve service members on orders for more than thirty days and their command-sponsored family members who are living in designated remote overseas locations also qualify for TRICARE Prime Remote Overseas.

TRICARE Standard and Extra

Family members of active duty service members and retirees, as well as survivors, have the choice of enrolling in TRICARE Prime or enrolling in TRICARE Standard and TRICARE Extra. Standard allows you more choices in your health care providers as you can seek care from any TRICARE-authorized provider, but this comes at a higher out-of-pocket cost. You can reduce your out-of-pocket costs by using the Extra option, which requires you to seek care from TRICARE-authorized providers within the TRICARE network. The Standard option is available worldwide, but the Extra option is not available overseas.

TRICARE Standard Overseas

This plan provides your family members with greater flexibility in choosing their health care provider in overseas locations than TRICARE Prime Overseas, but costs you more in out-of-pocket fees. Your family members can choose any qualified host nation health care provider. Active duty family members living overseas with their sponsors, retirees and their family members residing overseas, survivors living overseas, and some eligible former spouses who reside overseas are eligible for TRICARE Standard Overseas. Family members of National Guard and Reserve service members who are living overseas while their sponsor is on active duty for more than thirty consecutive days are also eligible for TRICARE Standard Overseas.

TRICARE Reserve Select

TRICARE Reserve Select is a premium-based health plan that qualified National Guard and Reserve service members may purchase. Reserve Select requires a monthly premium and offers coverage similar to TRICARE Standard and Extra. TRICARE Reserve Select applies to National Guard and Reserve service members and their families when not on active duty.

TRICARE Dental

The TRICARE Dental program is a voluntary, premium-based dental insurance plan administered by United Concordia Companies, Inc. The program is available to active duty family members, members of the National Guard and Reserve, and family members of National Guard and Reserve service members. Active duty and activated National Guard and Reserve service members are not eligible to enroll in TRICARE Dental, as they receive their dental care through their branch of Service either at a military dental treatment facility, through the Tri-Service Remote Dental Program, or through theTRICAREGlobalRemoteOverseasCallCenter, depending on their location and their plan.

TRICARE for Life

This is a Medicare-wraparound coverage, available to all Medicare-eligible TRICARE beneficiaries, regardless of age, provided they have Parts A and B. Medicare will serve as your primary insurance and TRICARE for Life acts as a secondary payer which minimizes out-of-pocket expenses.

TRICARE—Transition Assistance Management Program (TAMP)

TAMP provides 180 days of transitional health care benefits to members of the military and their families if  the service member meets the eligibility requirements, which generally require that the service member separated under honorable conditions and served more than thirty consecutive days in support of a contingency operation. The 180-day TAMP period begins on the date of separation and allows the service member and his or her family to enroll in TRICARE Prime, TRICARE Prime Overseas, or use TRICARE Standard and Extra or TRICARE Standard Overseas during that period.

Continued Health Care Benefit Program

After TAMP expires, service members and their families may choose to enroll in the Continued Health Care Benefit Program. The CHCBP  is a premium-based health care program offering temporary transitional health coverage (usually for eighteen months) after TRICARE ends. It requires that eligible service members and their families enroll within sixty days of separation from active duty or loss of eligibility under TAMP.

VA Health Care for Veterans of Military Service

After you complete your deployment, you may become eligible to receive health care through the VA. Eligibility for VA health care is dependent upon a number of variables, which may include: the nature of your discharge from military service, length of service in the military, VA-adjudicated disabilities (or service-connected disabilities), income level, and available VA resources. Generally, to receive benefits, you must be enrolled in the VA health care system.

If you qualify to receive VA health care, you may be required to pay co-pays for outpatient services, medication, inpatient, and long-term care. If you received the Purple Heart Medal, were formerly in prisoner of war status, have low income (as determined by the VA), or have a compensable service-connected disability, you can qualify for cost-free health care through the VA.

Civilian Health and Medical Program of the Department of Veterans Affairs

CHAMPVA is a comprehensive health care program in which the VA shares the cost of covered health care services and supplies with eligible beneficiaries. These beneficiaries include spouses and children of veterans who have been rated permanently and totally disables for a service-connected disability, surviving spouses and children of veterans who died from a VA-rated service-connected disability at the time of death, and surviving spouses and children of service members who died in the line of duty.