What is TRICARE?
TRICARE is the health care program serving active duty service members, National Guard and Reserve members, retirees, their families, survivors and certain former spouses worldwide. As a major component of the Military Health System, TRICARE brings together the health care resources of the uniformed services and supplements them with networks of civilian health care professionals, institutions, pharmacies and suppliers to provide access to high-quality health care services while maintaining the capability to support military operations.
Eligibility
TRICARE serves approximately 9.6 million beneficiaries worldwide. To be eligible for TRICARE, you must be registered in the Defense Enrollment Eligibility Reporting System
Who’s Eligible?
Eligibility for TRICARE is determined by the uniformed services and reported to the Defense Enrollment Eligibility Reporting System (DEERS). All eligible beneficiaries must have their eligibility status recorded in DEERS.
TRICARE beneficiaries can be divided into two main categories: sponsors and family members. Sponsors are usually active duty service members, National Guard/Reserve members or retired service members. When we say “sponsor,” we are referring to the person who is serving or who has served on active duty or in the National Guard or Reserves.
If you’re not in DEERS, you’re not eligible.
Be sure that all members of your family are registered in DEERS, and all information is kept current.
Active Duty Service Members and Their Families
Active duty service members of the uniformed services are eligible for TRICARE. The uniformed services include the: U.S. Army, U.S. Air Force, U.S. Navy, U.S. Marine Corps, U.S. Coast Guard, Commissioned Corps of the U.S. Public Health Service (PHS), and the Commissioned Corps of the National Oceanic and Atmospheric Association (NOAA).
TRICARE Standard Overseas
TRICARE Standard Overseas is available to beneficiaries who cannot or choose not to enroll in a Prime option overseas. You may visit any host nation provider at any time. Enrollment is not required to participate; coverage is automatic as long as your information is current in the Defense Enrollment Eligibility Reporting System.
Schedule appointments at your convenience
No referrals; authorization required for some services
You pay a percentage of the total cost (cost-share)
May have to file your own claims
TRICARE has partnered with International SOS to identify the best local providers and facilities and develop a network of licensed, qualified physicians overseas. You can contact International SOS for assistance finding a provider.
Out-of-Pocket Costs
Costs vary depending on the sponsor’s military status (active duty family members vs. retirees, their families and others). After you’ve met an annual deductible, you’re responsible to pay a cost-share (or percentage).
TRICARE Prime Overseas
TRICARE Prime Overseas is the Prime option for active duty service members and their command-sponsored family members residing together in overseas locations near a military treatment facility.
Enrollment required; no enrollment fees
Most care received from an assigned primary care manager (PCM) at a military treatment facility
PCM referrals required for specialty care
Providers coordinate your referrals and authorization and file health care claims
Easy to transfer when you move
TRICARE has partnered with International SOS to identify the best local providers and facilities and develop a network of licensed, qualified physicians in areas around overseas military treatment facilities. To learn more and to enroll, contact International SOS.
Other Health Insurance
When you have other health insurance (OHI) with a prescription drug plan, your OHI is the first payer for prescription coverage, and the rules of that insurer will apply. After your OHI has paid, you may be able to receive a partial or full reimbursement from TRICARE when you file a prescription claim.