Military

Tricare, formerly known as Champus, is the health plan that is available to the brave service men and women (and their families) that protect our country.

Initially, people in the military were required to go to a designated military facility for medical services and treatment. Due to issues with these facilities, including limited number of facilities and overcrowding, this requirement was changed sometime in the 1980’s when the program was restructured to mirror the way health plans are administrated by health insurance companies.

This restructuring included:

  • Direct access to any of the hundreds of providers that will accept the Tricare allowed amounts.
  • Internal departments that would handle the enrollment, premium collection and claim processing services.
  • Redesigned health plans to include the cost containment features of a managed care plan.

This simplification and expanded access to care made it much easier for our military heroes and their families to receive the care they need.   

Military members and their families can choose one of the numerous health plans based on the category they fall in, some of the categories are:

  • Active duty and their families
  • Active National Guard/Reserve and their families
  • Survivors
  • Children
  • Qualified Former spouses
  • Medal of Honor Recipients
  • Retired service members and their families
  • Missing in action

Military and their families have several different plan types available to them depending on their status, some of these plan types include:

  • TRICARE Prime, Remote and Overseas - this plan is available to active duty members and their families and well as other categories of service members and their families. This plan is a zero cost plan as long as in network providers are used. No premiums, no deductibles, no copays, and no out of pocket costs. This plan is similar to an HMO plan where members are assigned a Primary Care Physician and directed to participating providers. This plan also has a Point of Service component where out of network providers can be used at out of pocket costs.
  • TRICARE Standard, Extra and Overseas - this plan is available to active duty members and their families as well as other categories of service members and their families. This plan works like a PPO plan where in network or out of network providers can be used.
  • TRICARE for Life – Available to military members who have Medicare part A and Part B. This plan works like a Medigap plan were the Tricare plan will pay only after Medicare has paid its portion.
  • TRICARE Reserve Select – Available to Qualified Selected Reserve members and their families. This plan works like a PPO plan, in network or out of network providers can be used. Members pay the annual premium, plan deductibles and coinsurance amounts.
  • TRICARE Retired Reserve – Available to qualified retired reserve members and their families and survivors of retired reserve members. This plan works like a PPO plan where in network or out of network providers can be used. Members pay the annual premium, plan deductibles and coinsurance amounts.
  • TRICARE Young Adult- for adult dependents of eligible service men and women that are age 21-26. Premiums are required.
  • US Family Health Plan - available to active duty members and their families and well as others categories of service members and their families who live in designed areas.

Source: www.tricare.mil

In a nutshell

Military service members have a lot of different health plan options based on what category they fall into, but no need to worry, all of this has been sorted out by the time they reach the provider’s office.

The ID card will be the first step to finding out the plan, eligibility and benefits that are available – in other words you will handle this plan just as you would every other health plan.

 

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