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What is TRICARE?

An Introduction to TRICARE

In response to the challenge of maintaining medical combat readiness while providing the best health care for all eligible personnel, the Department of Defense introduced TRICARE. TRICARE is a regionally managed health care program for active duty and retired members of the uniformed services, their families, and survivors. TRICARE brings together the health care resources of the Army, Navy and Air Force and supplements them with networks of civilian health care professionals to provide better access and high quality service while maintaining the capability to support military operations. TRICARE is being implemented throughout the U.S., Europe, Latin America and the Pacific as a way to:


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Improve overall access to health care for beneficiaries;
Provide faster, more convenient access to civilian health care;
Create a more efficient way to receive health care;
Offer enhanced services, including preventive care;
Provide choices for health care; and
Control escalating costs.

Who is Eligible for TRICARE?

Active duty members and their families;
Retirees and their families; and
Survivors of all uniformed services who are not eligible for Medicare.

If you have other primary health care insurance, TRICARE Prime may not be your best option. Health Benefits Advisors are available at your local TRICARE Service Center (TSC) or Military Treatment Facility to help you decide which option is best for you.

TRICARE offers eligible beneficiaries three choices for their health care:

TRICARE Prime — where Military Treatment Facilities (MTFs) are the principal source of health care.
TRICARE Extra — a preferred provider option that saves money; and
TRICARE Standard — a fee-for-service option (the old CHAMPUS program);

The main challenge for most eligible beneficiaries is deciding which TRICARE option, Prime, Extra or Standard, is best for them. Active Duty personnel are enrolled in TRICARE Prime and pay no fees. Active duty family members pay no enrollment fees, but they must choose a TRICARE option and apply for enrollment in TRICARE Prime. There are no enrollment fees for active duty families in TRICARE Prime.

TRICARE Handbook
TRICARE Service Centers
Frequently Asked Questions
What does TRICARE Cost?
Supplemental Insurance
Enrollment Information
Claims Information

Provider Directory
Toll-free Numbers and Regional Web Sites
DEERS Address Change
Dental Programs
Pharmacy Options
Point of Service

In this option, most health care will come from a military treatment facility (MTF), augmented by the TRICARE contractor’s Preferred Provider Network (PPN). All active duty service members will be enrolled in TRICARE Prime and will continue to receive most of their care from military medical personnel. For active duty families, there is no enrollment fee for TRICARE Prime, but they must complete an enrollment form.

Your Primary Care Manager (or team of providers) will see you first for your health care needs. The Primary Care Manager:

Provides and/or coordinates your care;
Maintains your health records;
Refers you to specialists, if necessary. (To be covered, specialty care must be arranged and approved by your Primary Care Manager.)

Care is usually provided in a military treatment facility, but civilian clinics may be used in some cases.

Point of Service (POS) Option

Option under TRICARE Prime that allows enrollees the freedom to seek and receive non-emergent health care services from any TRICARE authorized civilian provider, in or out of the network, without requesting a referral from their Primary Care Manager (PCM) or the Health Care Finder (HCF). When Prime enrollees choose to use the POS option, all requirements applicable to TRICARE Standard apply except the requirement for a Nonavailability Statement (NAS). Point-of-Service claims are subject to outpatient deductibles ($300 individual and $600 family), 50% cost-shares for outpatient and inpatient claims, and excess charges up 15% over the allowed amount. The 50% cost-share continues to be applied even after the Enrollment Year catastrophic cap has been met.

Who is Eligible for TRICARE Prime?

All active duty personnel are enrolled in TRICARE Prime. There is no enrollment fee, but you do have to register yourself. The following people may also enroll:

Family members and survivors of active duty personnel and
Retirees and their family members and survivors under age 65.

Reserve Component and family members, of Reserve/National Guard members called to active duty for 30 days or more, may enroll in TRICARE Prime or may be eligible for TRICARE Prime Remote. But enrollment forms must be completed, and military medical facilities and/or TRICARE Prime network providers must be used.

Advantages

No enrollment fee for active duty and families;
Small fee per visit to civilian providers, and no fee for active duty members;
No balance billing;
Guaranteed appointments (access standards);
Primary care manager supervises and coordinates care;
Away-from-home emergency coverage;
Point-of-Service option (see Glossary); and
Reduced catastrophic cap for retirees ($7,500 now decreased to $3,000).

Disadvantages

Enrollment fee for retirees and their families;
Provider choice limited;
Specialty care by referral only; and
Not universally available.

I don't know what your point is by posting all this Tricare stuff. I live it in first person.

In the Dallas area doctor's don't accept new Tricare patients, if they take them at all. I can drive 30 miles and get a doctor for me, but I can't even do that for my wife and children

You might as well tell me that moon rocks sell for over a million dollars an ounce, and show me the moon in the sky.

Veterans can't benefit from healthcare if it's not available in their area, and for about 50% of them, it's not available because Tricare only pays about 30 cents on the dollar for doctors fees.

Hi! Long time no hear.

Thanks for the response. The original article is just an attempt to lure the weaker minded into the claws of the Dems (or as I call them, the EVIL ONES), and they seem to have a lot of easy marks, even among FREEPERS.

I believe President Bush has reasons for his decision, and has made them clear, and most are ignoring that in favor of bitching, but, that's just my opinion.