TRICARE is a regionally managed health care program for Active Duty, Activated Guard, and Reserves, 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. Here are my Top 10 Military Health Insurance Benefits through the TRICARE system.
1. 3 Choices for Coverage:
- TRICARE Prime – where Military Treatment Facilities (MTFs) are the principal source of health care.
- TRICARE Extra – a preferred provider option that saves money
- TRICARE Standard – a fee-for-service option (the original CHAMPUS program)
2. Low Annual Deductible:
- TRICARE Prime – NONE
- TRICARE Extra – $150/individual or $300/family for E-5 & above; $50/$100 for E-4 & below
- TRICARE Standard – $150/individual or $300/family for E-5 & above; $50/100 E-4 below
3. NO ANNUAL ENROLLMENT FEE!
4. Civilian Out Patient-Visits:
- TRICARE Prime – No Cost
- TRICARE Extra – 15% of negotiated fee
- TRICARE Standard – 20% of allowed charges for covered service
5. Civilian In-Patient Admission:
- TRICARE Prime – No Cost
- TRICARE Extra – Greater of $25 or $14.35/day
- TRICARE Standard – Greater of $25 or $14.35/day
6. Civilian In-Patient Behavioral Health:
- TRICARE Prime – No Cost
- TRICARE Extra – Greater of $20 per day or $25 per admission
- TRICARE Standard – Greater of $20 per day or $25 per admission
7. Civilian Inpatient Skilled Nursing Facility Care:
- TRICARE Prime – $0 per diem charge per admission
- TRICARE Extra – $11/day ($25 minimum) Charge per admission
- TRICARE Standard – $11/day ($25 minimum) Charge per admission
8. No separate co-payment/cost-share for separately billed professional charges!
9. TRICARE actually reimbursed doctors at a fair and reasonable rate: Not that this really benefits us, but TRICARE is unlike other Government insurance programs in this respect. Because of that, many practicing doctors and professionals are receptive of those using TRICARE.
10. Hardly ANY co-payment requirements!
This makes TRICARE a huge plus in the military insurance plan world.
FINAL THOUGHTS: Recently, the current administration unveiled their intentions of forcing active duty service members and veterans off of TRICARE, and into the state-run healthcare exchanges being established by each individual state as required by the Patient Protection and Affordable Care Act (PPACA). Administration officials told Congress that one goal of the increased fees was to force military retirees to reduce their involvement in TRICARE and eventually opt out of TRICARE altogether, in favor of the alternative plans established by the PPACA. Educate yourself on the changes on-going to ensure that the benefits of TRICARE don’t disappear!
What do you think about TRICARE? Give your comments or any questions below.
Chuck Holmes
Former Army Major (resigned)
Publisher, Part-Time-Commander.com
Email: mrchuckholmes@gmail.com
Suggested Resources
Our Books & Training Courses
Recommended Reading List
Fortunately, Congress backed off of the initial consideration to force military members out of Tricare and into the health care exchanges. The premiums, contrary to what the government claimed would happen, are sky high. For now, Tricare is safe.
In 2011 Tricare added a young adult option, available to those who aged out of coverage on their parent’s plan, but were still at home, unmarried, and not eligible for benefits provided by an employer. The cost is $186 a month and provides outstanding coverage.
Sounds like a pretty good deal to me!
All service members need to know about military health insurance benefits. Thanks for posting this list! Understanding exactly what the specifics are for Tricare can help you better asses the value of your coverage.
As of today the military does offer some great health benefits. But with the budget cuts and ObamaCare on the horizon, I’m not sure how good they will be by this time next year. Prices continue to rise for retirees and active members. Some people will be priced out of TriCare in no time.
What are your thoughts?
Chuck