TRICARE is a health care program for active duty service members, retirees and their families that offers health plans, special programs, prescription coverage and dental coverage.
Your TRICARE ID card comes equipped with an 11-digit Department of Defense Benefits Number (DBN), which serves to validate eligibility and file claims. In addition, it displays which type of coverage you have as well as associated costs.
TRICARE Eligibility
As a member of TRICARE, both service members and family members need a valid ID card. To secure one, first make sure your Defense Enrollment Eligibility Reporting System (DEERS) information is up-to-date; additionally if you have children ensure their Social Security numbers have been registered.
As part of your research process, you must select an TRICARE plan that best meets your situation. The Plans & Eligibility tool on the TRICARE website can be extremely helpful here; alternatively you may visit one of their regional contractors or US Family Health Plan providers to learn more. Generally service members and their families have two main choices for managed care: Prime offers higher coverage while Select provides point-of-service options for some services.
Once you’ve selected a TRICARE plan, schedule an appointment with your primary care manager (PCM). Your PCM can refer you for specialty care as necessary – be sure to get there early though as they only see so many patients per day!
Maintaining an updated TRICARE card is critical to accessing healthcare services. You’ll use it to verify eligibility at military treatment facilities or providers authorized by TRICARE and access pre-authorization for services. Furthermore, keeping it updated helps you track costs such as co-pays and deductibles more easily.
Along with your TRICARE card and Medicare card, you’ll require valid military ID as well. TRICARE For Life provides Medicare wraparound coverage if you are an eligible retiree or survivor with Medicare Parts A and B; healthcare claims filed with Medicare are then covered by TRICARE before payment by Medicare itself is made directly by them. In addition to that, enrolling includes access to 24/7 Nurse Advice Line as well as TRICARE Online which allows scheduling appointments, renewing prescriptions and accessing health records.
TRICARE Enrollment
TRICARE, the Department of Defense’s premier health care program, offers comprehensive medical, pharmacy and dental benefits for active duty military personnel and their families. This system works in concert with military hospitals and clinics as well as civilian healthcare providers to tailor benefits specifically to individual beneficiaries’ needs.
An essential first step toward accessing healthcare services, obtaining a TRICARE insurance card is an integral component of enrollment in a TRICARE plan and eligibility for its benefits. In addition, you’ll need this document when applying for government jobs or renting apartments to verify eligibility for these benefits.
To obtain a TRICARE card, enroll online via milConnect. You can log in using either your DS Logon or by creating an account; once logged in click “eCorrespondence and Documentation” from the menu bar – once there, scroll down until you see “Tricare Enrollment & eCare”, which provides access to begin the eTricare enrollment process.
The eTricare enrollment page presents you and your family members with various plans available to them, along with instructions to select the plan which meets their needs best. Once selected, select primary care managers (PCMs) for each of those listed in Enrolling Family Members; if enrolling into Prime plans no PCM is needed – instead you will simply be asked for payment information on subsequent pages.
As soon as your application is completed, you will be informed that you have been accepted into a TRICARE plan and will receive your official card in three to four weeks. To ensure uninterrupted coverage, always maintain accurate addresses in DEERS.
TRICARE For Life
TRICARE For Life (TFL) provides Medicare-wraparound coverage to TRICARE-eligible beneficiaries without needing enrollment; instead, Medicare monthly premiums are paid and care can be obtained using your TRICARE For Life card.
TFL providers may either participate or nonparticipate in Medicare, and you are responsible for making a 20% copayment. You can visit any civilian provider authorized to accept Medicare in the United States or military hospital or clinic overseas on an as-available basis (to locate these, use the Medicare Provider Directory or contact your local TRICARE office). When visiting nonparticipating providers, TFL will cover up to 20% of Medicare-allowable charges; remaining amounts remain your responsibility.
When you enroll in TFL coverage, your provider files claims with Medicare first and after it processes and pays their portion, sends them on to your regional TFL contractor who then processes and pays your portion of the claim.
TFL members with Medicare Parts A and B automatically enroll in TRICARE Select and can access pharmacy benefits through retail stores, mail order pharmacies or military treatment facilities on a space-available basis. In addition, the National Defense Authorization Act for 2001 extended coverage of dental, vision and prescription drug costs overseas through Pharmacy Home Delivery or Overseas Medical Program; enrollment in TFL is optional but highly encouraged among uniformed service retirees as part of TFL membership is encouraged but not required.
TRICARE Retired Reserve
TRICARE Retired Reserve is a premium-based health plan available to qualifying retirees and family members of both National Guard and Reserve retirees who meet certain eligibility requirements. When you leave either branch of service, an “Unqualifying Life Event (ULE) occurs which provides you with a 90-day window in which to enroll in or change coverage under TRICARE Retired Reserve plans.
Your options for TRICARE after retiring from military service can be found by reading the TRICARE Retired Reserve brochure and exploring TRICARE Costs and Fees webpage.
Once enrolled in TRICARE health plans, providers require you to present your Uniformed Services ID card as evidence of eligibility and filing claims. It is vital that this ID card be up-to-date.
As soon as you have decided to retire from the National Guard or Reserve, make sure that your DEERS information is updated. This step may be essential as some services require retiree costs such as deductibles and copayments to be covered.
MilConnect allows you to generate, download, and print an Eligibility Letter that shows your current TRICARE coverage. To do so, navigate to milConnect’s Correspondence/Documentation feature in the top navigation bar before selecting the “e-Correspondence and Proof of Coverage Submenu”. Here, a menu will appear that allows you to select your Eligibility Letter of choice – this one simply displaying current coverage whereas others might include enroll eligibility determination requests, changes to plan requests or even eligibility reports
TRICARE Young Adult
May is a month where many military families celebrate their young adult children completing college, but before this milestone takes place it’s essential that TRICARE eligibility doesn’t lapse.
Regular TRICARE eligibility ends for young adults between 21 and 23 (if they’re still students). But with TRICARE Young Adult, coverage can continue up until then – providing medical and pharmacy benefits worldwide and with two plans: Prime and Select (both plans have monthly premiums); these costs depend on which option your young adult chooses, their sponsor status and care location – the Compare Cost Tool is an invaluable way of learning more about how this plan works!
Your child must meet certain criteria to qualify for TRICARE Young Adult coverage, such as being in good standing with valid sponsorship. They must also be enrolled full-time at an approved institute of higher learning with financial support provided from both their sponsor and school providing at least 50%. DEERS must also be updated, maintaining valid military address information – any new addresses require 90 days notice prior to transferring coverage from one location to the other.
TRICARE is governed by public law and federal regulations that can change at any time, making the information on this site only as up-to-date at its time of publication. Any advice given herein should not replace that provided by your doctor or healthcare provider, so for questions pertaining to content of this site contact your local TRICARE office directly; The Defense Health Agency cannot vouch for its accuracy.
