TRICARE 101: Military Health Benefits Basics in Five Minutes or Less

TRICARE Prime is a managed care option health plan, which is similar to a health maintenance organization, or HMO. This military health plan centers around receiving care within a given network of medical facilities and providers, called a Prime Service Area. You may incur additional costs if you seek care outside of the provider network.

TRICARE Select is a fee-for-service health plan, which is similar to a preferred provider organization, or PPO. You’ll pay a set fee (copayment) or percentage (cost-sharing) every time you go to the doctor, but it’ll be less for in-network providers than out-of-network providers. Also, unlike TRICARE Prime, TRICARE Select does not require you to get a referral from your primary care physician for specialist treatment like surgeries or physical therapy.

TRICARE Young Adult is a military premium-based health plan designed to cover qualified adult children who have aged out of their sponsor’s regular TRICARE coverage at age 21 – or 23 if attending college. TYA is available in either TRICARE Prime or TRICARE Select formats, depending on the option chosen at the time of enrollment. You can enroll in this benefit until age 26, or until you otherwise become ineligible.

TRICARE For Life is Medicare-wraparound coverage for those TRICARE beneficiaries who have Medicare Part A and B. You don’t have to enroll in this, as it is an entitlement earned as part of military service. However, in order for you to be automatically enrolled by the DEERS, you must be eligible for both Medicare Part A and B, and be paying Medicare Part B premiums.

TRICARE eligible retirees and their families are newly eligible to enroll in the Federal Dental and Vision Insurance Program, currently offered to all federal government employees. FEDVIP has its own open season for new enrollments that occurs at the same time as TRICARE open season in the second week of November to the second week of December. FEDVIP offers a choice of 10 dental insurance carriers. The singular TRICARE Retired Dental Program ended Dec. 31, 2018. And, for the first time ever, retirees and active-duty family members are eligible to purchase vision insurance from four carriers through FEDVIP. Beneficiaries must enroll during open season or after a qualifying life event at the official website.

TRICARE Reserve Select is a premium-based plan for qualified Selected Reserve members and their families. When reserve service members go on active duty, they must enroll in TRICARE Prime, and their families may enroll, too. However, when leaving active duty, TRICARE Reserve Select can replace TRICARE Prime.