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If you're under age 65, TRICARE has a lot to offer. Learn more about your choices; information on everything from TRICARE Prime to Standard and Extra are at your fingertips!

TRICARE PROGRAMS FOR SERVICEMEMBERS AND DEPENDENTS UNDER AGE 65

Comprehensive information about your health care options.

TRICARE PRIME


A health maintenance organization (HMO) style plan.

TRICARE SELECT


A PPO-style plan for active duty families and retirees.

TRICARE RESERVE SELECT AND TRICARE RETIRED RESERVE


Premium-based health care options for Guard and Reserve members and their families.

TRICARE GUIDANCE & ADVICE

Additional information regarding TRICARE options for servicemembers and their families under the age of 65.

  1. What is TRICARE Prime Remote?

    TRICARE Prime Remote (TPR) is a health care program for active duty servicemembers and their families assigned to permanent duty stations that are not near a Military Treatment Facility (MTF). It is offered only in the 50 United States and requires enrollment. Eligibility is based on geographic location. Use the TRICARE Web site tool to enter your zip code to determine eligibility.

    In general you must live and work more than 50 miles or approximately one hour's drive from the nearest MTF. In order for a family member to be eligible for TRICARE Prime Remote Active Duty Family Member (TPRADFM), the servicemember must also be eligible, and the family members most reside with the sponsor.

  2. My child is turning 23 and aging out of TRICARE, what are the requirements for TRICARE Young Adult?

    TRICARE Young Adult (TYA) is a plan that qualified adult children can purchase after eligibility for "regular" TRICARE coverage ends at age 21 (or 23 if enrolled in college). To be eligible you must be an unmarried child of an eligible sponsor, at least 21 years old but not yet 26, and not have employer-sponsored health care.

    Eligible beneficiaries can choose between TYA Prime if they live in a Prime Service Area, or TYA Standard. The programs work the same as regular Prime and Standard and there are monthly premiums.

    For more information please click here.

  3. How does TRICARE work with my employer-sponsored healthcare?

    By law, TRICARE pays after all other health insurance. In other words, if you have other health insurance (OHI) coverage provided through employment or private insurance, your claim must first be submitted to your OHI for payment after which any remaining portion is submitted to TRICARE for reimbursement.

    The only exceptions to this rule are the following programs: Medicaid, TRICARE Supplement, State Victims of Crime Compensation Programs or other Federal Government Programs identified by the Director, Defense Health Agency (i.e. Indian Health Service). These insurances are processed first and then your doctor files your claim with TRICARE.

    Certain services and supplies require preauthorization in writing before they are received. Otherwise, TRICARE will not share the cost. Check with your local BCAC or TRICARE Service Center to find out which medical services require preauthorization.

  4. Is there a pharmacy benefit with TRICARE?

    TRICARE offers several convenient ways for you to have prescriptions filled depending on your family's specific needs. You can have prescriptions filled at any of these pharmacies, based on your specific situation, and you can use more than one option at a time. 

    Military Pharmacy:  Least expensive option with no out-of-pocket costs

    Mail Order Pharmacy (TMOP):  Safe, convenient and the most cost-effective option when a military pharmacy is not available.

    Network Pharmacy:  Fast and convenient...more than 54,000 network pharmacies in the United States and U.S. Territories

    Non-Network Pharmacy:  Most expensive option

    While each option is available worldwide, some may be limited outside of the United States.   

    Pharmacy costs are based on whether the prescription is classified as a formulary generic (Tier 1), formulary brand name (Tier 2) or non-formulary (Tier 3) drug, and where you choose to have your prescription filled.   

    See this TRICARE page for the latest pharmacy prices.

    There is no cost associated with filling a prescription at a military hospital.

TRICARE UNDER 65 FAQ

Frequently asked questions pertaining to TRICARE programs for those under age 65.

QQuestion

Does TRICARE meet the minimum essential coverage requirements under the Affordable Care Act?

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The majority of TRICARE plans meet the minimum essential coverage as long as you make sure that you qualify and buy coverage for your respective plan.

However, some plans do not meet the minimum essential coverage. Those plans include only TRICARE Plus, only Direct Care, only Line of Duty Care or only Transitional Care for Service-Related Conditions.

These plans are meant to act as supplemental or additional insurance and therefore do not meet the requirements for minimum essential coverage.

QQuestion

How do I locate a TRICARE provider?

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For Network Providers: 
North Region
South Region

West Region

For Non-Network Providers:
North Region
South Region
West Region

For Overseas Providers:
Canadian Forces Facilities
The Philippines

All Other Countries

QQuestion

Can I use TRICARE Standard and Extra overseas?

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TRICARE Standard overseas functions just as TRICARE Standard except that you can get care from any TRICARE- authorized provider, both network and non-network. In other words, you can only use TRICARE Standard overseas as there are no options to use TRICARE Extra. You do not need referrals for health care but for certain services you may need prior authorization. Also, you may be required (as sometimes with TRICARE Standard in the U.S) to pay for care up front and then file a claim with the TRICARE Overseas claims processor.

QQuestion

Do I need Prior Authorization for my TRICARE-covered services?

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For the majority of services you do not need a referral. However, if you are receiving one of the services below, you do need authorization from your regional contractor. 

Adjunctive dental care

Inpatient nonemergency behavioral health care or substance abuse admissions

Organ and stem cell transplants

Hospice care

Extended Care Health option Services (ECHO)

Outpatient mental health care beyond the eight visit in a fiscal year.

Emergency care never needs an authorization. 

QQuestion

How do I file a claim with TRICARE?

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There are very few cases when you will have to file your own claims with TRICARE. However, those cases do arise when traveling, if you receive care from a non-participating provider or if you use TRICARE for Life (TFL) and the provider does not participate in Medicare.   

In these cases you  should send your claims as soon as possible to TRICARE. Within the U.S. you have one year to file the claim, while overseas you have to file within 3 years of the care.   

To file the claims fill out the appropriate form for  Medical claimsPrescription claimsDental claims , and Continued Health Care claims.  After filling out the appropriate form, sign it and send it to the claims address for your healthcare region. However,  If you have TFL, send you claim to the TFL provider instead.   

You can find more detailed instructions about how to file your claim at tricare.mil/claims

QQuestion

How do I check if TRICARE covers my procedure?

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To check if a service is covered by TRICARE, please go to http://www.tricare.mil/CoveredServices/IsItCovered.aspx.

If you're over age 65, TRICARE options for you include TRICARE for Life (TFL), Medicare Part B, and a pharmacy benefit. Find what works best for you and your family.

TRICARE PROGRAMS FOR SERVICEMEMBERS AND DEPENDENTS OVER AGE 65

Comprehensive information about your health care options.

MEDICARE PARTS A AND B


Medical health insurance for individuals over age 65, or Social Security disabled individuals under age 65.

TRICARE FOR LIFE


TRICARE's wrap-around for Medicare Part-B.

TRICARE OVER 65 FAQ

Frequently asked questions pertaining to health care for servicemembers and their families over the age of 65.

QQuestion

I age into Medicare and TFL before my spouse. Do they need to enroll in Medicare also?

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No. You age independently into Medicare and TFL. If your spouse is younger than you, he or she will continue to use TRICARE Standard or Prime and you will transition to Medicare and TFL on your own. Once your spouse turns 65, he or she will also need to enroll in Medicare and TFL. The same applies if your spouse turns 65 before you, even if he or she is not the military sponsor.

QQuestion

I am turning 65 and I have employer-sponsored healthcare. I do not need Medicare but I want to keep TRICARE Standard. What can I do?

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Unfortunately once you turn 65 you are no longer eligible for TRICARE Standard or Prime. Your only TRICARE option is TFL. You must enroll in Medicare Parts A and B in order to remain eligible for TRICARE. If you have employer-sponsored health care you can delay enrollment in Medicare, but your TRICARE will be suspended.

QQuestion

How does the Affordable Care Act affect my TRICARE/TRICARE for Life coverage?

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The Affordable Care Act does not affect the coverage that TRICARE beneficiaries receive. Congress passed legislation (H.R. 4887 TRICARE Affirmation Act) specifically exempting TRICARE and VA Health Care beneficiaries from any potential for being taxed for not having health care coverage or not participating in pooled coverage.

QQuestion

Do I need Medicare Part D?

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For most TRICARE for Life (TFL) bene­ficiaries, there is no added value in purchasing Medicare prescription drug coverage. It is unlikely Medicare Part D coverage would provide better coverage than the robust pharmacy benefi­ts currently available under TRICARE; and unlike Medicare Part D, the TRICARE pharmacy benefi­t doesn't cost you monthly premiums. If a TFL bene­ficiary chooses to enroll in Part D, his or her TFL pharmacy benefi­ts will be affected, as TFL becomes the ­final payer behind Medicare Part D. Bene­ficiaries who lose TRICARE eligibility (i.e., remarrying survivors whose spouse is not a military bene­ficiary or certain benefi­ciaries in cases of divorce) might benefi­t from Medicare Part D. Those losing TRICARE eligibility must enroll in Part D within 63 days of losing TRICARE or they will face a late-enrollment penalty for Part D. Low-income benefi­ciaries eligible for Medicaid (not Medicare) automatically are enrolled in Part D and have Part D premiums waived. TRICARE will be the second payer to Part D for these beneficiaries.

QQuestion

How do I update my record with the Defense Enrollment Eligibility Reporting System (DEERS)?

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You must be registered in DEERS to be eligible for TRICARE. They require your address, email addresses (if available), phone number(s), as well as your family member information. 

There are several options for updating your information: 

Log into MilConnect
Call 1-800-538-9552 (TTY/TDD: 1-866-363-2883) 
Fax updates to 1-831-655-8317
Mail updates to:  
Defense Manpower Data Center Support Office
Attn: COA
400 Gigling Road
Seaside, CA  93955-6771 
QQuestion

What does Medicare cover?

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For more information on Medicare-covered services, please go to https://www.medicare.gov/what-medicare-covers/index.html.

Information on TRICARE dental options for active duty, Guard/Reserve, military retirees and their families.

TRICARE DENTAL PROGRAMS

Comprehensive information about your dental options.

ACTIVE DUTY DENTAL PROGRAM (ADDP)


Dental options for active duty servicemembers.

TRICARE DENTAL PROGRAM (TDP)


Dental Program (TDP) Premium-based dental options for active duty/activated Guard/Reserve servicemembers and their family.

TRICARE RETIREE DENTAL PROGRAM


TRICARE retiree dental plan option.

TRICARE DENTAL FAQ

Frequently asked questions pertaining to dental benefits.

QQuestion

Is dental coverage automatic with TRICARE?

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No, you must enroll in the appropriate TRICARE Dental plan.

QQuestion

How can I find a participating dentist?

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To find a participating dentist, please enter your zip code in the dentist directory.

QQuestion

Can I set up an allotment to pay the monthlty premiums?

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Yes, you can have your premiums deducted as an allotment from your retired pay, or you can sign up for auto-pay through your bank.

Long term care is needed by those who can't perform the basic tasks required to take care of themselves. This can include people suffering from a debilitating illness or chronic injury. The need for long term care can arise unexpectedly, often creating a large financial burden. Long term care insurance may help protect you against that risk.

LONG TERM CARE

Comprehensive information regarding long term care.

LONG TERM CARE GLOSSARY OF TERMS


Are you having trouble understanding long term care terms? Our glossary can help!

FEDERAL LONG TERM CARE


The Federal Long Term Care Insurance Plan (FLTCIP) is available to military members and civilian federal workers, still serving or retired, and their families. The federal plan is offered by John Hancock Life and Health Insurance Corporation.

LONG TERM CARE GUIDANCE AND ADVICE

Additional information about long term care.

  1. Do you need long term care insurance?

    Long term care is needed by those who can't perform the basic tasks required to take care of themselves. This can include people suffering from a debilitating illness or chronic injury. The need for long term care can arise unexpectedly, often creating a large financial burden. Long term care insurance may help protect you against that risk.

    Not everyone needs long term care insurance. You may be able to self insure depending on your asset level, the amount of guaranteed monthly income you have from reliable sources such as military retired pay, Social Security benefits, etc., and whether you plan to leave a large inheritance to your heirs.

    If you are eligible for VA domiciliary care, you never may need long term care insurance. Keep in mind, however, your spouse may need it. Also, if your income and assets are very low, you may qualify for Medicaid-sponsored long term care. To locate your state's VA facility call 1-800-827-1000.

    For information about the MOAA-endorsed Individual Long Term Care Insurance Plan, visit www.moaainsurance.com, and click on the link in the Long Term Care Availability box, or call 1-800-698-7943 to speak to a licensed long term care consultant. You also may want to see what is available through the Federal Long Term Care Insurance Plan by visiting their Web site at www.ltcfeds.com.

  2. Does MOAA offer Long Term Care?

    For information about the MOAA-endorsed Individual Long Term Care Insurance Plan, visit www.moaainsurance.com and click on the link in the Long Term Care Availability box, or call (800) 698-7943 to speak to a licensed long term care consultant.

LONG TERM CARE FAQS

Frequently asked questions regarding long term care.

QQuestion

Does Medicare cover LTC?

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No. Most long term care is custodial, not medical, and is not covered by Medicare.

QQuestion

Does the VA provide LTC services?

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The VA does provide some custodial benefits for elderly veterans. Home and Community Based services are part of the VA Medical Package for enrolled veterans, but they must have a clinical need for them. For more information, please click here.

As an MOAA member, you can take advantage of many different insurance products (including MEDIPLUS TRICARE Supplements) that offer outstanding members-only benefits at reasonable rates.

Learn more about products available under the MOAA Insurance Program.

Looking for the MEDIPLUS claim form?  Download a PDF version now.

MEDIPLUS TRICARE Supplements
Get information on the MOAA-Sponsored MEDIPLUS TRICARE Supplements here and manage your insurance plans online.

Life Insurance Plans
Get information on the MOAA-Sponsored Life Insurance Plans here by visiting MOAA Insurance, then mouse-over "Personal Insurance" to see their plans.

Vision Insurance Plan
Get information on the MOAA-Sponsored Vision Insurance Plan that offers savings on eye exams and glasses or contact lenses.

Pet Insurance
Get information on the MOAA-Sponsored Pet Insurance Program that offers coverage for your family's cat or dog.

Long Term Care Insurance
Get information on the MOAA-Sponsored Long Term Care Insurance plans here.

Do You Need Long Term Care Insurance?
Purchasing long term care insurance may help prevent you and your family from facing an unexpected financial burden.

How to Manage Your MOAA Insurance Plan Online
Do you have an MOAA Insurance Plan? Managing your plan now is easier than ever. Use the new Web portal to view and edit your account information, check the status of claims, request a certificate, make payments, and more!