Health

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.

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

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.

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. 

Emergency care never needs an authorization. 

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 claims, Prescription claims, Dental 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

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.

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.

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.

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.

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: 

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

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

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

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.

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

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.