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TRICARE is the health insurance program for military beneficiaries. Active duty servicemembers' and their dependents are mostly exempt from TRICARE fees; however, this changes with a change in status (e.g. retired, National Guard/Reserve, or TRICARE Young Adult). Coverage and fees vary with regard to the TRICARE coverage elected, and depend on whether:

(a) the military sponsor is on active duty or retired,
(b) the beneficiary is eligible for Medicare, or
(c) the beneficiary uses military or civilian facilities for health care and medications.

TRICARE Standard will be changing to TRICARE Select in January of 2018, please visit here to read about how this new change will affect your healthcare insurance.

Why do I need health insurance?

TRICARE PROGRAMS FOR ACTIVE DUTY SERVICEMEMBERS AND FAMILY MEMBERS STARTING JANUARY 2018

What are the TRICARE Pharmacy benefits?
Beneficiaries have four ways to fill prescriptions, listed below in the order of least to most costly to beneficiaries. Please note: Class III narcotics are not covered.

• Pharmacies at military treatment facilities fill prescriptions for both 30 and 90 days at no cost as long as they carry your medication.
• TRICARE Pharmacy Home Delivery provides a 90-day prescription, filled by mail, with a zero-dollar copay for formulary generic, $13 for brand name, and $43 for non-formulary,
• Retail pharmacies provide a 30-day prescription fill with cost shares of $5 for generic, $17 for brand name, or $44 for non-formulary.
• The most costly is a non-network pharmacy that provides a 30-day prescription fill for $44 or of 20 percent of the cost of the drug.

Initial medication prescriptions should be filled in military or retail pharmacies. TRICARE Pharmacy Home Delivery is for refills of longer-term maintenance medications.

Beneficiaries without regular access to military pharmacies would benefit from home delivery, which offers 67-percent or greater savings on refills compared to retail drug stores.

TRICARE declares certain drugs as “non-formulary” if they are no more effective than other available drugs for the same purpose but cost more for the military to buy. If your doctor prescribes a non-formulary drug, talk to him or her about substituting a generic or brand-name drug that’s equally effective for you but has lower copayment. If your doctor believes a non-formulary drug is medically necessary for you, the doctor can request that TRICARE grant a waiver to give you the drug at the regular, lower copayment.

Visit the TRICARE website for additional details.

Use the TRICARE Formulary Search Tool to determine the point-of-delivery options available for your prescription and the copayment as well as any applicable medical necessity or preauthorization forms.

Once you become eligible for Medicare Part B, which happens when you reach the 24th month of being rated 100-percent disabled by the Social Security Administration (not DoD or the VA,) you must enroll in Medicare Part B to keep TRICARE eligibility, with one exception: Medicare-eligible active duty servicemembers and/or their Medicare-eligible Social Security Disability Insurance family members enrolled in a TRICARE Prime option are allowed a special enrollment period for the servicemember’s remaining time on active duty. They can delay their enrollment in Medicare Part B until their service retirement or medical retirement. People in this situation must request an active duty certificate of creditable coverage from the Defense Manpower Data Center Support Office to use the special enrollment period. But they must enroll in Medicare Part B before they retire or are medically retired from active duty or receive activation orders to avoid a break in medical coverage and a Medicare penalty. It is highly advisable to accept Medicare when it is offered and pay the monthly enrollment fee early and start paying Medicare premiums when servicemember retires

The U.S. Family Health Plan (USFHP) is a TRICARE Prime option available to active duty and retired servicemembers and families who live in certain areas of the country, mainly the northeast (including all or parts of states from northern Virginia to New York and Maine), the Puget Sound area of Washington state, and Southeast Texas and Southwest Louisiana.

The USFHP is administered through six major facilities that have a separate, unique TRICARE Prime contract; maintain their own networks of doctors (separate from the regular TRICARE networks); and provide certain enhanced services.

One unique aspect of the program is some enrollees can continue TRICARE Prime coverage under USFHP even after they have attained Medicare eligibility. This continued coverage into Medicare eligibility applies only to people who already were enrolled in the USFHP as of Oct. 1, 2012. People who enrolled after that date must switch to Medicare and TRICARE For Life upon attaining Medicare eligibility.