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If you are on active duty, health care for you and your family is provided by the military. All active duty servicemembers are automatically covered under TRICARE Prime at no cost and are seen in a military treatment facility.
The federal TRICARE program covers a good portion of your family’s medical expenses, but it does not cover everything. Coverages and expenses depend on the TRICARE option you choose (Prime, Extra or Standard), and if they receive treatment at a military treatment facility or from a civilian health-care provider.
Family members of active duty servicemembers enrolled in Prime do not pay an enrollment fee, annual deductible or co-payments for care by TRICARE network providers (military or civilian). TRICARE Prime Remote covers medical care from civilian providers for active duty servicemembers and their families who are stationed in remote locations. There are no annual deductibles or co-payments for Prime Remote.
If you leave the military before retirement, you can purchase health insurance similar to TRICARE for up to 18 months for servicemembers and up to 36 months for family members. When you retire, health care from military facilities may be limited, and most retirees will turn to three options of the TRICARE program.
TRICARE Prime
With this option, military treatment facilities are the principal source of health care but could be augmented by contracted civilian health care networks. Prime is similar to HMO programs offered by private employers. Your total health care is guided by your primary-care manager. To receive health care through Prime, you must pay an annual enrollment fee, but there are no deductibles. This option provides the lowest cost but it is the most restrictive with use of health-care providers.
TRICARE Extra
This option allows participants to choose a physician, hospital or other medical provider listed in the TRICARE Provider Directory. There is no requirement to enroll. Expenses include deductibles and co-payments which are 5 percent less than with TRICARE Standard. Additional commercial supplemental health coverage may be desired.
TRICARE Standard
This option allows military retirees to seek an authorized provider of their choice. There is no requirement to enroll. While Standard offers the greatest flexibility in the choice of providers, it is the most expensive of the three options. Additional commercial supplemental health coverage may be desired.
TRICARE For Life
Medicare-eligible military retirees age 65 and older and their Medicare-eligible family members and survivors are now covered under TRICARE For Life. Medicare pays first and TRICARE pays second. Medicare-eligible military retirees can use Medicare and TRICARE prescription card benefits at military pharmacies, retail pharmacies and the TRICARE mail-order pharmacy.
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