TRICARE plans for insurance are available to military members and their families in order to provide low-cost health care options. Like many providers, there are various types of TRICARE insurance available to choose from that will best suit an individual’s needs. For instance, a standard program versus a fee-per-service program will provide better coverage options at a lower price point. However, annual premiums may be higher in such cases.
Before choosing an insurance plan through TRICARE, military members should understand the advantages and disadvantages of each program as well as the overall costs. Military members who have family that is also seeking coverage may want a more comprehensive plan when compared to a single-family household. It is also important to understand the enrollment eligibility for each plan. To find out more about the variety of TRICARE insurance options, continue reading below.
Find Out How to Choose a TRICARE Plan
With the different varieties of TRICARE insurance plans available, most military members wonder which plan is right for them. Anyone who has health care coverage through TRICARE will be able to access different plan options to best suit their needs.
However, no matter which TRICARE health plan is chosen, it is important that each enrollee meets the minimum requirements for eligibility. All enrollees should consider both their age and military status as they factor which insurance plan will be most beneficial for their needs. For instance, certain TRICARE plans will have benefits that are geared toward retirees, while the TRICARE Young Adult plan is most beneficial for those who have aged out of regular TRICARE benefits.
Learn About the Types of TRICARE Insurance Plans
There are two major health programs within the TRICARE health plan options: TRICARE Prime and TRICARE Select. Both plans offer the same great quality of care and both require enrollment. However, each of these TRICARE plans will bring different guidelines and coverages to those who sign up, which will be important to know before making any decisions.
The TRICARE Prime program is a managed care option and similar to that of a health maintenance organization (HMO). This means that enrollees will have the benefits of visiting military hospitals and clinics, with significantly reduced out-of-pocket costs for authorized services offered outside of hospitals and clinics by TRICARE network providers.
All active duty military members must sign up for this TRICARE option, as it is mandatory. Family members of active duty service members will have the option of whether or not they wish to enroll. Additionally, applicants who are eligible for TRICARE and are located in Prime Service Areas within the United States will also have the option to enroll. Within the TRICARE Prime insurance program, there are other plan options, which may be more beneficial to applicants in remote areas or who are living overseas.
All enrollees who join one of the Prime TRICARE plans should understand what the smaller plans look like and how each can significantly reduce out-of-pocket costs and additionally coinsurance payments.
TRICARE Select replaced what was formerly known as TRICARE Standard and TRICARE Extra. The Select TRICARE plan is a self-managed option for eligible beneficiaries who are not enrolled in TRICARE Prime. TRICARE Select allows enrollees to choose their own TRICARE-authorized provider and manage their own health care options. Under the TRICARE Select umbrella, there are other additional plans that can be considered, including:
- TOP Select.
- TRICARE for Life.
- TRICARE Select Overseas.
- TRICARE Reserve Select.
To learn more about the TRICARE Prime and TRICARE Select plans, download our helpful guide today.
Which TRICARE health plan is right for you?
The TRICARE military website offers different ways to determine which TRICARE health plan will be the best fit. By using different determining factors, potential enrollees will be able to figure out the TRICARE plan that will offer them the greatest advantages with few, if any, disadvantages. Factors that are considered when determining the right plan include:
- The relationship to the enrollee.
- The enrollee’s status in the military.
- Where the enrollee lives.
- Where the enrollee works.
By plugging in these answers within the TRICARE website, the eligible plan options will be formulated with help choosing the right option.
Learn About TRICARE Health Insurance Requirements
In order to be considered for any TRICARE options, eligibility requirements must first be met. TRICARE is a health care program geared toward certain individuals within the military and will not accept everyone for coverage. TRICARE health plans are only for certain current and former service members as well as qualified family members of service members. For instance, former and surviving spouses may be eligible for coverage provided they have not remarried. Likewise, beneficiaries may need to be registered in the Defense Enrollment Eligibility Reporting System (DEERS) in order to qualify.
TRICARE plans and benefits will vary for applicants depending on which beneficiary category they fall under. There are two types of beneficiaries; sponsors and family members. Sponsors are considered the active duty military members, retired military personnel and Guard or Reserve members. Family members are considered spouses and children who are registered in the DEERS program.
What is covered under TRICARE health plans?
An important aspect of choosing the right TRICARE plan is understanding what each option covers. Prospective enrollees will be able to determine the types of medical services that will be needed on a regular basis in order to figure out the best option with the lowest out-of-pocket costs. Enrollees can even search through the TRICARE Formulary to see which prescription medications will be covered under specific plans.
Additionally, the TRICARE website will also offer the option to view all the benefits that are excluded through TRICARE health plans, including acupuncture, aversion therapy, electrolysis, cosmetic drugs, massages, LASIK Surgery and more. Before signing up for TRICARE insurance, potential enrollees should understand what is covered and what is most certainly excluded from coverage in order to have a better idea of the next steps toward quality health care. To learn more about TRICARE options, download our guide today.