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Tricare Medical Policies & Procedures

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    Coverage

    • Tricare is a partnership of health care providers, medical researchers, medical educators and support staff worldwide. It is designed to provide comprehensive medical coverage to military personnel and their families in America and overseas.

      Tricare is an independent and comprehensive health care enterprise that consists of medical personnel from all branches of the army. Tricare providers include pharmacies, private hospitals and civilian health care providers.

      Tricare offers medical coverage for military personnel when they are in active service, when they retire if they have fulfilled 20 years or more of service, and when they sustain a disability in the course of duty. If a uniformed soldier sustains a 100 percent service-related disability or dies in service before completing his service, the servicemen and their families will continue to receive benefits from CHAMPVA (Civilian Health and Medical Program of the Department of Military Personnel Affairs). Tricare benefits also extend to families of military personnel. When a widow or a widower of a serviceman who is getting benefits remarries, the benefits are stopped. If the spouse separates or divorced, Tricare benefits are restored. Also, if the person the widow or widower of a serviceman marries is also a former member of the uniformed service, the benefits will continue.

    Benefits

    • Those enrolled under Tricare enjoy a range of benefits. Medical, dental and vision coverage is provided. Military members can go to an in-network hospital available on military bases or in civilian locations and benefits will be 100 percent covered. Members can also visit specialists and out-of-network doctors with a referral and benefits will also be covered, usually up to 100 percent or with a small co-pay depending on the nature of the treatment required and the reason for visiting an out-of-network physician.

    Enrollment

    • The procedure for enrolling in and getting benefits under Tricare is simple. Military personnel, depending on their rank and position, will be automatically covered under the Tricare plans or program appropriate to their rank. There are several different levels of coverage: Tricare Prime, which is available to personnel stationed in America; Tricare Prime Remote, which is available to servicemen and women in remote areas; Tricare Prime Overseas, which is available to people stationed overseas; Tricare Global Remote Overseas; Tricare Reserve Select and U.S. Family Health Plan, which are options available to reserve members and offer less-comprehensive coverage than that available to full-time military personnel.

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