Which TRICARE plan is the best fit for you?
You have a choice of TRICARE plans—and there are some important differences that may affect which plan works best for you and your family. In general, the plans that allow more flexibility in where you get your care are the ones that cost you more.
If you’re under 65 years old, you have four TRICARE plans to choose from.
If you’re 65 or older, you have two TRICARE choices.
Under age 65:
TRICARE Standard
You can go to any physician who accepts TRICARE payment. You pay deductibles and a percentage of the charges for medical services. These out-of-pocket deductibles and cost shares can make this more expensive than the other TRICARE options. You may have to file claims yourself, so there can be a lot of paperwork Annual physicals and routine care are not covered.
TRICARE Extra
With this plan, you have a network of preferred health care providers. You pay deductibles and a percentage of the medical costs. You also have the option to go outside the network, to any provider who accepts TRICARE payment, but your out-of-pocket costs will be higher when you get care from providers who are not part of the TRICARE Extra network, and you face considerable paperwork. Annual physicals and routine care are not covered.
TRICARE Prime
This plan gives you more comprehensive coverage than TRICARE Standard or TRICARE Extra, and at a lower cost. Health care is provided within the plan’s provider network, usually based around Military Treatment Facilities (MTFs). Your primary care physician provides most of your care and coordinates your referrals to specialists and hospitals. There’s very little paperwork. Unlike other TRICARE plans, TRICARE Prime covers annual physicals and routine care. TRICARE Prime has a Point of Service option that allows you to seek care outside the network, but at higher cost.
US Family Health Plan is one of your choices for TRICARE Prime here in southern New England. Health care is provided within a large local civilian health care network of primary care physicians, hospitals and affiliated specialists. (US Family Health Plan has a Point of Service option that allows you to seek care outside the network, but at higher cost.) You choose a doctor who provides most of your care and coordinates your referrals to specialists and hospitals. Annual physicals are covered. There’s no paperwork. You can be a member of US Family Health Plan at any age. If you’re already enrolled in US Family Health Plan when you turn 65, you don’t have to do a thing to retain your membership.
Age 65 or older:
TRICARE For Life
This is a Medicare Supplement plan for beneficiaries who are 65 or older. Medicare Part B is required. Because Medicare and TRICARE For Life coordinate benefits, there can be a lot of paperwork between the two programs. Annual physicals and routine care are not covered. The other TRICARE plan that’s available when you’re 65 or older is US Family Health Plan.
US Family Health Plan is the only TRICARE plan that serves military beneficiaries of all ages. Health care is provided within a large local civilian health care network of primary care physicians, hospitals and affiliated specialists. (US Family Health Plan has a Point of Service option that offers some coverage for care outside the network, at a significant cost.) You choose a doctor who provides most of your care and coordinates your referrals to specialists and hospitals. Annual physicals are covered. There’s no paperwork. If you’re already enrolled in US Family Health Plan when you turn 65, you don’t have to do a thing to retain your membership.
