TRICARE, Your Military Health Plan

In This Section:

• Cancer Clinical Trials
• Questions to ask Your Doctor
• Costs
• Chiropractic Care
• Designated Locations
• Combat-Related Special Compensation Travel Benefit
• Before Traveling for Specialty Care
• Requesting Reimbursement
• Computer and Electronic Accomodations Program (CAP)
• Continued Health Care Benefit Program (CHCBP)
• Purchasing CHCBP Coverage
• Getting Care Through the CHCBP
• Filing CHCBP Claims
• Extended Care Health Option (ECHO)
• Who May Qualify
• Benefits
• Costs and Coverage Limits
• ECHO Home Health Care
• Autism Services Demonstration
• Foreign Force Member Health Care Option
• Line of Duty/Notice of Eligibility
• Pre-activation Benefit for National Guard and Reserve
• Medical Benefits
• Dental Benefits
• Transitional Assistance Management Program (TAMP)
• TRICARE Prime Options
• TRICARE Standard Options
• Dental Options
• Transitional Care for Service Related Conditions
• TRICARE Philippine Demonstration
• Philippine Demonstration Designated Areas
• Getting Care under the Demonstration
• Submitting a Waiver Request
• Health Care Costs under the Demonstration
• Filing Health Care Claims under the Demonstration
• TRICARE Plus
• Women, Infants and Children (WIC) Overseas
• Offices

Medical Benefits

The Pre-activation Benefit provides the same level of coverage that National Guard or Reserve Members and their family members will have when the sponsor is activated.

National Guard and Reserve Member Coverage
You may receive medical care either at a military treatment facility (MTF) or from a TRICARE network or participating provider. You will be required to enroll in one of the TRICARE Prime options (TRICARE Prime, TRICARE Prime Remote, TRICARE Prime Overseas or TRICARE Prime Remote Overseas) at your final duty station.  Until then, any specialty care received outside of an MTF must be coordinated by the Military Medical Support Office (MMSO).

Family Member Health Care Options
When your sponsor is activated, you become eligible to use any of the following TRICARE health plan options. The options will vary depending on where you live while your sponsor is activated. Click on the options below to learn more about eligibility requirements for each:

• TRICARE Prime
• TRICARE Prime Remote
• TRICARE Standard and Extra
• US Family Health Plan
• TRICARE Prime Overseas
• TRICARE Prime Remote Overseas
• TRICARE Standard Overseas

Enrollment is required for all of these except for TRICARE Standard and Extra and TRICARE Standard Overseas. However, we do not recommend that you enroll during the pre-activation period, especially if you already have another primary insurance plan. Instead, wait until the sponsor is on active duty before enrolling in a Prime option to ensure there is no break in coverage. Here are some ways you can access you medical benefits during the pre-activation period without enrolling in a Prime option.

1. Continue to get care through your primary health insurance plan
   If you have other health insurance (i.e., employer-sponsored), you can continue to use that plan and use TRICARE as secondary coverage until your sponsor reports to his/her final duty station.  Deductibles, cost shares or copayments under the other plan can be reimbursed by TRICARE. Learn more about how TRICARE works with other health insurance.
2. Get care from any TRICARE-authorized provider
   You can get care under the TRICARE Standard and Extra option by visiting any TRICARE-authorized provider. Family members will pay cost shares, but annual deductibles (up to $300) are waived, and TRICARE will cover the extra 15% charged by nonparticipating providers.
3. Make an appointment at any MTF
   You can get appointments at an MTF on a space-available basis. If you decide to enroll in TRICARE Prime at the MTF, they will have priority access for appointments. Find an MTF near you.
   

In all cases, keep copies of your health care receipts and explanations of benefits (EOBs) for care received during this pre-activation period.  For assistance with health care during this time, contact a beneficiary counseling and assistance coordinator, your regional contractor (in the U.S.) or the TRICARE Area Office (outside of the U.S.)

Keep DEERS updated!

USERRA Rights & Protections

Last Modified:March 28, 2012