US Family Health Plan
The US Family Health Plan is an additional TRICARE Prime option available through networks of community-based, not-for-profit health care systems in six areas of the United States.
Eligibility
The US Family Health Plan is available to the following beneficiaries who live in a designated US Family Health Plan area:
- Active duty family members
- Retired service members and their families*
- Family members of Activated National Guard/Reserve members
- Non-activated National Guard/Reserve members and their families who qualify for care under the Transitional Assistance Management Program
- Retired National Guard/Reserve members (age 60 and receiving retired pay) and their families*
- Survivors
- Medal of Honor recipients and their families
- Qualified former spouses
*Before October 1, 2012, the US Family Health Plan was also available to all Medicare-eligible beneficiaries age 65 and older. On October 1, 2012, this rule changed for all NEW US Family Health Plan enrollees, but existing enrollees are not affected.
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If Enrolled Before October 1, 2012
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If you are already enrolled in the US Family Health Plan when you become eligible for Medicare (US Family Health Plan coverage begins before September 2012), you can stay enrolled as long as there is no break in coverage. However, we strongly encourage you to enroll in Part B when you first become eligible. If you disenroll from the US Family Health Plan or move to a non-US Family Health Plan area, you won't be eligible for other TRICARE benefits if you don't have Part B. And, if you don't enroll in Part B when first eligible, you may be required to pay the 10 percent Medicare surcharge for each 12-month period you were eligible to enroll in Part B, but didn't. |
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New Enrollments on or After October 1, 2012
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Beginning October 1, 2012, Medicare-eligible beneficiaries age 65 and older can no longer enroll in the US Family Health Plan. If you are under age 65 and using Medicare due to a disability or other reason, you can remain enrolled in the US Family Health Plan until your 65th birthday. At that time, you will transition to TRICARE For Life. |
Availability
You must live in the one of the designated US Family Health Plan service areas to enroll.
| Service Area | Designated Provider |
| Maryland, Washington D.C.; and parts of Pennsylvania, Virginia, Delaware and West Virginia |
Johns Hopkins Medicine 1-800-808-7347 |
| New York City, Long Island, southern Connecticut, New Jersey and Philadelphia and area suburbs |
St. Vincent Catholic Medical Centers 1-800-241-4848 |
| Maine, New Hampshire, Vermont, upstate and western New York and the northern tier of Pennsylvania | Martin's Point Health Care 1-888-241-4556 |
| Southeast Texas and Southwest Louisiana |
CHRISTUS Health 1-800-678-7347 |
| Massachusetts, including Cape Cod; Rhode Island; and Northern Connecticut | Brighton Marine Health Center 1-800-818-8589 |
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Puget Sound area of Washington state |
Pacific Medical Centers |
Getting Care
When you enroll in the US Family Health Plan, you will not access Medicare providers, military treatment facilities or TRICARE network providers, but instead receive your care (including prescription drug coverage) from a primary care physician that you select from a network of private physicians affiliated with one of the not-for-profit health care systems offering the plan. Your primary care physician assists you in getting appointments with specialists in the area and coordinates your care.
Out-of-Pocket Costs
Active duty family members pay no enrollment fees and no out-of-pocket costs for any type of care as long as care is received from the US Family Health Plan provider. All other beneficiaries pay annual enrollment fees and network copayments. >>Learn More
Is the US Family Health Plan Right for You?
If you live in one of the six designated areas, you may want to consider the US Family Health Plan. It is a robust Prime option that even offers enhanced coverage at each location. Visit www.usfhp.com for more information.
Enrolling in the US Family Health Plan
You may enroll in US Family Health Plan at any time during the year by completing an application for the plan in your area. >>Learn More about Enrolling in the US Family Health Plan
Last Modified:October 1, 2012
PrintContact
US Family Health Plan
1-800-74-USFHP
(1-800-748-7347)
www.usfhp.com
