Health care is, without a doubt, one of the top concerns in the civilian world when it comes to career choice, and some people still couldn’t afford to get themselves covered through the very expensive private health insurance market. In the army, the health care benefit service members are fortunate enough to receive health care and benefit at little to no cost, along with their family.
The Army health care is provided by TRICARE, a health care system under the Department of Defense. Army servicemen and their dependents can be covered by the different Tricare plans as long as they are enrolled in the Defense Eligibility Enrollment System (DEERS).
Active Duty Service Member with no Dependents
Active Duty Service members are automatically enrolled in Tricare Prime. It is 100% free for active duty service members. They also get dental care, routine eye exams and a standard issue of glasses and frame for free.
Depending on the duty station, the service member will be enrolled into one of the following Prime Plans:
- If you are located in a Prime Service Area
- Prime Remote
- If your work location and living location are outside of 50 miles (or an hour drive) radius from the closest Military Treatment Facility.
- Prime Overseas
- If your duty station is outside of continental United States (include Guam, etc)
- Prime Remote Overseas
- If your work location oversea are outside of 50 miles radius from the closest Military Treatment Facility
The active duty service member is expected to have a Primary Care Manager under the Tricare Prime, and he/she will consult their PCM first (usually at a Military Treatment Facility) for any medical concerns. If the PCM cannot provide the care the service member needs, then the service member will be referred to other MTF or network provider for further treatment. Examples of such include routine, urgent, preventive or specialty cares.
If the service member is going to see a civilian doctor without a referral then he/she will pay for the care out of pocket.
Active Duty Service Member with Spouses
Spouses who are living with their active duty service members have the option to choose from Tricare Prime or Tricare Select.
If the work location of the active duty service member is in a Prime Service Area, then the spouse can also enroll Tricare Prime for free. The Tricare Prime provides military spouse the same benefit as to the active service member. The spouse only has to pay when he/she is using a Point-of-Service option. The Point-of-Service includes using a network provider without a referral, using a non-network provider, getting routine or urgent care.
If the work location of the active duty service member is outside the Prime Service area, then the spouse can enroll in Tricare Prime Remote, especially when living with a service member on Prime Remote. The Prime Remote is free as long as the spouse receives care from their PCM or any network provider with a referral. Otherwise, he/she will pay out of pocket for the Point-of-Service option.
If the work location of the active duty service member is at an overseas location, and the spouse happened to be a command-sponsored beneficiary, then he/she can enroll in Tricare Prime overseas or Prime Oversea Remote for free. Rules and benefits of this plan are similar to Prime.
(*A command-sponsored beneficiary means the dependent is authorized by the military to accompany the active duty member to reside at an overseas duty station.)
If none of the above scenarios are applicable, then Tricare Select(include Tricare Select Overseas) would be the next option for the spouse of an active duty service member. (Since January 2018, Tricare Select replaced the previous Tricare Standard and Tricare Extra. ) Tricare Select is good for the spouse who has other employer-sponsored health insurance plan or prefers to keep seeing their non-network provider. It offers more flexibility than Tricare Prime—the spouse can choose any network or non-network Tricare-authorized provider without a referral from the Primary Care Manager.
In terms of cost, there’s no enrollment fee for Tricare Select but the military spouse does have to pay for cost-share/copay for covered services. There’s also an annual deductible in Tricare Select depending on the active service member’s rank.
Besides Tricare Select, the spouse can also choose Tricare for Life if they have Medicare B, or they can choose Tricare U.S Family Health Plan if they live in one of the six designated areas.
Dental Care for family members is a separate, voluntary Tricare program that can be purchased with a fee.
You must enroll or purchase the following health plans to participate.
- TRICARE Prime*
- TRICARE Prime Remote*
- TRICARE Prime Overseas*
- TRICARE Prime Remote Overseas*
- TRICARE Select
- TRICARE Select Overseas
- US Family Health Plan
- TRICARE Reserve Select
- TRICARE Retired Reserve
- TRICARE Young Adult
- Continued Health Care Benefit Program
*Active duty service members must enroll in TRICARE Prime, TRICARE Prime Remote, TRICARE Prime Overseas or TRICARE Prime Remote Overseas (based on the duty station).