What You Need to Know if You’re New to TRICARE
If you’re newly enrolled in TRICARE health or dental coverage, you’re in good company. You now have access to a global network of military and civilian providers. Learning about your health care coverage now will help you maximize your benefit and take command of your health in 2020.
First Things First: Eligibility
You must keep your information updated in the Defense Enrollment Eligibility Reporting System (DEERS). If you don’t, you may miss important information and enrollment deadlines. This could mean you or your family lose access to care. You have several options for updating your information in DEERS (online, phone, mail, and fax). Remember to update DEERS anytime you experience a change or Qualifying Life Event (QLE).
TRICARE Plan Options
Your eligibility for certain TRICARE plans depends on factors like your sponsor’s status, your relationship to your sponsor, and where you live. Different family members may be eligible for different plans.
Visit the TRICARE Plan Finder to see which plan best meets your needs. You can also use the Compare Plans Tool to compare the key features of health plans side-by-side. This includes information on how to enroll, get care, file claims, and more.
It’s important to understand the basics of your TRICARE plan options. The TRICARE Plans Overview also provides information on available TRICARE plans, including TRICARE Prime, TRICARE Select, and premium-based plans. Premium-based plans include:
- TRICARE Retired Reserve
- TRICARE Reserve Select
- TRICARE Young Adult
- Continued Health Care Benefit Program
As described in the TRICARE Plans Overview, you can purchase premium-based plans anytime.
When comparing plans, you should also compare costs. You can view, download, or print the TRICARE Costs and Fees Sheet from the TRICARE publications page. Depending on who you are and the plan you enroll in, you may have out-of-pocket costs for certain covered services. Another helpful resource is the TRICARE Compare Cost Tool. Use it to view comprehensive costs for your plan and compare them with those of other plans.
Choosing or Changing TRICARE Plans
Now that you’re covered by TRICARE, you may be wondering how you and your family members can choose or change plans in the future. For TRICARE Prime (including the US Family Health Plan) and TRICARE Select, you may only choose or change your enrollment:
- Following when you or a family member experiences a QLE, or
- During the annual TRICARE Open Season.
Other TRICARE plans offer continuous open enrollment.
- Finding a provider. With some plans, you may be assigned to a military hospital or clinic, as well as a primary care manager (PCM). If not, begin by locating a provider. You can do this with the TRICARE Find a Doctor Tool. If you already know the type of provider you’re looking for, view the provider directories for your TRICARE region.
- Understanding what’s covered. Explore what’s covered prior to getting care. TRICARE covers clinical preventive services. For TRICARE Prime plansTRICARE Prime plans include: TRICARE Prime, TRICARE Prime Remote, TRICARE Prime Overseas, TRICARE Prime Remote Overseas and TRICARE Young Adult-Prime, you get your preventive care from your PCM or any network provider. Referrals or pre-authorizations aren’t required, and you pay nothing out of pocket. If you use any other TRICARE plan, you can visit any TRICARE-authorized providerAn authorized provider is any individual, institution/organization, or supplier that is licensed by a state, accredited by national organization, or meets other standards of the medical community, and is certified to provide benefits under TRICARE. There are two types of TRICARE-authorized providers: Network and Non-Network. DS, network or non-network. The cost will depend on whom you see.
- Types of care. The types of care you need fall into five categories: routine, preventive, specialty, urgent, and emergency. How you seek non-emergency care may differ by plan. However, if you reasonably think you have an emergency, always go to the nearest emergency roomThe hospital department that provides emergency services to patients who need immediate medical attention. or call 911.
Last Updated 10/14/2021