TRICARE Prime Option - 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.

Who Can Participate?

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
Includes members of the:
- Army National Guard
- Army Reserve
- Navy Reserve
- Marine Corps Reserve
- Air National Guard
- Air Force Reserve
- U.S. Coast Guard Reserve
Non-activated National Guard/Reserve members and their families who qualify for care under the Transitional Assistance Management Program
Retired National Guard/Reserve members at age 60 and their families*
Survivors
Medal of Honor recipients and their families
Qualified former spouses

Where Can You Use It?

You must live in the one of the designated US Family Health Plan service areas to enroll.

US Family Health Plan Service Area	Designated Provider
Maryland Washington D.C. Parts of Pennsylvania, Virginia, Delaware, and West Virginia	Johns Hopkins Health Plans 800-808-7347 Secure Login Portal Provider Directory
Maine New Hampshire Vermont Upstate and Western New York Northern and Western Tier of Pennsylvania Northeastern and Central Ohio	Martin's Point Health Care 888-241-4556 Secure Login Portal Provider Directory
Massachusetts, including Cape Cod Rhode Island Northern Connecticut	Brighton Marine Health Center 800-818-8589 Secure Login Portal Provider Directory
New York City Long Island Lower Hudson Valley New Jersey Western Connecticut, including New London and Hartford Eastern Pennsylvania	St. Vincent Catholic Medical Centers 800-241-4848 Secure Login Portal Provider Directory
Central Texas Coastal Bend Texas Northeast Texas Southeast Texas Central Louisiana	CHRISTUS Health 800-678-7347 Secure Login Portal Provider Directory
Western Washington State Most of Central and Eastern Washington State Northern Idaho Western Oregon Most of California	Pacific Medical Centers (PacMed Clinics) 866-418-7346 Secure Login Portal Provider Directory

How it Works

You'll get all care (including prescription drug coverage) from a primary care provider that you select from the network of private physicians affiliated with one of the not-for-profit health care systems listed above. Your primary care provider assists you in getting appointments with specialists in the area and coordinates your care.

You won't get care at military hospitals and clinics or from TRICARE network providers when enrolled in the US Family Health Plan.

What You Pay

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 others 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's a robust Prime option that even offers enhanced coverage at each location.

How to Enroll

>>Visit the US Family Health Plan Enrollment Page to learn more.

For information on disenrolling or ending plan coverage, visit the Disenrolling in the US Family Health Plan page.

Can I enroll in the US Family Health Plan if I'm Medicare-eligible?

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 aren't affected.

If Enrolled Before October 1, 2012

If you're 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 Medicare Part B Late Enrollment Penalty.

New Enrollments on or After October 1, 2012

Beginning October 1, 2012, Medicare-eligible beneficiaries age 65 and older can no longer enroll in the US Family Health Plan. If you're under age 65 and using Medicare due to a disability or other reason, you can remain enrolled in the US Family Health Plan until you age out. At that time, you will transition to TRICARE For Life.

Last Updated 9/19/2024