Explain TRICARE

TRICARE is the health plan available to people in or retired from the military, and their families. As of 2009, 9.5 million people are eligible to receive benefits from this plan.

History

• The Civilian Health Program for the Uniformed Services was a precursor to the current TRICARE system. Reform led to a system with three levels of TRICARE: TRICARE Standard, TRICARE Extra, and TRICARE Prime.

Eligibility

• Active duty and retired military personnel and their families, commissioned members of the National Oceanic and Atmospheric Association and the Public Health Service, and Medal of Honor recipients are eligible for TRICARE. Families of retirees and military members who died on active duty also may claim TRICARE benefits.

Deductibles

• TRICARE Standard and TRICARE Extra have deductibles. These are set amounts of money that must be paid by the insured person before the insurance kicks in. TRICARE Prime has no deductible.

Cost Shares

• TRICARE Standard has the highest cost shares. TRICARE Extra members get a 5 percent discount on the cost share. Those enrolled in TRICARE Prime have the lowest cost share. Although there is no premium for either Standard or Extra, there is a small monthly premium for TRICARE Prime.

Providers

• TRICARE Extra uses providers from a set network of health care professionals. TRICARE Standard uses providers outside the network. People enrolled in TRICARE Prime may use any provider, as long as they get approval for the service.

Catastrophic Cap

• In TRICARE's terms, the catastrophic cap is the amount at which the recipient no longer has to pay for anything. The most an active duty member would have to pay in 2009 is $1,000. For retired members, the amount is $3,000.