What is TRICARE?
TRICARE is the government-funded health care plan for active-duty uniformed personnel, some retirees and their dependents, as well as some reservists. For active-duty and other beneficiaries under age 65, TRICARE offers a variety of options for coverage, including Standard, Extra and Prime options.
Beneficiaries who have reached age 65 or older lose their eligibility for all TRICARE programs but TRICARE for Life (TFL). TFL is a supplemental benefit to Original Medicare, designed so that TRICARE covers most or all deductibles and co-payments of Medicare Parts A and B, as well as providing other benefits and a payer of last-resort. TFL is NOT a Medicare Supplemental Insurance Policy or a Medicare Advantage Plan, though it may do many of the same things.
How is TRICARE different than Veterans Administration Benefits?
TRICARE eligibility is determined by registration in the Defense Enrollment Eligibility Reporting System (DEERS). All uniformed service-members (from Army, Air Force, Navy, Marine Corps, Coast Guard, Public Health Service, or National Oceanic & Atmospheric Administration) are automatically entered into DEERS at the start of service. These ‘sponsors’ can then enroll their eligible dependents in DEERS. TRICARE for those under 65 acts as their primary insurer, with policies, co-pays, deductibles and other normal aspects. As outlined above, Medicare eligible persons receive TFL, which acts to supplement their Medicare coverage.
Benefits provided through the Veterans Administration(VA) are usually for service-connected disability, rather than just for service. The VA health system is technically open to any veteran not dishonorably discharged, however a priority system in practice limits VA benefits to those who were majority disabled, unemployable, prisoners of war or Purple Heart recipients. Depending on the level of need, length of service, income and other criteria, other veterans may be eligible for VA Health Benefits. A person can receive VA benefits and Medicare at the same time, though they will not duplicate payments and will only coordinate payment for VA-approved treatment outside of the VA system. For more information, please click here.
Who is eligible for TRICARE?
In most circumstances, TRICARE eligible individuals include; active duty and retired service members, spouses and unmarried children (up to age 21 or 23 in full time schooling), dependent incapacitated adult children, some reservists (including those activated for 30 days or more by federal order, those injured or killed during active-duty training and retirees), spouses and unmarried children of reservists while reservist’s coverage is active, widows and unmarried children of deceased active-duty service members, Medal of Honor recipients and their eligible families, and certain former, but un-remarried, spouses of active duty or retired service members.
It is the responsibility of these ‘sponsors’ to enroll their eligible dependents (including spouses, children, dependent parents) in DEERS. This can be done in person, online or by fax or mail. To update DEERS in person, individuals should find their local Real-Time Automated Personnel Identification Card System (RAPIDS) center (you can find your local office here or call 1-800-538-9552). By fax or mail individuals should contact the Defense Manpower Data Center (DMDC) by fax and mail at 1-831-655-8317 and Defense Manpower Data Center Support Office, ATTN: COA, 400 Gigling Road, Seaside, CA 93955-6771 respectively. Online individuals should visit the DEERS/TRICARE online management system, available here.
TRICARE and seniors
Generally seniors will interact with TRICARE in one of two ways. Those who have reached age 65 will be switched to TRICARE for Life (TFL) which will supplement their Medicare coverage. Those who are not 65 or who are dependent parents (or parents-in-law) will be covered under the regular TRICARE options for health care (Prime, Extra, or Standard).