Understanding your veteran benefits – TRICARE: An Overview – Part 2
In Part 1 last week, we discussed the TRICARE options available for active duty members and their dependents both stateside and while overseas. In Part 2, we will continue with other TRICARE options including:
- Selected Reservists and Dependents
- Retirees
- Dental
- Pharmacy
- Vision
- Transitional Assistance Management Program (TAMP)
Selected Reservists and Dependents
For actively drilling reservists including National Guardsmen (and their families), TRICARE Select is a premium-based program that has an annual deductible and per visit co-pays, or cost sharing, for some services provided. TRICARE Select is not an option for reservists on active duty orders, covered under Transitional Assistance Management Program or eligible for Federal Employees Health Benefits.
Retirees
Retiring active duty members under age 65 have the option to keep their current TRICARE plan or switch to one of the other options, including Prime, Extra, Standard or US Family Health. Once at age 65, they can then switch over to Medicare and TRICARE for Life.
National Guard and Reserve retirees under the age of 60 can purchase TRICARE Retired Reserve. At age 60 they switch to Prime, Extra or Standard; then at age 65, they too switch over to Medicare and TRICRE for life. Under the Medicare/TRICARE for Life option, Medicare is the primary coverage with TRICARE for Life being the supplement. If living overseas, TRICARE for Life is the primary health care coverage.
While there is a cost for Medicare, TRICARE for Life is provided free-of-charge. All the other TRICARE options are premium-based meaning they have a monthly cost.
Dental
Available as a premium-based program, TRICARE Retiree Dental not only covers retirees from both active duty and the Selected Reserve, but also family members up to age 23 (if in school – otherwise age 21).
Pharmacy
Under the Pharmacy Plan, prescriptions can be filled via three different options: Military Pharmacy, Home Delivery or Retail Pharmacy Network. Up to a 90-day supply of a routine prescriptions are provided with a low-to-no-cost co-pay depending on the plan used and type of prescription; generics are provided when available. For retirees having TRICARE for Life, there is not a need to have Medicare Part D.
Vision
The type of vision coverage depends on the TRICARE option. For active duty members with Prime, annual eye exams for age 3 and older are provided free of charge. Retirees however are provided one eye exam every 24 months. For active duty members with Extra or Standard, coverage is much the same as it is for Prime, however retirees with Standard, Extra or TRICARE for Life are not eligible for routine eye exams under this vision coverage.
Transitional Assistance Management Program (TAMP)
TAMP provides select TRICARE coverage to the following members and their families for up to 180 days:
- Selected Reservists (including National Guard) coming off a contingency support operation order of 30 days or more
- Active duty members involuntarily separated
- Active duty members involuntarily retained when on a contingency support operation order
- Active duty members who were on a contingency support operation order of less than one year by their agreement
Coverage under TAMP is the same as it is under the TRICARE Prime option. Members having Prime while on a contingency order must re-enroll in Prime, or enroll in Prime if under a different TRICARE plan, before the order ends to prevent having a break in coverage.
It is easy to see the options available under TRICARE are numerous and varied. While the military member’s status drives in large part which options are available, other TRICARE premium-based plans are available and in most cases are as competitive, or provide better coverage, than other non-TRICARE programs available in the Healthcare Marketplace. All TRICARE plans meet the minimum requirement of essential coverage under the Affordable Care Act. For more information on all of the TRICARE plans, and the benefits and coverages available under each plan, go to the TRICARE Health Plan website.
