TRICARE is the military’s health care system. TRICARE provides free or government subsidized dental and medical care to the following military personnel, depending on their status:
- Active duty members
- Members of the Guard or Reserves
- Retired members
- Family members
- Certain veterans
TRICARE has three basic plans:
- TRICARE Prime – similar to an HMO (link). Active duty members are enrolled automatically. Enrolled persons are assigned to a Primary Care Provider, who can then refer them to specialists if necessary. There may be co-pay requirements, but enrollment into the program involves no deductible and is free for active members and their families.
- TRICARE Extra – more flexible than Prime, but potentially more costly. Active and retired members pay different co-payments. Enrolled persons can see any authorized provider instead of just a Primary Care Provider.
- TRICARE Standard – greatest flexibility, but has the highest costs. There is an annual deductible, but you can see almost any medical provider you want to. Retired persons may have to pay significantly more than active duty members.
Family members of individuals in the Reserve and Guard can use any of the three TRICARE plans when the Reserve or Guard member is called to active duty for more than 30 days.
Not all veterans and military retirees can obtain free medical care from the government. To receive medical care from the Veterans Administration, you must:
- Be a veteran (served more than 180 days in the military)
- Have a service-related illness or disability, or fall into a certain poverty level
- Have an honorable discharge
Up until recently, retired persons and their families were ineligible for TRICARE after the age of 65. But now there is a program called "TRICARE for Life." To be eligible, you must enroll in Medicare B. Under TRICARE for Life, you can see any authorized Medicare provider, and TRICARE will pick up any costs that Medicare doesn’t cover.
Under TRICARE, you can receive medication through:
- Military Pharmacies
- Civilian Pharmacies
- TRICARE Mail Order Pharmacy (TMOP)
Sometimes it can be difficult to get health benefits you have been denied. An experienced administrative law attorney can help you get the benefits you deserve. An administrative lawyer can also represent you in administrative hearings and court.