Disclaimer


Making Your Case

Making Your Case

If you want to sign up for a TRICARE health care plan, this page contains everything you need to know and useful links leading onto further and more detailed information.

TRICARE is a health insurance plan sponsored by the military for the military personnel and it comes in four different types: TRICARE Standard, TRICARE Prime, TRICARE Extra and TRICARE for Life.  TRICARE provides coverage for everyone- Active duty, reserves, retirees and their families. However, retirees and their dependents have to pay a certain amount of charges for medical costs.

After determining whether you are eligible to qualify for TRICARE coverage, the next step is enrollment. The process of enrollment into TRICARE is mandatory and can vary according to the plan selected. TRICARE is not available for the general population; it is supposed to foster medical wellness for the United States military and its dependencies.

Health care costs can be quite exorbitant and pretty much impossible to pay out of your own pocket or in change. This is why health insurance policies and plans are in place.  For civilians, multiple options are available. Similarly, TRICARE is one such option for military personnel and their families. When the latter are faced by a medical emergency or require professional care, TRICARE is in place to meet all the needs and requirements.

Military sponsors and their families are eligible for TRICARE. Sponsors include uniformed service men (active duty retired and reserves) from all the seven branches of the United States military.  Active service duty members and activated National Guard or Reserve members must enroll in one of the TRICARE Prime programs:

  • TRICARE Prime
  • TRICARE Prime Remote
  • TRICARE Prime Overseas
  • TRICARE Global Remote Overseas.

The Affordable Care Act was passed by the United States legislature in 2010 and it aimed to provide more expansive and simplified health care coverage to the citizens. TRICARE Prime, under the banner of the newly minted “ObamaCare”, covers the requirements for the essential coverage for military personnel and their dependents. It is mandatory for all in service members to enroll in TRICARE Prime.

How to Enroll In TRICARE coverage:

  1. Determine Eligibility: Check to make sure that you fall under the beneficiaries that are covered under TRICARE. These will most likely include sponsors (military personnel) and their beneficiaries (families usually spouses and children).
  2. In addition to meeting eligibility criteria for TRICARE, you need to make sure that your families and other beneficiaries are registered in the Defense Enrollment Eligibility Reporting System (DEERS). If you are in fact eligible for TRICARE, it means that you are already in DEER, but it does not hurt to make sure that all your information is valid and updated in order to avoid any future problems regarding program claims.
  3. Decide on the plan most suitable for you and your family. TRICARE offers several different health plans:

In order to purchase or participate in any of the plans, you must purchase one. Enrollment is not required to use the following plans; coverage is automatic as long as you are registered in the Defense Enrollment Eligibility Reporting System:

  • TRICARE Standard and Extra
  • TRICARE Standard Overseas
  • TRICARE for Life (you must have Medicare Part A and B).

TRICARE Standard is the plan, which offers the most amount of flexibility to its dependents. You do not need to apply to or enroll in the TRICARE Standard program. TRICARE Prime on the other hand is a different business. Beneficiaries are offered the opportunity to enroll in Prime on a continuing basis. Beneficiaries who select TRICARE prime Or TRICARE Prime Remote for active duty family members remain enrolled for 12 months increments until they are unenrolled for any reason.  TRICARE prime is available in Prime Service Areas. To view these, if you live in one, you can either check your zip code online or else check with your regional contractor. TRICARE Prime Enrollment can prove to be challenging as compared to other TRICARE plans. First, you have to choose a Primary Care Manager (PCM) who can be either military or network provider. Next, you have to complete the Enrollment Application Form:

  • Enroll all family members in one enrollment
  • Send Enrollment fees (if applicable) along with your enrollment form.
  • If you have any questions or are plagued by any problems, it is best to first contact your regional contractor.

Finally, you will be contacted by your regional contractor once your enrollment is successful and you will be able to access the benefits of TRICARE.

It is also possible to purchase or enroll in some kinds of TRICARE plans through phone or email. There are two websites, where you can enroll online:

  • https://www.dmdc.osd.mil/appj/bwe/
  • https://www.dmdc.osd.mil/appj/reserveTRICARE

To log on to either site, you need the Common Access Card (CAC), DFAS (MyPay) Account and DoD Self-Service Logon (DS Logon) Premium (Level 2) account.

The Beneficiary Web Enrollment Website allows you to enroll in:

  • TRICARE Prime (only if you live in a Prime Service Area)
  • TRICARE Prime Remote
  • TRICARE Young Adult
  • US Family Health Plan
  • TRICARE Dental Program
  • TRICARE Retiree Dental Program

Enroll by Phone

You can enroll in any of the following plans by calling your regional or plan contractor:

  • TRICARE Prime
  • TRICARE Prime Remote Overseas
  • TRICARE Prime Remote
  • TRICARE Prime Overseas
  • US Family Health Plan
  • TRICARE Young Adult

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6 comments

  1. Charles T. Hoffner, LtCol, USAF Retired

    My claim (B294X1R34-00-00) was denied.

    The EOB remark says: 1 – REQUESTED INFORMATION NOT RECEIVED. FOR ADDITIONAL INFORMATION ABOUT NON-APPEALABLE DENIALS, PLEASE SEE BLOCK E ON THE BACK OF THIS SUMMARY.

    Is there some way I can find out what information was requested so I can reach out to the service provider and try to get whatever it is TRICARE needs?

  2. Lesley R. Fowlow

    I cannot get into my account, kept getting my late husbands. I need to change my insurance to Medicare Advantage and Tricare effective 1/1/2016. Also need to find out what I need to do to get my claims for this year approved.

  3. Was married 49 years to a 20 year retired Navy man. I have remarried, have heard I am eligible for Tricare. Is this correct?

    Thank you for information

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