TRICARE Glossary
Clear definitions of military healthcare terms—making TRICARE easier to understand
Expert Definitions
All terms researched from official TRICARE documentation and healthcare guidelines for accurate, trustworthy definitions.
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Select terms include curated YouTube videos to help visualize concepts and understand complex healthcare topics.
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A
Active Duty
Full-time service in any branch of the U.S. Armed Forces.
Active Duty Family Member
ADFM
Eligible family members of active duty service members.
Allowable Charge
Maximum amount TRICARE will pay for a covered service.
Annual Enrollment Fee
Yearly fee required for enrollment in certain TRICARE plans.
Ambulatory Surgery
Surgical procedures performed on an outpatient basis without requiring an overnight hospital stay.
Appeal
A formal request to have TRICARE reconsider a denied claim or coverage decision.
Applied Behavior Analysis
ABA
Evidence-based therapy for autism spectrum disorder covered by TRICARE.
Ambulance Services
Emergency ground and air ambulance transportation covered by TRICARE when medically necessary.
B
Beneficiary
Person eligible to receive TRICARE benefits.
Balance Billing
When a non-network provider charges you the difference between their fee and TRICARE's allowable charge.
Beneficiary Category
Classification that determines your TRICARE plan options, costs, and eligibility.
Behavioral Health
Mental health and substance use disorder services covered by TRICARE.
C
Catastrophic Cap
Maximum out-of-pocket expenses for covered services each fiscal year.
Claim
Request for payment of covered medical services.
Copayment
Fixed amount you pay for covered services.
Cost-Share
Percentage of costs you pay for covered services.
Continued Health Care Benefit Program
CHCBP
Temporary transitional health coverage for those losing TRICARE eligibility.
Coinsurance
The percentage of healthcare costs you pay after meeting your deductible.
Clinical Trial
A research study testing new medical treatments that may be covered under specific TRICARE guidelines.
Claims Filing Deadline
The time limit for submitting a claim to TRICARE for reimbursement of covered services.
Coordination of Benefits
COB
The process of determining which insurance pays first when you have multiple health coverage plans.
Chiropractic Care
Spinal manipulation services available to active duty members and covered for other beneficiaries under specific conditions.
Caregiver Support
Programs and resources available to support caregivers of TRICARE beneficiaries with special needs.
D
Deductible
Amount you pay before TRICARE starts cost-sharing.
Defense Enrollment Eligibility Reporting System
DEERS
Database of all individuals eligible for military benefits.
Defense Health Agency
DHA
The agency that manages the Military Health System and administers TRICARE.
Durable Medical Equipment
DME
Reusable medical equipment prescribed for home use, such as wheelchairs and oxygen equipment.
Disenrollment
The process of leaving or being removed from a TRICARE plan.
Dependent
A family member who receives TRICARE benefits through a military service member sponsor.
Dental Care
Dental services available through TRICARE Dental Program, FEDVIP, or Military Treatment Facilities.
E
Extended Care Health Option
ECHO
Additional benefits for qualifying disabilities and chronic conditions.
Explanation of Benefits
EOB
Statement showing how TRICARE processed your claim.
Express Scripts
The pharmacy benefit manager administering the TRICARE pharmacy program.
Enrollment Fee
Annual or monthly fee required to participate in certain TRICARE plans.
Experimental Procedure
A medical treatment not yet proven safe or effective and generally not covered by TRICARE.
Exceptional Family Member Program
EFMP
A mandatory military program that coordinates assignments and support for families with special needs members.
Emergency Care
Immediate medical treatment for life-threatening conditions, covered by TRICARE without prior authorization.
F
Formulary
The list of prescription drugs covered by the TRICARE pharmacy benefit.
Federal Employees Dental and Vision Insurance Program
FEDVIP
Dental and vision insurance program available to retirees and their families.
Fertility Treatment
Limited reproductive assistance services covered by TRICARE for eligible beneficiaries.
G
Group A Retiree
Military retirees who initially enrolled in TRICARE Prime or Select before January 1, 2018.
Group B Retiree
Military retirees who first became eligible for TRICARE on or after January 1, 2018.
Grievance
A formal complaint about TRICARE service quality, access, or administrative issues.
H
Humana Military
The managed care support contractor for the TRICARE East Region.
Host-Nation Provider
A healthcare provider in a foreign country who treats TRICARE beneficiaries stationed overseas.
Hospice
End-of-life care focused on comfort and quality of life for terminally ill beneficiaries.
Home Health Care
Skilled medical services provided in your home when you are unable to leave for regular care.
Hearing Aids
Hearing devices and audiology services covered by TRICARE for diagnosed hearing loss.
I
International SOS
The overseas contractor that assists TRICARE beneficiaries living or traveling abroad.
Individual Ready Reserve
IRR
Reserve members not in active training units who may be called to duty in national emergencies.
Inpatient
Healthcare services requiring formal admission to a hospital for at least one overnight stay.
Immunization
Vaccines and preventive immunizations covered at no cost by TRICARE for all beneficiaries.
M
Military Treatment Facility
MTF
Military hospital or clinic providing healthcare to beneficiaries.
MHS GENESIS
The electronic health record system used across all Military Treatment Facilities.
milConnect
Online self-service portal for managing DEERS information and benefits.
Military OneSource
Free support service providing resources and counseling for military members and families.
Maternity Care
Comprehensive prenatal, labor and delivery, and postpartum services covered by TRICARE.
Mental Health Parity
Federal requirement that mental health benefits be comparable to medical and surgical benefits.
Medical Evacuation
MEDEVAC
Emergency medical transport from an overseas or remote location to a facility capable of providing needed care.
N
Network Provider
Healthcare provider contracted with TRICARE.
Non-Availability Statement
NAS
Documentation that a needed service is not available at your local Military Treatment Facility.
Nurse Advice Line
NAL
24/7 telephone service where registered nurses provide health advice to TRICARE beneficiaries.
Non-Formulary
Prescription drugs not on TRICARE's preferred medication list, requiring higher copayments.
Non-Network Provider
A healthcare provider who does not have a contract with TRICARE, resulting in higher costs.
O
Open Season
Annual enrollment period when TRICARE beneficiaries can change health plans.
Other Health Insurance
OHI
Any non-TRICARE health insurance that a beneficiary may have.
Outpatient
Healthcare services that do not require an overnight hospital stay.
Overseas Region
The TRICARE service area covering beneficiaries living or stationed outside the United States.
Occupational Therapy
OT
Therapy services to help patients perform daily activities and improve functional independence.
P
Primary Care Manager
PCM
Your main doctor who coordinates your healthcare.
Prime Service Area
PSA
Geographic area where TRICARE Prime is available.
Prior Authorization
PA
Approval required from TRICARE before receiving certain services or medications.
Point of Service
POS
Option for TRICARE Prime enrollees to receive care without a referral at higher cost.
Point-of-Service Charge
POS Charge
Higher out-of-pocket costs incurred when TRICARE Prime enrollees seek care without a referral.
Permanent Change of Station
PCS
Official relocation of a service member to a new duty station, requiring updates to TRICARE enrollment.
Palliative Care
Specialized care focused on relieving symptoms and improving quality of life for patients with serious illnesses.
Preventive Care
Routine health screenings and wellness services covered at no cost by TRICARE.
Physical Therapy
PT
Rehabilitative services to restore movement and function after injury, surgery, or illness.
Pre-Authorization
Advance approval from TRICARE required before receiving certain healthcare services.
Prescription Coverage
TRICARE pharmacy benefits covering prescription medications through multiple fill options.
Q
R
Referral
Authorization from your PCM to see a specialist.
Respite Care
Temporary relief care for primary caregivers of TRICARE beneficiaries with special needs.
Radiology
Diagnostic imaging services including X-rays, MRIs, CT scans, and ultrasounds covered by TRICARE.
S
Sponsor
Active duty or retired service member whose service qualifies family for benefits.
Specialty Tier
A category for high-cost specialty medications with specific coverage requirements.
Step Therapy
A program requiring you to try lower-cost medications before TRICARE covers more expensive alternatives.
Selected Reserve
Reserve component members who train regularly and are available for active duty when needed.
Skilled Nursing Facility
SNF
A facility providing 24-hour skilled nursing care and rehabilitation services covered by TRICARE.
Speech Therapy
Therapy services addressing speech, language, voice, and swallowing disorders.
Substance Use Disorder
SUD
Treatment services for alcohol and drug dependency covered by TRICARE under behavioral health benefits.
Supplemental Health Insurance
Additional private insurance policies that work alongside TRICARE to cover remaining costs.
T
TRICARE For Life
TFL
Medicare wraparound coverage for TRICARE-eligible beneficiaries age 65+.
TRICARE Prime
Managed care option with assigned PCM and lowest costs.
TRICARE Select
Self-managed option with provider choice and flexibility.
TRICARE Reserve Select
TRS
Premium-based health plan for qualified Selected Reserve members and their families.
TRICARE Young Adult
TYA
Premium-based plan for adult children who age out of regular TRICARE coverage.
TRICARE Retired Reserve
TRR
Premium-based health plan for retired Reserve members not yet age 60.
TriWest Healthcare Alliance
The managed care support contractor for the TRICARE West Region.
TRICARE Dental Program
TDP
Voluntary dental insurance plan for active duty family members.
TRICARE Prime Remote
TPR
Managed care option for active duty members and families stationed far from MTFs.
Transitional Assistance Management Program
TAMP
Provides 180 days of transitional TRICARE coverage after separation from active duty.
TRICARE East Region
The TRICARE service region covering states east of the Mississippi River.
TRICARE West Region
The TRICARE service region covering states west of the Mississippi River.
TRICARE Overseas Program
TOP
TRICARE coverage for beneficiaries living or traveling outside the United States.
TRICARE-Authorized Provider
Any healthcare provider who meets TRICARE licensing and certification requirements to provide care.
Temporary Duty
TDY
Short-term assignment to a location other than your permanent duty station.
Telehealth
Healthcare services delivered remotely through video, phone, or digital communication technologies.
Third-Party Liability
TPL
When another party is legally liable for your medical costs, such as in accident or injury cases.
TRICARE Supplement
Private insurance that helps cover out-of-pocket TRICARE costs like copays, deductibles, and cost-shares.
Transitional Assistance Management Program
TAMP
Temporary 180-day TRICARE coverage for service members and families transitioning from active duty.
U
US Family Health Plan
USFHP
A TRICARE Prime option offered through designated healthcare networks in specific geographic areas.
Uniformed Services
The eight U.S. uniformed services whose members are eligible for TRICARE benefits.
Urgent Care
Immediate medical care for non-life-threatening conditions that need attention within 24 hours.
W
Wounded Warrior
Programs and extended TRICARE benefits for service members who are seriously ill or injured.
Well-Child Care
Routine pediatric checkups and screenings covered at no cost by TRICARE.
Weight Management
Obesity screening, counseling, and certain weight management services covered by TRICARE.
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