Beneficiary
Quick Definition
Person eligible to receive TRICARE benefits.
Video Explanation
Full Definition
A TRICARE beneficiary is any person who is eligible to receive healthcare benefits through the TRICARE program. Beneficiary status is determined by relationship to a military service member and registration in the Defense Enrollment Eligibility Reporting System (DEERS).
Beneficiary categories include: • Active duty service members • Active duty family members • Retired service members • Retired family members • National Guard and Reserve members (when activated) • Survivors of deceased service members • Medal of Honor recipients and families • Certain former spouses
Each beneficiary category has different plan options, costs, and coverage levels. All beneficiaries must be registered in DEERS to access TRICARE benefits. Beneficiary status can change based on life events such as marriage, divorce, aging out of dependent coverage, or changes in military status.
Related Questions
What is TRICARE?
TRICARE is the healthcare program for uniformed service members, retirees, and their families worldwide.
Who is eligible for TRICARE?
Active duty members, retirees, National Guard/Reserve members, their families, survivors, and Medal of Honor recipients.
How do I enroll in TRICARE?
Ensure you're registered in DEERS, then choose your plan during open enrollment or within 90 days of a qualifying life event.
What is TRICARE For Life and who qualifies?
TRICARE For Life is Medicare wraparound coverage for TRICARE-eligible beneficiaries age 65+ who have Medicare Parts A and B.
Does TRICARE cover my family members?
Yes, TRICARE covers eligible family members including spouses, children under 21 (or 23 if students), and children with disabilities.
What TRICARE options are available for Reserve and National Guard members?
Reserve and Guard members have TRICARE Reserve Select when not activated, and regular TRICARE when on active duty orders over 30 days.
Does TRICARE cover dental care?
TRICARE medical plans include limited dental (emergency only). Separate dental insurance available through FEDVIP program.
How do TRICARE and Medicare work together?
TRICARE For Life works with Medicare for beneficiaries 65+ who have both Medicare Part A and B, with Medicare paying first and TRICARE second.
Does TRICARE cover eye exams and glasses?
TRICARE covers medical eye care and exams for conditions/diseases. Routine vision exams and glasses require separate FEDVIP vision insurance.
Do surviving family members keep TRICARE after a service member dies?
Yes, surviving family members retain TRICARE coverage indefinitely if the sponsor died on active duty or after retirement with 20+ years of service.
How do I register in DEERS?
Register in DEERS at any ID card office (RAPIDS site) with required documents including military ID, marriage certificate, or birth certificates.
Does a divorced spouse keep TRICARE coverage?
Divorced spouses may keep TRICARE coverage if married 20+ years with 20+ years of military service overlapping by 20+ years (20/20/20 rule).
Are parents of service members eligible for TRICARE?
No, parents of service members are not eligible for TRICARE benefits, even if they are dependent on their military child for support.
When is TRICARE Open Season and how do I switch plans?
TRICARE Open Season runs from November 11 through December 9 each year. During this period, eligible beneficiaries can enroll in, change, or cancel their TRICARE health plan.
Do I need Medicare Part B with TRICARE?
Yes. If you are a TRICARE beneficiary turning 65, you must enroll in Medicare Part B to keep TRICARE For Life coverage. Late enrollment results in permanent premium penalties.
Does TRICARE cover college students?
TRICARE covers dependent children until age 21, or until age 23 if they are enrolled as full-time students at an approved college or university.
How do I use milConnect for TRICARE?
milConnect is a secure online portal where you can check TRICARE eligibility, enroll in plans, update DEERS information, and manage beneficiary records.
What happens to TRICARE after divorce?
Former spouses may keep TRICARE coverage under the 20/20/20 rule if the marriage lasted 20+ years overlapping with 20+ years of military service. Otherwise, coverage ends and CHCBP may be available.
What is TRICARE's policy on gender-affirming care?
TRICARE coverage for gender-affirming care is limited. Mental health counseling and hormone therapy may be covered, but surgical procedures are generally not covered for most beneficiaries.
Does TRICARE cover braces and orthodontics?
TRICARE Dental Program (TDP) covers orthodontic treatment for dependent children. Coverage includes braces for dependents under age 21 (or 23 if full-time students) with a lifetime maximum benefit.
Does TRICARE cover home births?
TRICARE covers home births when attended by a TRICARE-authorized certified nurse-midwife (CNM). The pregnancy must be low-risk, and specific requirements must be met for coverage.
Does TRICARE cover braces?
TRICARE does not cover braces for cosmetic purposes, but orthodontic treatment may be covered through the TRICARE Dental Program for dependents when medically necessary.
Does TRICARE cover LASIK?
TRICARE does not cover LASIK or other refractive eye surgery for most beneficiaries. Active duty members may receive LASIK through military programs at no cost.
Does TRICARE cover IVF?
TRICARE does not cover in vitro fertilization (IVF) for most beneficiaries. However, limited assisted reproductive technology may be available for active duty members with service-connected injuries.
Does TRICARE cover chiropractic care?
TRICARE covers chiropractic care only for active duty service members through the Chiropractic Health Care Program at designated military treatment facilities.
Does TRICARE cover acupuncture?
TRICARE covers acupuncture only for active duty service members when provided at military treatment facilities or through specific authorized programs.
Does TRICARE cover fertility treatments?
TRICARE covers diagnostic fertility testing and some treatments for underlying causes of infertility, but does not cover IVF, artificial insemination, or most assisted reproductive technologies.
Does TRICARE cover prosthetics?
Yes, TRICARE covers prosthetic devices including artificial limbs, breast prostheses after mastectomy, and other prosthetic appliances when medically necessary.
Does TRICARE cover home health care?
Yes, TRICARE covers home health care services including skilled nursing, physical therapy, and medical social services when a beneficiary is homebound and meets medical necessity criteria.
Does TRICARE cover hospice care?
Yes, TRICARE covers hospice care for terminally ill beneficiaries with a life expectancy of six months or less, including pain management, counseling, and bereavement support.
Does TRICARE cover clinical trials?
TRICARE covers routine patient care costs associated with qualifying clinical trials but does not pay for the experimental treatment or investigational items themselves.
Does TRICARE cover annual physicals?
Yes, TRICARE covers annual preventive health exams at no cost-share for all beneficiaries, including age-appropriate screenings and immunizations.
What is TRICARE For Life?
TRICARE For Life is Medicare-wraparound coverage for TRICARE-eligible beneficiaries age 65 and older who have both Medicare Part A and Part B.
What is DEERS?
DEERS (Defense Enrollment Eligibility Reporting System) is the database that verifies eligibility for military benefits including TRICARE healthcare coverage.
What is a qualifying life event for TRICARE?
A qualifying life event (QLE) is a significant change in circumstances that allows you to enroll in or change your TRICARE plan outside of the annual open enrollment season.
What is TRICARE Reserve Select?
TRICARE Reserve Select (TRS) is a premium-based health plan available to qualified members of the Selected Reserve and their families who are not on active duty orders.
What is CHCBP?
CHCBP (Continued Health Care Benefit Program) is a temporary transitional health coverage program for people losing TRICARE eligibility, lasting 18 to 36 months.
What is the TRICARE Dental Program?
The TRICARE Dental Program (TDP) is a voluntary dental insurance plan for TRICARE-eligible family members and retirees, administered by United Concordia Companies.
What is the TRICARE US Family Health Plan?
The US Family Health Plan is a TRICARE Prime option offered through select healthcare networks in specific geographic areas, providing comprehensive coverage through designated providers.
What is the TRICARE Overseas Program?
The TRICARE Overseas Program (TOP) provides healthcare coverage for military beneficiaries living or traveling outside the United States, administered by International SOS.
What is the Defense Health Agency?
The Defense Health Agency (DHA) is the agency within the Department of Defense that manages TRICARE and the Military Health System, overseeing healthcare delivery for all beneficiaries.
What is MHS GENESIS?
MHS GENESIS is the new electronic health record system for the Military Health System, replacing legacy systems with a single, integrated platform for all military medical records.
What is TRICARE Retired Reserve?
TRICARE Retired Reserve (TRR) is a premium-based health plan for retired Reserve and Guard members who are under age 60 and not yet eligible for regular TRICARE retiree coverage.
What is the TRICARE Nurse Advice Line?
The TRICARE Nurse Advice Line is a 24/7 telephone service where registered nurses provide health advice, help assess symptoms, and direct beneficiaries to appropriate care.
What is the Extended Care Health Option (ECHO)?
ECHO is a supplemental TRICARE benefit for active duty family members with qualifying disabilities, providing additional services beyond standard TRICARE coverage.
What is TRICARE Young Adult?
TRICARE Young Adult (TYA) is a premium-based health plan for adult dependents ages 21 to 26 who are no longer eligible for regular TRICARE dependent coverage.
What is the TRICARE Open Season?
The TRICARE Open Season is the annual enrollment period, typically mid-November through mid-December, when beneficiaries can enroll in, change, or disenroll from TRICARE plans.
How to appeal a TRICARE denial?
Submit a written appeal to your regional contractor within 90 days of the denial, including your explanation, supporting medical records, and a provider's letter of medical necessity.
How to add a dependent to TRICARE?
Register the new dependent in DEERS within 30 days of the qualifying event (marriage, birth, adoption) by visiting an ID card office with required documentation.
How to update DEERS?
Update DEERS online through milConnect, by visiting a RAPIDS ID card office, by calling the DEERS Support Office at 1-800-538-9552, or by mailing required documents.
How to get TRICARE overseas?
Contact International SOS, the overseas TRICARE contractor, to enroll in TRICARE Prime Overseas or TRICARE Select Overseas before or upon arriving at your overseas duty station.
How to use TRICARE after retirement?
After retiring, enroll in TRICARE Prime or Select through your regional contractor. At age 65, enroll in Medicare Parts A and B to automatically receive TRICARE For Life.
How to check TRICARE eligibility?
Check your TRICARE eligibility by logging into milConnect to view your DEERS record, calling the DEERS Support Office, or visiting an ID card office.
How to use milConnect?
Access milConnect at milconnect.dmdc.osd.mil using DS Logon, CAC, or ID.me to manage DEERS, enroll in TRICARE plans, check claims, and update personal information.
How to get TRICARE during military transition?
Separating service members and families may receive 180 days of transitional TRICARE coverage through TAMP, after which they can purchase CHCBP for up to 18 months.
How to get TRICARE for a newborn?
Register your newborn in DEERS within 30 days of birth by visiting an ID card office with the birth certificate and Social Security number. The baby is covered from birth.
How to disenroll from TRICARE?
Disenroll from TRICARE during Open Season or following a qualifying life event by contacting your regional contractor, using milConnect, or visiting an ID card office.
How to get TRICARE after divorce?
Former spouses may retain TRICARE eligibility under the 20/20/20 rule (20 years marriage, 20 years service, 20 years overlap) or receive temporary coverage under the 20/20/15 rule.
How to use TRICARE with other insurance?
When you have both TRICARE and other health insurance (OHI), the other insurance typically pays first and TRICARE pays second, reducing or eliminating your out-of-pocket costs.
How to request medical records from TRICARE?
Request medical records through the MHS GENESIS patient portal, from your military treatment facility's medical records office, or by submitting a written request to your provider.
How to contact TRICARE customer service?
Contact TRICARE through your regional contractor: Humana Military (East) at 1-800-444-5445, TriWest (West) at 1-844-866-9378, or the TRICARE general line at 1-800-874-2273.
How to use the TRICARE Nurse Advice Line?
Call 1-800-TRICARE (1-800-874-2273) and select option 1 to speak with a registered nurse 24/7 for health advice, symptom assessment, and guidance on where to seek care.
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