Beneficiary Category

Your beneficiary category is the classification assigned based on your relationship to military service that determines which TRICARE plans you can enroll in, what costs you pay, and what benefits you receive. Understanding your category is essential for choosing the right healthcare coverage.

Major beneficiary categories: • Active Duty Service Members (ADSMs): Automatically enrolled in TRICARE Prime at no cost • Active Duty Family Members (ADFMs): Lowest-cost options with multiple plan choices • Retired Service Members (Group A): Retired before January 1, 2018 • Retired Service Members (Group B): Retired on or after January 1, 2018 • National Guard/Reserve Members: Coverage varies by activation status • Survivors: Family members of deceased service members

How categories affect coverage: • Plan availability: Some plans restricted to certain categories • Cost-sharing: Different copay and cost-share rates by category • Enrollment fees: Vary by category and plan choice • Catastrophic cap: Different annual limits by category • Pharmacy costs: Copay amounts differ by category

Your beneficiary category can change due to life events such as retirement, activation/deactivation of Reserve status, death of a sponsor, or aging out of dependent coverage. Update DEERS promptly when your status changes to ensure uninterrupted benefits.