Approximately 200,000 service members leave the military annually, according to the Department of Veterans Affairs. Navigating health care for yourself and your family after military retirement or medical separation can be confusing. One way to ensure a smoother transition to continuous coverage is to enroll in a TRICARE plan within the first 90 days after leaving the service.
You do have 12 months to retroactively enroll in TRICARE. As long as you enroll within those 12 months, your coverage will extend back to your first day of retirement. However, you will have to pay all the enrollment fees for previous months. Claims will not be paid until enrollment is complete.
If you do not enroll within those 12 months, you won’t have another opportunity until the next TRICARE Open Season or you have a new qualifying life event, such as marriage, divorce, birth, or death. Without TRICARE, you can only receive care at military hospitals and clinics if space is available.
Most service members will choose between TRICARE Prime and TRICARE Select for their coverage.
- TRICARE Prime is similar to an HMO, where each beneficiary is required to choose a Primary Care Manager and receive referrals for specialist care.
- TRICARE Select is more like a PPO and allows you to see any TRICARE-authorized provider without a referral.
TRICARE Select offers more flexibility and freedom of choice, and is available worldwide, even outside of Prime service areas. However, out-of-pocket costs will be higher than with TRICARE Prime. If you live outside the continental U.S., TRICARE Select Overseas might be your only option.
There are six areas in the U.S. where beneficiaries can enroll in the US Family Health Plan, including the majority of the Northeast region, central and eastern Texas, and the west coast. This plan allows you to see a network of private providers rather than using TRICARE network providers and military hospitals.
Family members who are eligible for Medicare must have Medicare Part B coverage to stay eligible for TRICARE. TRICARE For Life is available as wrap-around coverage for retired service members who have Medicare Part A and Part B. Coverage is automatic and does not require enrollment, but it does not extend to family members.
Some services that were available during active duty are no longer covered. These include chiropractic care, hearing aids, eye exams for all plans other than TRICARE Prime, and TRICARE Extended Care Health Option for family members with serious physical, intellectual, or psychological disabilities.
For more information, or to learn more about your TRICARE options, visit their website.
Read comments
