By Dr. Katy Votava
TRICARE is a healthcare insurance of the U.S. Department of Defense Military Health System that provides health benefits for U.S. Armed Forces military personnel, some members of the Reserves, military retirees, and their dependents who are under 65 years of age and not on Medicare. TRICARE brings together the healthcare resources of the Military Health System—such as military hospitals and clinics—with a network of civilian healthcare professionals, institutions, pharmacies, and suppliers.
To avoid confusion, it is important to know that TRICARE FOR LIFE (TIF) is a related but separate program for retired military and their spouses who are on Medicare. For more information about TIF check out my recent article Medicare and the Military: How to optimize Medicare for military veterans and retirees.
TRICARE offers a robust menu of health insurance coverages through a tiered structure. The tiers move from brackets with lower out-of-pocket costs for members using in-network healthcare professionals and organizations to higher-cost brackets for services from out-of-network care sources. TRICARE allows its members to use healthcare services within the Military Health System as well as community-based healthcare providers. As is always the case, members will get a bigger bang for their buck when using in-network providers. That’s why people need to compare their healthcare needs with those covered by TRICARE to decide if TRICARE meets their needs best.
There may be occasions when current or prospective TRICARE beneficiaries ought to evaluate other health coverage options to determine if there is a more suitable alternative. For example, a spouse may have access to an employer health plan that is more suitable and cost-effective than a TRICARE plan.
Affordable Care Act (ACA) plans might provide alternatives. Now is the time to look at those offerings to decide if there is a more suitable health plan. ACA annual enrollment is open Nov. 1, 2022, and ends Jan. 15, 2023. Applications filed by Dec. 15, 2022, have a 1/1/23 start date. Those who apply between 12/16/22 and 1/15/23 will have a 2/1/23 effective date.
Medicaid and Child Health Plus might work for some military families to provide more cost-effective healthcare than TRICARE. Medicaid and Child Health Plus are income-related health insurance plans that are administered at the state and local levels. Folks can get more information about those options by contacting their state department of health.
For more TRICARE information and to determine which regional office covers you call 866-773-0404, or visit www.Tricare.mil.
For more ACA plan information call 1-800-318-2596 or visit www.Healthcare.gov.
Also, read Preview 2023 TRICARE Health Plan Costs.
About the author: Katy Votava
Dr. Katy Votava, president and founder of GOODCARE.com®, is a registered professional nurse and has a Ph.D. in health economics and nursing from the University of Rochester in Rochester, New York. With her in-depth experience as a nurse practitioner and healthcare administrator, Dr. Votava is an expert in healthcare reimbursement and outcomes, including those related to Medicare, Medicaid, and long-term care. A major focus of Dr. Votava’s research is health care costs for people during their retirement years, and she has been published widely and spoken frequently on these topics.