When you retire, one of the decisions you will need to make is which health insurance provider you’ll use. You may have the option to get coverage through your post-military employer’s healthcare plan or you could choose to continue with TRICARE, which offers two options: TRICARE Prime and TRICARE Select. Learning more about TRICARE can help you make a more informed decision on which option will ultimately be best for you. You should be aware that TRICARE rates, enrollment fees, deductibles, co-pays and more are evaluated and can change annually. Information about your TRICARE benefits are available at https://www.tricare.mil/.
TRICARE Prime
TRICARE Prime is a managed care option that works through a primary care manager (PCM) with no claims, but your PCM will need to provide referrals to any specialist care. There is an annual enrollment fee for either individual or family. There is no annual deductible for an individual or family. Outpatient visit costs can vary according to the type of care. The catastrophic cap for a family per year varies according to Group A or Group B eligibility. For more information, visit https://www.tricare.mil/prime/.
TRICARE Select
TRICARE Select is a preferred provider network for authorized providers with a claim form. Referrals are not required. However, authorization for certain procedures is required. The annual enrollment fee for TRICARE Select depends on individual or family and Group A or B eligibility. The annual deductible varies according to individual or family, Group A or B eligibility, and for Group B whether Network or Out-of-Network. Outpatient visits vary depending on the type of care as well as in or out of Network. The annual catastrophic cap also depends on Group A or B eligibility. For more information, visit https://www.tricare.mil/Plans/HealthPlans/TS.
Note: Group A is for individuals or sponsors who enlisted, or whose appointment occurred before January 1, 2018.
TRICARE Coverage for Young Adults
If you have a child or young adult enrolled in TRICARE, it is important to note that they are eligible for coverage under the TRICARE plans mentioned above until they turn 23 and/or complete college (if they are enrolled full time at an approved college/university). While the young adult is in school, the sponsor must provide 50% of the child’s financial support. The health plans are dependent upon the sponsor’s military status and where the child attends college/university. Once your dependent either turns 23 or has graduated but is not yet 26, they can qualify to purchase TRICARE Young Adult or the Continued Health Care Benefit Program. For more information, visit https://www.tricare.mil/TYA.
More to Consider
As you prepare for your military retirement, you’ll need to keep these in mind:
If you have questions, please contact an AAFMAA Member Benefits Representative at 800-522-5221 select option 2, then option 2 again or [email protected].