This blog is the most recent in a series helping members of the Coast Guard family understand how to use their TRICARE benefits. The blog series will continue every Monday, right here on Coast Guard All Hands.
Written by Lt. j.g. Colleen McCue, Health, Safety and Work-Life Service Center
Congratulations on your retirement and thank you for your service! First and foremost, for access to your TRICARE benefits, you must ensure the information within DEERS is current:
- While your Servicing Personnel Office (SPO) should update your DD-214 in DEERS, we advise you to verify this update.
- If your retirement plans include relocating your residence, be sure to update your new address in DEERS.
- Finally, be sure you obtain new ID cards for you and your family.
Note: In order to avoid a lapse in your healthcare coverage, you must enroll within 30 days of your retirement.
Next you should determine which TRICARE coverage option suits the needs of you and your family. Be advised, as a new retiree, you will see an increase in cost for your new TRICARE plan, including annual enrollment fees and network copayments, so it is important to understand the differences of each plan. In addition to the below summary, the following health plan options are available for review at the TRICARE website under ‘Get my plan info’: TRICARE Prime, TRICARE Standard and Extra, US Family Health Plan, TRICARE For Life, and TRICARE Standard Overseas.
Note: If you do not select a plan, you will be enrolled into Tricare Standard and Extra.
If you are planning on residing within a prime service area (PSA), you have the option to enroll in TRICARE Prime. To determine if you live in a PSA, enter your zip code on the TRICARE website. You are allowed to select a primary care manager (PCM) at a military treatment facility (MTF) if space permits. If space is not available, you may request a civilian TRICARE network PCM.
TRICARE Standard and Extra is another available coverage plan which offers the most freedom in choosing your provider(s). TRICARE Standard allows you to see both network and non-network TRICARE authorized provider, but your out-of-pocket costs will increase including an annual deductible for outpatient services and cost-shares for most services. TRICARE Standard and Extra may be the right choice if you live outside a TRICARE Prime area and if you are receiving care from a non-network provider and do not desire to change. Within this plan, your access to MTF care is limited to space availability, but you have that option.
Note: While enrolled into the Tricare Standard and Extra plan, if you obtain care through a network provider, your cost share will decrease from 20 percent to 15 percent.
The US Family Health Plan may also be a viable coverage option to consider. The US Family Health Plan is available in the District of Columbia and 16 states. As a US Family Health Plan member, you receive all the benefits offered by the TRICARE Prime Program through a network of community-based health care systems. You will pay annual enrollment fees and network copayments. The below depiction displays where the US Family Health Plans are available:
TRICARE For Life is available to beneficiaries who have Medicare Part A and B. You may visit any authorized provider and your provider files your claims with Medicare. You will not pay enrollment fees, but you will pay a Medicare monthly premium which is based on your income.
If you are planning on residing overseas, then TRICARE Standard Overseas may be your only option. You will be required to pay an annual deductible and a cost share based on the type of care. As a TRICARE Standard Overseas member, you are eligible to receive care at military hospitals and clinics, if space permits.
Have more questions about your TRICARE benefits? Leave a note in the comments below!