TRICARE is the health care program for active duty and retired members of the uniformed services, their families, and survivors. It offers different health care options depending on status, including TRICARE Prime, Extra, Standard, Remote, and TRICARE For Life for Medicare-eligible beneficiaries. TRICARE also includes the TRICARE Dental Program, TRICARE Retiree Dental Program, and TRICARE Pharmacy Program which provides prescription drugs through military treatment facilities, mail order delivery, or retail network pharmacies.

1. TRICARETRICARE

2. WHAT IS TRICARE ?
• DoD health care program for active duty
and retired members of the uniformed
services, their families, and survivors.
• OBJECTIVE:OBJECTIVE: optimize delivery of health
care and services in MTFs and attain the
highest level of beneficiary satisfaction
through the delivery of world-class health
care benefits.

3. ACTIVE DUTY SERVICE MEMBERSACTIVE DUTY SERVICE MEMBERS
• All active duty service members are covered under
TRICARE Prime or Remote. ADSM must complete
enrollment application for each program.
• PRIME:PRIME: no health care cost, priority at all MTFs,
enrollment required when ADSMs live and work
within 50 miles or an hour's drive of MTF.
• REMOTE:REMOTE: no health care cost, may access primary
care from a non-network provider if network
provider unavailable, enrollment required when
ADSMs live and work in remote areas usually 50
miles or an hour's drive of MTF.

4. ACTIVE DUTY FAMILY MEMBERSACTIVE DUTY FAMILY MEMBERS
• May choose to enroll in TRICARE Prime or Extra or
Standard.
• PRIME:PRIME: no cost for authorized network care, Point-of
Service (POS) charges apply for care received without
referral, access to MTF or TRICARE network providers,
enrollment required, lowest out-of-pocket costs.
• EXTRA:EXTRA: annual deductible and 15% cost-share of
negotiated costs, seek care from TRICARE network
providers, discounted cost-shares; no claims to file.
• STANDARD:STANDARD: annual deductible and 20% cost-share of
allowed charges, care from any authorized TRICARE
provider, enrollment not required.
• REMOTE:REMOTE: no cost, except POS charges apply for non-
referred care, access to network and non-network TRICARE
providers, enrollment required.

5. RETIREES UNDER AGE 65 AND THEIR FAMILIESRETIREES UNDER AGE 65 AND THEIR FAMILIES
• May choose to enroll in TRICARE prime or EXTRA
or STANDARD.
• PRIME:PRIME: annual enrollment fee of $230/individual or
$460/family, $12/network visit co-payment, $0 for
MTF care, POS charges apply for non-referral care,
enrollment required.
• EXTRA:EXTRA: annual deductible fee of $150/individual or
$300/family, 20% cost-share of negotiated costs, care
from TRICARE network providers, enrollment not
required.
• STANDARD:STANDARD: annual deductible fee of
$150/individual or $300/family, 25% cost-share
allowed charges, care from TRICARE authorized
provider, enrollment not required.

6. MEDICARE-ELIGIBLE BENEFICIARIESMEDICARE-ELIGIBLE BENEFICIARIES
• TRICARE For Life is coverage for TRICARE
beneficiaries who become entitled to Medicare Part
A due to age, disability, or end-stage renal disease
and who purchased Medicare Part B. TRICARE
becomes secondary payer to Medicare beginning
on the first day of month you turn 65.
• TFL:TFL: Medicare part B premiums, no TRICARE
enrollment fees on premiums, care from TRICARE
provider that accepts Medicare, no TRICARE
enrollment required, Purchase of Medicare B is
mandatory.
• Services covered by both Medicare and TRICARE,
Medicare pays first.

7. TRICARE DENTAL PROGRAMTRICARE DENTAL PROGRAM
• Available to ADFMs, members of the
Individual Ready and Selected Reserve and
their families.
• Enrollment:Enrollment: Single and family plans available.
• Voluntary and portable worldwide, low
monthly premiums and cost-shared based on
sponsor's pay grade, comprehensive coverage
for most dental services; 100% coverage for
preventive, diagnostic, and emergency services.

8. TRICARE RETIREE DENTAL PROGRAMTRICARE RETIREE DENTAL PROGRAM
• Available to:Available to: retired service members
(including medal of honor recipients)
regardless of age, retired members of the
Reserve Component entitled to retire pay but
under 60, current spouses and children of
enrolled members, unremarried widow and
children of deceased service member.
• ENROLLMENT:ENROLLMENT: single, two-party, and family
plans available, monthly premiums depend on
ZIP code, minimal deductibles and cost-share.

9. TRICARE PHARMACY PROGRAMTRICARE PHARMACY PROGRAM
• All beneficiaries including Medicare beneficiaries 65
and older, may fill prescriptions in MTF pharmacy.
• MTF:MTF: no cost.
• TRICARE Mail Order Pharmacy:TRICARE Mail Order Pharmacy: $3 generic drugs (up
to 90-day supply), $9* brand name drugs (up to 90
days).
• TRICARE RETAIL NETWORK PHARMACY:TRICARE RETAIL NETWORK PHARMACY: same
cost as TMOP, but 30-day supply of drugs.
• Non-Network Pharmacy:Non-Network Pharmacy: $9 or 20% of total cost,
whichever is greater (up to 30-days supply).
• Non-Formulary Drugs:Non-Formulary Drugs: with TMPO or TRRx $22 cost-
share, Non-Network Pharmacy $22 cost-share or 20%
whichever is greater.

10. TRICARE PHARMACY PROGRAMTRICARE PHARMACY PROGRAM
• All beneficiaries including Medicare beneficiaries 65
and older, may fill prescriptions in MTF pharmacy.
• MTF:MTF: no cost.
• TRICARE Mail Order Pharmacy:TRICARE Mail Order Pharmacy: $3 generic drugs (up
to 90-day supply), $9* brand name drugs (up to 90
days).
• TRICARE RETAIL NETWORK PHARMACY:TRICARE RETAIL NETWORK PHARMACY: same
cost as TMOP, but 30-day supply of drugs.
• Non-Network Pharmacy:Non-Network Pharmacy: $9 or 20% of total cost,
whichever is greater (up to 30-days supply).
• Non-Formulary Drugs:Non-Formulary Drugs: with TMPO or TRRx $22 cost-
share, Non-Network Pharmacy $22 cost-share or 20%
whichever is greater.