TRICARE Health Insurance Options for Retired Service Members and Their Families

Retiring from military service is a big transition in many ways – one of those ways is how healthcare is provided to the service member and their family members. TRICARE offers several health insurance options for retired service members and their eligible family members. Understanding these options is key to making the best choices for your healthcare needs during retirement.

Who’s Eligible?

If you’re a retired service member, you’re eligible for TRICARE benefits if you fall into one of these categories:

• You retired from active duty.
• You retired from the National Guard or Reserve (beginning at age 60 or earlier if drawing retirement pay due to specific service credits).
• You’re placed on the Temporary Disability Retirement List (TDRL) or Permanent Disability Retirement List (PDRL).
• You’re receiving retired pay, even if it’s due to a medical retirement.

Eligible Family Members Include:

• Spouses
• Unmarried children (up to age 21, or 23 if enrolled in college full time)
• Adult children with disabilities that occurred before age 21 (or 23 if in college)

TRICARE Plan Options for Retirees

Once you retire, your TRICARE options change from what you had on active duty. Here’s a breakdown of the available plans:

1. TRICARE Prime

• Who Can Enroll: Retired service members and eligible family members in Prime Service Areas (PSAs) in the U.S.
• Cost: Enrollment fees apply, and there may be copayments for certain services.
• How It Works: You have a Primary Care Manager (PCM) who coordinates your care and referrals. It’s similar to an HMO. If your family was enrolled in TRICARE Prime during active service, or you were a service member receiving care at a Military Treatment Facility (MTF), this is the same process.

2. TRICARE Select

• Who Can Enroll: Retirees and families worldwide (where TRICARE Select is offered).
• Cost: Annual enrollment fees and cost-shares (percentage of covered services you pay). No referrals needed, but some services require prior authorization.
• How It Works: You manage your own health care. You can see any TRICARE-authorized provider without a referral.

3. TRICARE For Life (TFL)

• Who Can Enroll: Retirees and their family members who are eligible for Medicare Part A and have Medicare Part B.
• Cost: No enrollment fee, but you must pay for Medicare Part B. TFL acts as a secondary payer to Medicare.
• How It Works: Available worldwide. Medicare pays first in the U.S., and TFL pays what’s left. Outside the U.S., TFL is the primary payer.

4. TRICARE Reserve Select (TRS) / TRICARE Retired Reserve (TRR)

• TRS: For actively serving National Guard/Reserve members (not retirees).
• TRR: For “gray area” retirees—those under age 60 not yet drawing retired pay. It’s a premium-based plan.

5. US Family Health Plan (USFHP)

• Who Can Enroll: Retirees and family members under age 65 in specific areas of the U.S.
• Cost: Enrollment fees and copayments, similar to TRICARE Prime.
• How It Works: Care is provided by a network of private providers. Once you turn 65 and become eligible for Medicare, you can no longer stay in this plan.

Dental and Vision Coverage

TRICARE Dental Program (TDP)

• Not available to retirees.
• Retirees can enroll in the Federal Employees Dental and Vision Insurance Program (FEDVIP) for dental coverage.

Vision Coverage

• Retirees enrolled in a TRICARE health plan can also get vision coverage through FEDVIP.

What Changes at Age 65?

At age 65, you typically become eligible for Medicare Part A and Part B, and TRICARE For Life becomes your primary TRICARE coverage. You must enroll in Medicare Part B to keep TRICARE coverage.

Key Takeaways

• Enrollment Fees & Costs: Retirees pay enrollment fees and cost-shares, unlike active-duty members. These fees change annually.
• Open Season: Annual TRICARE Open Season runs from mid-November to mid-December, allowing you to enroll in or switch plans.
• Visit TRICARE’s Retired Service Members and Their Families page for up-to-date information, resources, and to check your eligibility or enrollment status.