annual deductible for Active Duty families. Prime provides enhanced vision coverage and preventative services. Your provider will file claims for you (in most cases) and you’ll have fewer out-of-pocket costs. Most TRICARE Prime care is received from your Primary Care Manager (PCM). This military or network provider refers you to specialists for care he/she cannot provide, works with your regional contractor for referrals and authorizations, accepts copayments and files claims for you. While the TRICARE Prime program offers the most comprehensive health care benefit, it has some restrictions. Visit the official website for more details. TRICARE SELECT Replacing TRICARE Standard and Extra, TRICARE Select is a self-managed, fee-for-service preferred provider network plan available to all Non-Active Duty beneficiaries. It differs from TRICARE Standard through a “fixed fee” for care received from network providers. TRICARE Select also requires enrollment with a fee, but only for service members and families entering Active Duty on or after Jan. 1, 2018. TRICARE Select allows choosing any TRICARE authorized provider for services covered by TRICARE, and to do so without a referral. But in some cases, you may need prior authorization. You can also receive additional preventive care services from a network provider (previously only under TRICARE Prime). However, TRICARE will only reimburse care received from authorized providers, and you may have to pay an annual enrollment fee. With the TRICARE Select system, users will be able to switch only during annual Open Season enrollment or when they have a Qualifying Life Event. Find more information about Open Season Enrollment on the TRICARE official website. TRICARE FOR LIFE Available worldwide, TRICARE For Life (TFL) offers secondary coverage to Medicare for all beneficiaries who have both Medicare Part A and B. Medicare provides coverage in the U.S. and U.S. Territories. In all other overseas locations, TRICARE is the primary payer. With TFL, you may visit any authorized provider, have no claims to file (in most cases) and have minimal out-of-pocket costs aside from Medicare Part B premium and enrollment fee. Note that Group A retirees are required to pay enrollment fees. In areas without Medicare, TRICARE is the primary provider. For further information and assistance, contact TFL contractor Wisconsin Physicians Service (WPS) at (866) 773-0404 or visit Tricare4u.com. EXTENDED CARE HEALTH OPTION The Extended Care Health Option (ECHO) provides financial assistance to beneficiaries with special needs for an integrated set of services and supplies. To use ECHO, qualified beneficiaries must be enrolled in the Exceptional Family Member Program (EFMP) through the sponsor’s branch of service. Enrollment in the EFMP may be waived, for example, when the sponsor’s branch of service does not provide the EFMP, or when the beneficiary resides with the custodial parent who is not the Active Duty sponsor. Note that the qualifying family member’s disability must be entered properly in DEERS to have access to ECHO services. Contact your regional contractor for more information. You may register for ECHO with case managers in each TRICARE region. To check for eligibility, call (888) 874-9378. TRICARE YOUNG ADULT Military dependents concerned about health care coverage may be eligible for TRICARE Young Adult (TYA). Based on the sponsor’s status and dependent’s geographic location, TYA Prime or TYA Select coverage includes medical and pharmacy benefits but excludes dental coverage. For details on this option for unmarried young adult dependents who have aged out of regular TRICARE coverage at age 21 or up to age 23 if enrolled in college, visit the official TRICARE website or contact a military health benefits advisor. Health Care 160
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