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Wednesday, October 20, 2010

TRICARE Plans

All current military spouses are entitiled to Free Medical Benefits through TRICARE. Most people agree that TRICARE is the most confusing benefit that is offered from the military.  As you can see, there are three different TRICARE plans and the table below will give you a short description of each and in the next few blogs I will further explain them.

Eligible Active Duty, Guard and Reserve Family Members:

TRICARE
Prime
TRICARE
Extra
TRICARE
Standard
Annual Deductible
None
$150/individual or $300/family for E-5 & above; $50/$100 for E-4 & below
$150/individual or $300/family for E-5 & above; $50/100 E-4 below

Annual Enrollment Fee
None
None
None
Civilian Outpatient Visit
No Cost
15% of negotiated fee
20% of allowed charges for covered service
Civilian Inpatient Admission
No Cost
Greater of $25 or $14.35/day
Greater of $25 or $14.35/day
Civilian Inpatient Behavioral Health
No Cost
Greater of $20 per day or $25 per admission
Greater of $20 per day or $25 per admission
Civilian Inpatient Skilled Nursing Facility Care
$0 per diem charge per admission
$11/day
($25 minimum) Charge per admission
$11/day
($25 minimum) Charge per admission
No separate co-payment/cost-share for separately billed professional charges


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