Current uniformed service members receive no-cost health care benefits through TRICARE, the Department of Defense's health insurance program, and their family members are also covered at little or no cost. TRICARE also covers National Guard/Reserves members, military retirees, their families, and certain others, but most of those beneficiaries have out-of-pocket costs for care.
All recruits receive medical insurance coverage through TRICARE while in training. You cannot use any other insurance, and coverage/enrollment are automatic. Members of the Guard and Reserve are also covered during training periods.
Other separated personnel (i.e., non-retired veterans) may get care from the VA, but there are often costs involved. Many veterans rely primarily on private health insurance coverage, especially since VA does not typically provide care for dependents. This article summarizes the health insurance and care options available to:
Active-duty service members and their families
National Guard/Reserves and their families
Retired personnel and their families
Separated service members (non-retired veterans)
Coverage for active duty service members and their dependents
TRICARE covers hospital stays, doctor visits, tests, and prescriptions. There is no cost to active duty beneficiaries (called sponsors) and little or no cost to their dependents (family members who are registered in DEERS). However, each type of beneficiary has different benefits available to them.
Active duty military personnel must enroll – at no cost – in one of four TRICARE Prime options, depending on their geographic location. Prime plans provide managed care: enrollees are assigned a Primary Care Manager and have to go through their PCM for all medical needs or get a referral when a specialist is needed. Most Prime enrollees must use an MTF (Military Treatment Facility) to receive treatment unless the MTF lacks capacity. There are no out-of-pocket charges to active duty members for medical services.
Active duty family members can choose to participate in Prime with their sponsor. Under this plan, you'll pay nothing unless you use the point-of-service option, which offers a greater choice of providers. But there are other TRICARE options as well: in the US, you can choose TRICARE Select. This plan doesn't restrict beneficiaries to military medical facilities and offers a much greater choice of doctors. TRICARE Select is similar in structure to civilian PPO health care plan; fees and costs vary based on the sponsor's military status but may include:
Annual outpatient deductibles: an amount paid out-of-pocket before the plan pays for services
Cost shares: plan members pay a percentage of the provider's regular fee for covered services
In some parts of the country, active duty dependents can also enroll in the TRICARE US Family Health Plan. This option lets them receive enhanced healthcare coverage at regional not-for-profit civilian healthcare systems instead of a military medical facility.
For a more comprehensive guide to the TRICARE medical program, see TRICARE Health Insurance Benefits Explained.
Coverage for National Guard/Reserve personnel and their dependents
There are several TRICARE health insurance benefits available to the reserve component and dependent family listed in DEERS. However, the specific military health plan options available are based on the sponsor's service status, which can change multiple times throughout their careers.
Active Duty Reserves: TRICARE Prime and Select
Generally speaking, when a Reserves member is activated for 30 days or more, they and their family become eligible for Prime and Select plans. (See active duty section above for more information.)
Selected Reserve: TRICARE Reserve Select
Also known as SELRES or SR, these are members of a US Military Ready Reserve unit enrolled in the Ready Reserve program and attached to a reserve unit. These active status Reserves members and their families can enroll in TRICARE Reserve Select or TRS, a PPO-style premium-based plan. It is available worldwide and lets you see TRICARE-authorized providers without a referral. There are also copays, cost-shares, and deductibles; however, the premium cost is significantly lower than a comparable civilian plan.
Retired National Guard/Reserves under age 60: Tricare Retired Reserve
Retired reserve members and their families are eligible to enroll in TRICARE Retired Reserve (TRR). Like TRICARE Reserve Select, this PPO-style plan is available worldwide and lets you see any TRICARE-authorized provider without a referral. However, the copays, cost-shares, and deductibles are somewhat higher than TRS, and the monthly premiums are significantly higher (but may still be lower than a comparable civilian plan. This coverage ends the day you turn age 60; you then become eligible for TRICARE Prime or TRICARE Select (see retired benefits section below).
Coverage for retired service members and their dependents
Retirement from the military is a QLE (Qualifying Life Event) that triggers a change in TRICARE benefits, disenrolling you from TRICARE Prime. However, you are still eligible for TRICARE benefits to cover your health care needs:
You must enroll in one of the TRICARE plans available to you within 90 days after your retirement.
If you don't enroll within 90 days of military retirement, you may request a retroactive enrollment if you do so within 12 months of your retirement.
If you fail to enroll, you will lose all TRICARE coverage. You will only be able to receive treatment at military hospitals and clinics if space is available.
Retirees and their dependents have a wide choice of plans depending on their age, location, preferences for receiving care (i.e., managed care or not), and whether or not they have Medicare. To find out more about how to re-enroll in one of the plans available to you and your family, choose one of the following links:
TRICARE Prime (in areas in the US where TRICARE Prime is offered)
US Family Health Plan (in specific US locations)
TRICARE For Life (with Medicare Part A & B coverage)
TRICARE Select Overseas
Additional VA health benefits:
If you're being medically retired from active duty, you may be eligible to receive care through the Veterans Administration for any service-connected disabilities. You may also qualify to receive all other medical coverage through TRICARE. In addition, your family members may also qualify for health care coverage through TRICARE. To learn more, contact your nearest Veterans Administration medical center to talk with a benefits counselor who can help you determine what your military and Veterans Administration medical board ratings mean and how they affect your options.
Supplemental coverage available to TRICARE beneficiaries
A handful of organizations, such as the Military Benefit Association (MBA), specialize in helping personnel supplement their military benefits. MBA is a non-profit organization created to safeguard the economic welfare of current and former servicemembers, federal employees, and their families. Generally speaking, there are two kinds of coverage available to supplement your health benefits from the Department of Defense.
Supplemental TRICARE plans: Active duty personnel, who must enroll in a Prime plan, usually don't have out-of-pocket health care expenses. However, with all other plans (including Prime, when the point-of-service option is chosen), beneficiaries can face various out-of-pocket costs. These may include:
Annual deductibles: An amount you or your family must pay out-of-pocket before the plan pays for services
Cost-shares: A percentage of the provider's regular fee that you have to pay for covered services
Copayments: A fixed dollar amount you pay for covered services
Enrollment fees: This is similar to a monthly or yearly premium for a civilian plan.
MBA offers TRICARE Supplement insurance programs starting at under $12 a month. This coverage can help minimize, or in many cases eliminate, the copays and cost-shares beneficiaries face for services, treatments, prescriptions, and even certain Select excess charges. Learn more about TRICARE Supplement coverage.
Hospital Indemnity Insurance: Depending on the TRICARE plan and sponsor status, there can be numerous out-of-pocket cost-sharing and other expenses associated with an unexpected hospital stay, including transportation, alternate child care arrangements, and so on. Hospital indemnity insurance from MBA can provide a daily cash payment in the event of an unexpected hospital stay for a covered illness or injury, even for retirees with Medicare. The benefit amount can be used for deductibles, out-of-pocket expenses, or any other purpose – there's no need to submit expense receipts and minimal paperwork. Learn more about hospital indemnity insurance.
Dental benefits: TRICARE Prime and Select don't provide dental coverage, but beneficiaries can separately enroll in a dental plan.
Government and private health care options for separated personnel
Active-duty personnel don't have to pay for medical care, but that's not the case in civilian life. So when separating from the service, you should plan ahead to ensure that you and your family have uninterrupted health care coverage.
The Transitional Assistance Management Program (TAMP) can cover you for 180 days
This program provides about six months of premium-free TRICARE insurance benefits after your regular TRICARE benefits end. Military dependents are also eligible for coverage, giving military veterans time to settle into civilian life and explore their health care options. Learn more about TAMP.
The Continued Health Care Benefit Program (CHCBP)
This program can provide temporary health coverage for 18-36 months after you lose TRICARE or TAMP eligibility, but unlike with TAMP, you have to pay premiums. CHCBP provides the same coverage as TRICARE Select, including prescriptions. Learn more about CHCBP.
Coverage through a civilian employer
As you look for a job after your service, ask prospective employers about what kind of health insurance benefits they offer. It's an important part of your overall compensation package, but not all employers are required to provide coverage. You may well find yourself with a choice of opportunities, including a lower-paying job that provides health insurance and a higher-paying job that doesn't. In such cases, you should consider the value of health benefits before rejecting the job that pays less: health insurance premiums for a family can cost $2,000 or more every month.
Health care from the VA
Separated veterans are eligible to receive medical care through the Veterans Administration (but not their family members). It's important to understand that the VA doesn't provide health insurance – it's a hospital system that provides actual medical care. While the VA must provide health care for any service-connected illness or injury, other care is often not free.
Each veteran's medical benefits package is unique: depending on your priority group and the type of care needed, copays are charged – flat fees per treatment or procedure. Some veterans will qualify for added benefits such as dental treatment, and others won't. Your specific covered benefits depend on:
Your priority group, and
The advice of your primary care provider, and
The medical standards for treating any health conditions you may have
When you apply for Veterans Administration health care, you are assigned to one of eight priority groups. Your priority group affects how soon you can get health benefits and how much (if anything) you'll have to pay toward the cost of treatment. Separated personnel with service-connected disabilities are assigned the highest priority; those who earn a higher income and don't have any service-connected disabilities get a lower priority. Your priority group will be based on:
Your military service history, and
Your disability rating, and
Your income level, and
Whether or not you qualify for Medicaid, and
Other benefits you may be receiving
To learn more about health care for veterans, visit VA.gov.
Other health care coverage options for veterans and their dependents
You can purchase private health insurance as an individual or family directly from an insurance company. However, if you're not enrolled in VA benefits or other veterans' health coverage, you may be able to get lower-cost coverage through the Health Insurance Marketplace ®. Depending on your household size and income, you may also qualify for subsidies that further lower your monthly premiums and out-of-pocket costs. You or your family members may also qualify for free or low-cost coverage through Medicaid or the Children's Health Insurance Program (CHIP).
Hospital indemnity insurance: Veterans and members of their family up to age 80 may also apply for hospital indemnity insurance from MBA. This coverage can provide a daily cash payment in the event of an unexpected hospital stay for a covered illness or injury. The money can be used for deductibles, out-of-pocket expenses, or any other purpose – there's no need to submit expense receipts and minimal paperwork. Find more information about hospital indemnity insurance.
Frequently asked questions about military health insurance
Is health insurance free in the military?
Active duty service members have TRICARE, the health insurance program from the Department of Defense. They are not charged premiums for coverage, and they have no out-of-pocket costs for medical care or prescriptions. However, all other TRICARE beneficiaries (e.g., family members, reserves, retirees) may have to pay enrollment fees, annual deductibles, cost-shares, and copayments when they visit a doctor or receive other services.
What medical insurance does the military use?
The Department of Defense (DOD) has its own health insurance program called TRICARE, which provides care to almost 10 million current and former military members and dependent beneficiaries.
Do I qualify for TRICARE?
Current uniformed service members and their families are eligible for military health insurance coverage under one or more TRICARE plans, many of which are also available to National Guard/Reserves, retired servicemembers, and their families. Separated servicemembers are generally not eligible for this program, except for any veteran who is a Medal of Honor recipient. However, they are eligible for many medical services through the VA health system.
Does the military offer good health insurance?
Yes. TRICARE provides comprehensive coverage and delivers a high level of care. While there are costs for beneficiaries not on active duty, the overall expense is low compared to most civilian health plans. And, TRICARE for Life provides free Medicare wraparound coverage for retirees with Medicare Parts A and B.
Does TRICARE satisfy the minimum essential coverage requirement of the Affordable Care Act?
Yes. All TRICARE plans from the Department of Defense satisfy the requirement. In addition, military veterans enrolled in VA health care also meet the coverage standards of the Affordable Care Act (ACA).
*Article adapted from https://www.militarybenefit.org/membership-benefits/get-educated/militaryhealthinsurance/