✅ Reviewed for accuracy and relevance by Deanna Cooper Gillingham, RN, CCM, FCM on June 26, 2025.

TRICARE

TRICARE is a healthcare program for military members, retirees, and their families. It utilizes military healthcare as its primary delivery system, supplemented by a civilian network of providers and facilities.

TRICARE is a health program for:

• Uniformed service members and their families
• National Guard/Reserve members and their families, which includes          
  • Army National Guard
  • Army Reserve
  • Navy Reserve
  • Marine Corps Reserve
  • Air National Guard
  • Air Force Reserve
  • U.S. Coast Guard Reserve
• Survivors (e.g., surviving spouse or children)
• Former spouses
• Medal of Honor recipients and their families
• Others registered in the Defense Enrollment Eligibility Reporting System (DEERS)

TRICARE offers a comprehensive range of healthcare services; however, the specific benefits received depend on several factors, including the beneficiary’s branch of service, healthcare needs, and military status (active duty or retired). Therefore, it is essential to look at the individual’s plan. TRICARE generally covers medical, rehabilitation, and mental health services, prescription medication, dental, and DME, as well as special needs services for individuals with disabilities.

TRICARE offers three basic options for care:

• TRICARE Prime: a managed care plan
• TRICARE Select: a fee-for-service plan
• TRICARE For Life: Medicare wraparound coverage

TRICARE For Life

TRICARE For Life (TFL) is supplemental insurance for military retirees and their dependents who are eligible for Medicare. It is Medicare wraparound coverage for TRICARE beneficiaries with Medicare Part A and Part B, covering deductibles, copayments, and coinsurance for Medicare-covered services. No premiums are paid for TFL. However, beneficiaries must maintain enrollment in Medicare Part B.

Veterans Affairs (VA) benefits

VA healthcare is available to veterans who have served on active duty in the military, meet specific length-of-service requirements, and were discharged under conditions other than dishonorable. Veterans may receive healthcare at a VA medical center or an approved community healthcare provider. Veterans Health Administration (VHA) medical facilities provide a variety of services, including traditional hospital-based services and outpatient clinics.

Veterans can receive free VA healthcare for any illness or injury the VA determines is related to their military service, known as “service-connected” conditions. They may also receive treatment for conditions unrelated to their service, which may require a copayment; whether and how much depends on their disability rating, income level, military service record, and which of the VA’s eight priority groups they were assigned to when they enrolled in VA healthcare.

The VA also provides certain other services for free, including readjustment counseling and related mental health services, care for issues related to military sexual trauma (MST), and a registry health exam to determine the risk of health problems linked to military service.

Content adapted from CCM Certification Made Easy, 4th Edition by Deanna Cooper Gillingham, RN, CCM, FCM (2025) and used with permission from the Case Management Institute. Purchase your copy at CCMCertificationMadeEasy.com.