Tricare Tricare ( styled TRICARE ) , formerly known as the Civilian Health and Medical Program of the Uniformed Services ( CHAMPUS ) , is a health care program of the United States Department of Defense Military Health System . Tricare provides civilian health benefits for military personnel , military retirees , and their dependents , including some members of the Reserve Component . The Tricare program was managed by Tricare Management Activity ( TMA ) under the authority of the Assistant Secretary of Defense ( Health Affairs ) . Tricare is the civilian care component of the Military Health System , although historically it also included health care delivered in the military medical treatment facilities . On the 1st of October 2013 TMA disestablished and Tricare responsibility was transfered to the Defense Health Agency ( DHA ) which was established on the same day . History . Historically , health care for military personnel and their dependents was provided in military medical facilities as promised by the military , and through a referral system , by civilian medical personnel where military physicians were not available in a certain specialty , or overcrowding of a military medical facility occurred . After World War II and the Korean War , access to care in military facilities became increasingly unavailable due to resource constraints and growing demands on the system , and " space - available basis " was first noted . To address this problem , Congress passed the Dependents Medical Care Act of 1956 and the Military Medical Benefits Amendments of 1966 . These acts allowed the Secretary of Defense to contract with civilian health care provider s . This civilian health care program became known as the Civilian Health and Medical Program of the Uniformed Services ( CHAMPUS ) in 1966 . In the late 1980s , because of escalating costs , paperwork demands , and general beneficiary dissatisfaction , DoD initiated a series of demonstration projects . Under a program known as the CHAMPUS Reform Initiative ( CRI ) , a contractor provided both health care and administrative - related services , including claims processing . The CRI project was one of the first to introduce managed care features to the CHAMPUS program . Beneficiaries under CRI were offered three choices – a health maintenance organization - like option called Tricare ( CHAMPUS ) Prime that required enrollment and offered enhanced benefits and low - cost shares , a preferred provider organization - like option called Tricare ( CHAMPUS ) Extra that required use of network providers in exchange for lower cost shares , and the standard CHAMPUS option that continued the freedom of choice in selecting providers but required higher cost shares and deductibles known as Tricare Standard . Although DOD ’ s initial intent under CRI was to award three competitively bid contracts covering six states , only one bid , made by Foundation Health Corporation ( now Health Net ) covering California and Hawaii , was received . Foundation delivered services under this contract between August 1988 and January 1994 . In late 1993 , in response to requirements in the DOD Appropriation Act for Fiscal Year 1994 , the DoD announced plans for implementing a nationwide managed care program for the MHS that would be completely implemented by May 1997 . Under this program , known as Tricare , the United States was divided into 12 health care regions . An administrative organization , the lead agent , was designated for each region and coordinated the health care needs of all military treatment facilities in the region . Under Tricare , seven managed care support contracts were awarded covering DOD ’ s 12 health care regions . Since then , Tricare has undergone several restructuring initiatives , including re - alignment of contract regions , Base Realignment and Closure , and the addition of " Tricare for Life " benefits in 2001 for those who are Medicare - eligible , and " Tricare Reserve Select " in 2005 . Tricare ' s options . Tricare Standard . Tricare Standard provides a similar benefit to the original CHAMPUS program and is available to retirees from the Active Component , retirees from the Reserve Component age 60 or older , and their eligible family members . Under Tricare Standard , beneficiaries can use any civilian health care provider that is payable under Tricare regulations . The beneficiary is responsible for payment of an annual deductible and coinsurance , and may be responsible for certain other out - of - pocket expenses . There is no enrollment fee for Tricare Standard . Tricare Extra . Tricare Standard beneficiaries can elect to use the Tricare Extra option by using a civilian health care provider from within the regional contractor ' s provider network . In this way , Tricare Extra represents a preferred provider organization ( PPO ) . When using Tricare Extra , the beneficiary ' s coinsurance amount is reduced by at least five percentage points . There is no fee for use of the Tricare Extra benefit other than the coinsurance . Tricare Prime . Tricare Prime is a health maintenance organization ( HMO ) style plan available to active duty personnel , retirees from the Active Component , retirees from the Reserve Component age 60 or older , and their eligible family members . Under Tricare Prime , beneficiaries must choose a primary care physician and obtain referrals and authorizations for specialty care . In return for these restrictions , beneficiaries are responsible only for small copayment s for each visit ( retirees and their families only ) . There is an annual enrollment fee for Tricare Prime for military retirees and their family members . There is no enrollment fee for active duty military and their family members . US Family Health Plan . US Family Health Plan , a Tricare Prime - sponsored health plan option , is made available by nonprofit health care providers in the Northeast U . S . , Southeast Texas / Southwest Louisiana , and the Puget Sound region of Washington state . Tricare Reserve Select ( TRS ) . Tricare Reserve Select is a premium - based health plan that active status qualified National Guard and Reserve members may purchase . The classification is sometimes referred to as Tricare Reserve Component ( RC ) . It requires a monthly premium and offers coverage similar to Tricare Standard and Extra for the military member and eligible family members . It has a partial premium cost sharing arrangement with DoD similar to civilian private or public sector employer plans , although typically at a lower cost than civilian plans . The program coverage is available world wide to Selected Reserve ( SELRES ) members of both the Title 10 USC Federal Reserve Components ( Army Reserve , Navy Reserve , Air Force Reserve , Marine Corps Reserve ) , Title 14 USC Federal Reserve Component ( Coast Guard Reserve ) and the Title 32 National Guard ( Army National Guard and Air National Guard ) in a drill pay ( also known as " paid " ) status . As of February 2008 , retired Reserve Component personnel under the age of 60 , actively drilling Individual Ready Reserve ( IRR ) personnel in a non - paid status , or actively drilling Volunteer Training Unit ( VTU ) personnel in a non - paid status do not qualify for TRS . IRR and VTU members are eligible for reinstatement under TRS is they return to a SELRES status . Reserve Component personnel who are also Federal civil servants ( to include Army Reserve Technicians and Air Reserve Technicians ( ART ) in the Army Reserve , Army National Guard , Air Force Reserve and Air National Guard ) and eligible for the Federal Employee Health Benefit Program ( FEHBP ) are also excluded from TRS . Retired Reserve Component personnel and eligible dependent family members become eligible Tricare Standard , Tricare Extra or Tricare Prime on the service member ' s 60th birthday in the same manner as Active Component retirees and their eligible dependents are eligible immediately upon retirement from active service . Qualification questions should be referred to Tricare . Tricare Reserve Retired ( TRR ) . Tricare Reserve Retired is a premium - based health plan that qualified retired members of the National Guard and Reserve under the age of 60 may purchase for themselves and eligible family members . Established in 2008 and opened for enrollment in 2010 , it is similar to Tricare Reserve Select ( TRS ) , but differs in that there is no premium cost - sharing with DoD as there is with TRS . As such , retired Reserve Component members who elect to purchase TRR must pay the full cost ( 100 % ) of the calculated premium plus an additional administrative fee . Although open to all eligible retired Reserve Component personnel under the age of 60 , the program ' s principal focus is often perceived as being focused on recent Reserve Component retirees who are self - employed or otherwise ineligible for civilian employer provided / subsidized health insurance , especially those who were mobilized for full - time active duty service subsequent to 11 September 2001 in support of Operations Enduring Freedom , Enduring Freedom , Iraqi Freedom , and / or Noble Eagle . Retired Reserve Component personnel who elect to participate in TRR will exit TRR when the service member reaches age 60 and he / she and their eligible dependent family members become eligible for the same Tricare Standard , Tricare Extra or Tricare Prime options as Active Component retirees and , in the case of Tricare Prime , at the same cost as Active Component retirees . Qualification questions should be referred to Tricare . Tricare for Life ( TFL ) . Tricare for Life was first incorporated as part of the then - seven regional Managed Care Support Contracts of Tricare in May 2001 . The benefit was enacted by Congress in response to growing complaints from beneficiaries that as Medicare out of pocket costs increased a benefit was needed to pay these costs in lieu of Tricare retirees being required to purchase Medicare Supplemental Coverage to pay for prescriptions , physician and hospital dispensed drugs , cost shares and deductibles . Before Tricare for Life , Tricare beneficiaries immediately lost Tricare coverage upon attaining Medicare eiligibility . This included becoming Medicare eligible due to disability . Tricare for Life is designed to pay patient liability after Medicare payments . There is no enrollment necessary for Tricare for Life and to be eligible , members must be Tricare and Medicare Eligible and have purchased coverage . An exception to the requirement for Part B coverage exists when the beneficiary that is Medicare eligible is the spouse of an Active Duty Service Member . In some instances Tricare for Life is primary payer when the services are normally a Tricare benefit but not covered by Medicare . This includes drug charges , when Medicare benefit limits are attained and services performed outside the United States or in a Veterans Affairs facility where Medicare does not pay . TFL does not pay patient liability for services that are not a Tricare benefit even though they may be paid by Medicare , such as chiropractic benefits . The policy limitations applying to Tricare also apply to TFL and must therefore be deemed medically necessary and skilled care . Custodial care therefore is not covered . In 2004 the Tricare for Life benefit was transferred from the individual regional Tricare contractors . Medical claims are processed by the national Tricare Dual Eligible Fiscal Intermediary Contractor ( TDEFIC - Wisconsin Physicians Service Insurance Corporation ) . Pharmacy claims are processed by the Tricare Pharmacy Contractor ( Express Scripts ) and Overseas TFL claims are processed by the Tricare Overseas Program Contractor ( as of September 2010 this will be International SOS using Wisconsin Physicians Service as their Fiscal Intermediary partner ) . Tricare Young Adult ( TYA ) . Tricare Young Adult ( TYA ) is a premium - based health care plan available for purchase by qualified dependents who have aged out of Tricare at age 21 , or age 23 for full - time college students . Dependents are eligible if they are unmarried , not eligible for Tricare coverage or their own employer - sponsored health care coverage , and as long as their sponsor remains Tricare eligible . Eligible dependents have the option to purchase Tricare Standard / Extra health coverage on a month - to - month basis . Purchased coverage includes medical and pharmacy benefits but does not include dental . A premium - based Tricare Prime benefit will be available later in 2011 . The signing of the National Defense Authorization Act in January 2011 aligned Tricare with the provisions of the 2010 Patient Protection and Affordable Care Act , and lead to the creation of TYA . Enrollment began May 1 , 2011 . Program administration . The ultimate responsible organization for administration of Tricare is the U . S . Department of Defense Military Health System , which organized the Tricare Management Activity ( TMA ) . The Tricare Management Activity contracts with several large health insurance corporations to provide claims processing , customer service and other administrative functions to the Tricare program . Basic structure . Currently , there are three regional Managed Care Support Contractors ( MCSCs ) , a Medicare / Tricare Dual Eligible Fiscal Intermediary Contractor ( TDEFIC ) , and a Tricare Pharmacy contractor , who administers both Mail Order Pharmacy ( TMOP ) and Retail Pharmacy ( TRRx ) programs . In addition several administrative contractors provide quality management , auditing , and statistical services . Dental insurance . TMA contracts and administers a couple of dental programs . Health insurance . In 2004 , Tricare Management Activity re - aligned the previous twelve regions into three large regions , known as Tricare North , Tricare South , and Tricare West . Services in these regions are provided by : All medical claims are processed ( " adjudicated " ) by the following claims processing sub - contractors : In 2009 , the Tricare Overseas Program contract consolidated the following : In October 2009 International SOS Assistance , Inc . was awarded the contract to provide comprehensive health care support services to the Department of Defense Tricare Overseas Program .