TRICARE Beneficiary Handbook
Table of Contents
Purpose of the Handbook Who Uses It? Key Topics Covered How to Obtain the Handbook Using the Handbook Effectively Common Questions & Answers Staying Current with Updates Additional ResourcesPurpose of the Handbook
The TRICARE Beneficiary Handbook is a comprehensive guide designed to help military families, retirees, and other eligible individuals understand the benefits, rights, and responsibilities associated with the TRICARE healthcare program. It serves as a single reference point for everything from enrollment procedures to claims processing, costsharing details, and how to access care in the United States and overseas.
Who Uses It?
The handbook is intended for:
- Activeduty service members and their families
- Retired service members and their families
- Survivors and family members of deceased beneficiaries
- National Guard and Reserve members activated for duty
- Eligible civilians receiving TRICARE through certain federal programs
Key Topics Covered
Eligibility and Enrollment
Information on who qualifies for TRICARE, the enrollment windows, and steps to register or renew coverage.
Plan Types
Descriptions of the major TRICARE plansPrime, Standard, Extra, and the different options for retirees (e.g., TRICARE for Life, TRICARE Retired Reserve). Each plans costshare structure, network rules, and referral requirements are explained.
Cost Sharing
Details on copayments, deductibles, and the annual outofpocket maximums for various services, including primary care, specialist visits, emergency care, and prescription drugs.
Pharmacy Benefits
Guidance on using the TRICARE Pharmacy Program, preferred pharmacy networks, mailorder options, and handling specialty medications.
Claims and Billing
Stepbystep instructions for filing claims, understanding Explanation of Benefits (EOB) statements, and dealing with denied claims.
Travel and Overseas Care
How to obtain coverage for care while traveling abroad or on deployment, including the use of the International Travel Card and the role of the Local Service Support (LSS) system.
Dental, Vision, and Other Ancillary Benefits
Overview of the Dental Program (TRICARE Dental), vision coverage, and supplemental services such as mental health, preventive care, and wellness programs.
Rights and Responsibilities
Beneficiary rights under federal law, privacy protections (HIPAA), and the responsibilities to keep information current and to use the appropriate network when required.
How to Obtain the Handbook
The latest edition of the TRICARE Beneficiary Handbook is available in several formats:
- Online PDF Download directly from the official TRICARE website at www.tricare.mil under Resources & Forms.
- Printed Copy Request a mailed copy by calling the TRICARE Beneficiary Services (TBS) number at 18003334443.
- Mobile App The TRICARE app for iOS and Android includes a searchable version of the handbook.
Updates are released annually, and interim revisions may be posted online when policy changes occur.
Using the Handbook Effectively
- Bookmark the Table of Contents The digital version lets you click directly to sections you need.
- Highlight CostShare Tables These tables summarize outofpocket costs for each plan and are essential for budgeting.
- Use the What to Do If Flowcharts Quickreference flowcharts help you navigate common situations such as emergency care abroad or a denied claim.
- Save Contact Numbers Keep the TBS, regional contractor, and local pharmacy numbers handy.
- Check the Revision Date Ensure you are reading the most recent version; outdated information can lead to coverage gaps.
Common Questions & Answers
Q: How often can I change my plan?
A: Beneficiaries may switch between Prime and Standard during the annual Open Season (typically OctoberDecember). Retirees have a limited window each year to change between TRICARE Prime, Standard, and the supplemental retiree plans.
Q: Will my family be covered if I move to a new state?
A: Yes. TRICARE coverage is nationwide. However, you must update your address with the Defense Enrollment Eligibility Reporting System (DEERS) to ensure proper billing and communications.
Q: What if I need care from a nonnetwork provider?
A: Nonnetwork care may be covered only in emergencies or with prior authorization. Expect higher costshare, and you must submit a claim for reimbursement.
Q: How do I access care while deployed overseas?
A: Use the Local Service Support (LSS) system for routine care, and the International Travel Card for emergencies. The handbook provides detailed stepbystep instructions.
Staying Current with Updates
The healthcare landscape changes regularly. To stay informed:
- Subscribe to TRICARE email alerts.
- Check the News & Updates section on the TRICARE website monthly.
- Follow the official TRICARE social media channels for quick notices.
- Periodically review the Revision History page in the handbooks PDF.
Additional Resources
- TRICARE Contact Center Phone and chat support.
- Benefits Overview Detailed explanations of each benefit line.
- Forms Library Download enrollment, claim, and authorization forms.
- Military Health Care Portal Access to personal health records and appointment scheduling.
Freedom Of Information Act Request For Deceased Beneficiary Records and Reference File Dow...
