Tricare: Uniformed services family health plan - Getting out, military health issues - Navy Times

Tricare: Uniformed services family health plan

Some beneficiaries — including active-duty family members, retirees and their family members, can use an additional Tricare Prime option available through networks of community-based, not-for-profit health care systems in six areas of the U.S. through the Uniformed Services Family Health Plan. These facilities are “designated providers,” offering a range of coverage at little out-of-pocket cost.

Enrollment is required and can be on an individual or family basis. To enroll, participants must live within the designated provider’s area. USFHP enrollees must agree not to use other military or government health care facilities except for emergencies or if USFHP refers the patient to such a facility. Active-duty members cannot enroll in USFHP.

Beneficiaries must choose either Tricare or USFHP if they live in a USFHP location. Eligible beneficiaries enrolled in Tricare Prime who are patients at a military facility or with a civilian Prime provider can withdraw at any time and enroll in the Prime program offered by USFHP, and vice versa.

If beneficiaries are transferred to an area without a USFHP facility, they can withdraw and resume using military facilities, Medicare or Tricare.

Unlike in Tricare, retirees over age 65 do not need to have Medicare Part B in order to participate in USFHP. However, the Defense Department highly encourages beneficiaries to enroll in Part B when they first become eligible, to avoid Part B premium surcharges if they move away from a USFHP area.

If beneficiaries do not enroll in Medicare Part B when first eligible, and choose to do so later, they will pay (in addition to the normal Medicare Part B monthly premium) an annual 10 percent penalty for each year they were eligible to enroll but did not. In addition, they will only be able to enroll in Medicare Part B during the general enrollment period, Jan. 1-March 31 of each year, and Part B benefits/Tricare coverage will not become effective until July 1 of that year. Beneficiaries, other than active duty, are encouraged to enroll in Medicare Part B when first eligible.

USFHP operating areas:

• Maine, New Hampshire, Vermont, northeastern New York: Martin’s Point Health Care, (888) 241-4556

• Maryland, Washington, D.C., and parts of Virginia, West Virginia and Pennsylvania: Johns Hopkins Community Physicians, (800) 801-9322

• Massachusetts, Rhode Island, northern Connecticut: Brighton Marine Health Center, (800) 818-8589

• New Jersey, parts of New York (including New York City), southeastern Pennsylvania, western Connecticut: St. Vincent Catholic Medical Centers, (800) 241-4848

• Southeast Texas, southwest Louisiana: CHRISTUS Health, (800) 678-7347

• Puget Sound region, Washington state: PacMed Clinics, (888) 958-7347

Contact: www.usfhp.org; www.tricare .mil/mybenefit/home/overview/Plans