Federal Employees' Health Benefits Program and TRICARE

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The federal government has created health insurance programs for it's own employees and those serving in the military.  These programs, TRICARE and the Federal Employees' Health Benefits Plan, are unlike other employer-sponsored health insurance programs in many ways.

 

 

TRICARE

 

TRICARE is the federal government’s health insurance program for active duty and retired military personnel.  Read the Department of Defense's TRICARE at a Glance brochure.

  

Eligibility for TRICARE depends on an individual's affiliation with the U.S. military.  The following groups of individuals are eligible for the standard or prime versions of TRICARE:

• Family members and survivors of active duty personnel
• Retirees and their family members and survivors under age 65
• Reserve component family members if Reserve member is activated for more than 30 consecutive days.

TRICARE for Life is the name of the TRICARE program for the military’s retirees and those affiliated with the military who are Medicare eligible.  Anyone retired from the uninformed services who is entitled to Medicare Part A and enrolled in Medicare Part B is eligible as are the Medicare eligible dependents of those on active duty.   

 

Individuals in TRICARE often face the same challenges in navigating their health insurance that those with private employer-sponsored health insurance do, but TRICARE beneficiaries often have extraordinary family circumstances (with one or both parents in combat) or difficult situations involving providers or facilities overseas.  TRICARE is governed by different laws and rules than other health insurance programs so consumers with TRICARE coverage may have different appeal rights and responsibilities and their providers are governed by different reimbursement rules. 

 

The Department of Defense maintains an excellent Web site, which allows users to ask questions online or search a database of questions and answers. 

 

 

 

Federal Employees' Health Benefits Program

 

The Federal Employees' Health Benefits Program (FEHBP) is a number of different local, regional, and national health plans that provide health insurance to over 8 million federal employees, retirees, and dependents.  Individuals enrolled in the FEHBP, like those in TRICARE, have different rights than those in other employer-sponsored health insurance programs and should read all of their plan and other information about the program carefully. 

 

To learn more about the details of the program, visit the Federal Employees Health Benefits Program Home where you will find information about: