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differs in that there is no premium cost-sharing with DoD as there is with
Tricare Reserve Select. As such, retired Reserve Component members who elect to purchase Tricare Reserve Retired must pay the full cost (100%) of the calculated premium plus an additional administrative fee. Payments could range as high as $ 900.00 a month. 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
546:
status. Reserve
Component personnel who are also Federal civil servants (to include Army Reserve Technicians and Air Reserve Technicians 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 Tricare Reserve Select. 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.
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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. Pharmacy claims are processed by the Tricare Pharmacy Contractor (Express Scripts) and Overseas Tricare for Life 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).
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571:. Retired Reserve Component personnel who elect to participate in Tricare Reserve Retired exit 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.
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476:(Military Treatment Facility) to receive their care, as long as the MTF has capacity. If the MTF does not have capacity, the commander of the MTF notifies the region's contractor and the contractor's provider network is used to supplement the MTF's capacity. If the MTF regains capacity, the MTF reserves the right to move the beneficiaries back to receiving their care at the MTF in a process known as "recapture."
331:, access to care in military facilities became increasingly unavailable for military retirees and the dependents of both active duty and retired military personnel due to resource constraints and growing demands on the system. It was at this time that the concept of "space-available basis" for military retirees and military dependents was first noted. To address this problem,
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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 worldwide to
Selected Reserve (SELRES) members of both the
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The East Region includes
Alabama, Arkansas, Connecticut, Delaware, the District of Columbia, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi New Hampshire, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island,
593:
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
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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
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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, a contractor provided both health care and administrative-related services, including
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The West Region includes Alaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa (excluding Rock Island
Arsenal area), Kansas, Minnesota, Missouri (except the St. Louis area), Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Texas (the southwestern corner, including El
703:
The West Region includes Alaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa (excluding Rock Island
Arsenal area), Kansas, Minnesota, Missouri (except the St. Louis area), Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Texas (the southwestern corner, including El
612:
facility where Medicare does not pay. Tricare for Life 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 Tricare for Life and must therefore be
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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
545:
personnel in a non-paid status, or actively drilling Volunteer Training Unit personnel in a non-paid status do not qualify for Tricare Reserve Select. Individual Ready Reserve and Volunteer Training Unit members are eligible for reinstatement under Tricare Reserve Select is they return to a SELRES
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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
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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 when and where overcrowding of a military medical
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operates a health care delivery system that served approximately 9.4 million beneficiaries in 2018. The Department of Defense's unified medical program represents $ 50.6 billion or 8% of total FY2019 U.S. military spending. With the exception of active duty service members (who are assigned to the
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The North Region includes Connecticut, Delaware, the District of Columbia, Illinois, Indiana, Kentucky, Maine, Maryland, Massachusetts, Michigan, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Vermont, Virginia, West Virginia, Wisconsin and portions of Iowa
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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. The majority of Tricare PRIME enrollees must exclusively use the MTF
598:
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 eligibility at age 65, placing them at the same level of coverage as U.S. citizens who had never
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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, but
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Currently, there are three regional Managed Care Support Contractors, a Medicare/Tricare Dual Eligible Fiscal Intermediary Contractor, and a Tricare Pharmacy contractor, who administers both Mail Order Pharmacy and Retail Pharmacy programs. In addition several administrative contractors provide
579:
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 either Tricare coverage or their own
385:
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
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Tricare Select provides a similar benefit to the original CHAMPUS program and is available to dependents Active Duty personnel, retirees from the Active Component, retirees from the Reserve Component age 60 or older, and their eligible family members.
629:, which organized the Tricare Management Activity. 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.
363:-like option called Tricare (CHAMPUS) Extra that required use of network providers in exchange for lower cost sharing, and the standard CHAMPUS option that continued the freedom of choice in selecting providers but required higher cost sharing and
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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 led to the creation of TYA. Enrollment began on 1 May 2011.
463:(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
925:
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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
487:, 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.
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The South Region includes Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, Oklahoma, South Carolina, Tennessee (excluding the Ft. Campbell area) and Texas (excluding the El Paso area).
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Although DOD's initial intent under the CHAMPUS Reform Initiative was to award three competitively bid contracts covering six states, only one bid, made by Foundation Health Corporation (now
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Tricare Prime option and pay no out-of-pocket costs for Tricare coverage), Military Health System beneficiaries may have a choice of Tricare plan options depending upon their status (e.g.,
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South Carolina, Tennessee, Vermont, Virginia, West Virginia, Wisconsin and portions of Iowa (Rock Island Arsenal area), Missouri (St. Louis area) and Texas (excluding the El Paso area)..
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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.
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Tricare Select is also available to reservists and their family under the Tricare Reserve Select Component. Under Tricare Select, beneficiaries can use any civilian
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Effective January 1, 2018 the Tricare regions were consolidated into two large regions, Tricare East and Tricare West. Services in these regions are provided by:
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343:. This civilian health care program became known as the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) in 1966.
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passed the Dependents Medical Care Act of 1956 and the Military Medical Benefits Amendments of 1966. These acts allowed the
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includes drug charges, when Medicare benefit limits are attained and services performed outside the United States or in a
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served full 20 to 30-plus year careers in the armed forces. This included becoming Medicare eligible due to disability.
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In 2004, Tricare Management Activity re-aligned the previous twelve regions into three large regions, known as Tricare
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Since then, Tricare has undergone several restructuring initiatives, including re-alignment of contract regions,
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355:-like option called Tricare (CHAMPUS) Prime that required enrollment and offered enhanced benefits and low
272:, although historically it also included health care delivered in military medical treatment facilities.
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279:. Before 1 October 2013, it was managed by the Tricare Management Activity under the authority of the
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All medical claims are processed ("adjudicated") by the following claims processing sub-contractors:
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Active duty military personnel always have priority for care in military medical facilities. After
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that is payable under Tricare regulations. The beneficiary is responsible for payment of an annual
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923:- New in 2021: Are you a retiree who will lose Tricare Select coverage Jan. 1? Here’s what to do.
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941:- Nearly 175,000 military retirees, family members may soon have no Tricare Select coverage.
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claims processing. The Tricare Reserve Retired project was one of the first to introduce
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689:(Rock Island Arsenal area), Missouri (St. Louis area) and Tennessee (Ft. Campbell area).
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Please help update this article to reflect recent events or newly available information.
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471:. In return for these restrictions, beneficiaries are responsible only for small
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882:"Defense Health Care: Despite Tricare Procurement Improvements, Problems Remain"
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employer-sponsored health care coverage, and their sponsor is Tricare eligible.
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New Tricare Program Offers Coverage for Young Adults Under 26. Retrieved from
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features to the CHAMPUS program. Beneficiaries were offered three choices – a
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1037:
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398:, and the addition of "Tricare for Life" benefits in 2001 for those who are
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In 2009, the Tricare Overseas Program contract consolidated the following:
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The ultimate responsible organization for administration of Tricare is the
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Tricare Management Activity contracts and administers dental programs.
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324:
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250:
440:. There were no enrollment fees for Tricare Select prior to 2021.
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856:. United States Department of Defense. 2007-12-20. Archived from
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851:"Task Force on the Future of Military Health Care: Final Report"
958:
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costs in lieu of Tricare retirees being required to purchase
638:
quality management, auditing, and statistical services.
1025:
887:. United States General Accounting Office. 1995-08-03
299:, child under age 26 ineligible for family coverage,
804:
Official website of the Tricare Management Activity
712:North, South and West – PGBA, LLC (a subsidiary of
101:. Unsourced material may be challenged and removed.
447:for individuals: $ 12.50 per month or $ 150 a year
627:U.S. Department of Defense Military Health System
402:-eligible, and "Tricare Reserve Select" in 2005.
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1008:Tricare Young Adult begins; monthly premiums set
996:http://tricare.mil/mediacenter/news.aspx?fid=706
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268:. Tricare is the civilian care component of the
719:Tricare Overseas claims and Tricare for Life –
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281:Assistant Secretary of Defense (Health Affairs)
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450:for families: $ 25 per month or $ 300 per year
27:U.S. Department of Defense health care program
1327:Chief of Staff of the United States Air Force
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832:Congressional Research Service (2018-04-20).
680:. Services in these regions are provided by:
490:
467:and obtain referrals and authorizations for
737:Three area Tricare Service Center contracts
436:, and may be responsible for certain other
64:Learn how and when to remove these messages
1060:
1046:
1030:
843:
549:
303:-eligible, etc.) and geographic location.
756:Humana Military Healthcare Services, Inc.
694:Humana Military Healthcare Services, Inc.
620:
495:
215:Learn how and when to remove this message
161:Learn how and when to remove this message
2882:1956 establishments in the United States
1312:Chief of Staff of the United States Army
834:"Defense Primer: Military Health System"
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226:
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2872:Military medicine in the United States
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714:BlueCross BlueShield of South Carolina
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275:The Tricare program is managed by the
1150:Deputy Secretary of Homeland Security
1041:
783:Health insurance in the United States
1826:Air Force Historical Research Agency
767:Paso), Utah, Washington and Wyoming.
704:Paso), Utah, Washington and Wyoming.
443:As of January 1, 2021 The fees are:
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172:
99:adding citations to reliable sources
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29:
2877:United States Department of Defense
1951:Officer candidate/training school:
663:
659:– as Tricare Retiree Dental Program
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258:U.S Armed Forces military personnel
244:United States Department of Defense
24:
1821:Naval History and Heritage Command
734:Tricare Overseas claims processing
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242:) is a health care program of the
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1010:Stars and Stripes, April 11, 2011
814:Defense Health Agency - About TMA
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45:This article has multiple issues.
2816:
2815:
2774:
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2381:Uniform Code of Military Justice
1198:United States military seniority
972:"Tricare Insurance for Veterans"
764:Health Net Federal Services, LLC
686:Health Net Federal Services, LLC
505:USC Federal Reserve Components (
454:
264:, including some members of the
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75:
34:
2363:Military Occupational Specialty
1811:Army Center of Military History
1416:Military Auxiliary Radio System
1286:Department of Homeland Security
1193:Active duty three-star officers
1001:
988:
964:
525:USC Federal Reserve Component (
461:health maintenance organization
361:preferred provider organization
353:health maintenance organization
260:, military retirees, and their
86:needs additional citations for
53:or discuss these issues on the
2386:Judge Advocate General's Corps
1317:Commandant of the Marine Corps
1188:Active duty four-star officers
1145:Secretary of Homeland Security
1130:President of the United States
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934:
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825:
807:
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740:Tricare Global Remote Overseas
596:Medicare Supplemental Coverage
13:
1:
1816:Marine Corps History Division
1337:Commandant of the Coast Guard
1203:National Security Act of 1947
1172:Committees on Armed Services
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411:Enrollment-based Health Plans
1421:Marine Corps Cyber Auxiliary
721:Wisconsin Physicians Service
584:Medicare-wraparound Coverage
396:Base Realignment and Closure
7:
2005:Enlisted recruit training:
1273:Department of the Air Force
1140:Deputy Secretary of Defense
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653:– as Tricare Dental Program
367:known as Tricare Standard.
10:
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1305:Service branches and heads
1069:United States Armed Forces
491:Premium-based Health Plans
339:to contract with civilian
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743:Tricare Puerto Rico Prime
186:This article needs to be
2371:Air Force Specialty Code
2085:Awards & decorations
543:Individual Ready Reserve
295:family member, retiree,
651:United Concordia Dental
550:Tricare Reserve Retired
2391:Military Health System
1261:Department of the Navy
1249:Department of the Army
621:Program administration
496:Tricare Reserve Select
465:primary care physician
438:out-of-pocket expenses
270:Military Health System
247:Military Health System
232:
1849:Air Force Art Program
1436:Coast Guard Auxiliary
1234:Department of Defense
1208:Goldwater–Nichols Act
1155:Joint Chiefs of Staff
778:US Family Health Plan
723:Insurance Corporation
485:US Family Health Plan
480:US Family Health Plan
365:insurance deductibles
341:health care providers
288:Department of Defense
277:Defense Health Agency
230:
2640:Aircraft designation
2289:Creeds & Codes:
1408:Civilian auxiliaries
1226:Military departments
1135:Secretary of Defense
976:veteranaddiction.org
961:Retrieved April 2011
519:Marine Corps Reserve
426:health care provider
337:Secretary of Defense
95:improve this article
2526:Crew-served weapons
2415:Chiefs of Chaplains
1636:Current deployments
959:Tricare Young Adult
731:Overseas enrollment
575:Tricare Young Adult
535:Army National Guard
527:Coast Guard Reserve
459:Tricare Prime is a
316:facility occurred.
249:. Tricare provides
2521:Individual weapons
1761:Hispanic Americans
1741:Buddhist Americans
1524:United States Code
1494:Special Operations
1347:Reserve components
946:2021-01-09 at the
928:2021-01-01 at the
910:2023-04-01 at the
905:Tricare.Mil/Select
819:2013-12-13 at the
539:Air National Guard
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515:Air Force Reserve
406:Tricare's options
266:Reserve Component
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2224:Warrant officers
2000:The Basic School
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802:What is Tricare?
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664:Health insurance
642:Dental insurance
610:Veterans Affairs
589:Tricare for Life
557:Enduring Freedom
533:National Guard (
231:The Tricare logo
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455:Tricare Prime
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151:February 2016
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112: –
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106:Find sources:
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84:This article
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2675:designations
2469:Designations
2410:Conscription
2394:
1781:Marine Corps
1715:World War II
1606:Unit mottoes
1551:The Pentagon
1469:Indo-Pacific
1291:
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1239:
1232:
1090:Marine Corps
1003:
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979:. Retrieved
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889:. Retrieved
876:
865:. Retrieved
858:the original
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657:Delta Dental
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511:Navy Reserve
507:Army Reserve
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357:cost sharing
349:managed care
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321:World War II
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93:Please help
88:verification
85:
61:
54:
48:
47:Please help
44:
2671:Electronics
2628:World War I
1836:War artists
1776:Coast Guard
1724:By ancestry
1114:Coast Guard
1108:Space Force
569:Noble Eagle
434:coinsurance
374:) covering
313:health care
293:active duty
2866:Categories
2750:Biological
2400:Separation
2278:Enlistment
2228:Enlisted:
1615:Operations
1354:Reserves:
1218:Components
1123:Leadership
981:2021-08-22
891:2008-05-26
867:2008-05-20
789:References
672:, Tricare
529:) and the
473:copayments
430:deductible
376:California
372:Health Net
325:Korean War
262:dependents
121:newspapers
50:improve it
2820:Navboxes
2596:Weapons:
2457:Equipment
2188:Officer:
1862:Personnel
1771:Air Force
1766:Civil War
1641:Conflicts
1596:Logistics
1517:Structure
1499:Strategic
1293:Secretary
1278:Secretary
1266:Secretary
1254:Secretary
1241:Secretary
1102:Air Force
297:reservist
110:"Tricare"
56:talk page
2779:Category
2755:Chemical
2623:Aircraft
2607:Reactors
2531:Vehicles
2478:vehicles
2052:Uniforms
2045:Uniforms
1869:Training
1710:Colonial
1702:Timeline
1544:Title 50
1539:Title 32
1534:Title 14
1529:Title 10
1479:Southern
1474:Northern
1464:European
1161:Chairman
944:Archived
926:Archived
908:Archived
817:Archived
772:See also
692:South –
684:North –
565:New Dawn
531:Title 32
523:Title 14
503:Title 10
400:Medicare
333:Congress
329:Cold War
323:and the
301:Medicare
251:civilian
238:(styled
2745:Nuclear
2727:Guidons
2556:Ships:
2483:weapons
2395:Tricare
2283:Officer
2126:Devices
2116:Foreign
1791:Academy
1660:History
1619:history
1560:Units:
1459:Central
762:West –
754:East –
699:West –
567:and/or
307:History
240:TRICARE
236:Tricare
188:updated
135:scholar
18:TRICARE
2717:Ensign
2633:active
2575:future
2570:active
2535:active
2367:Rating
2274:Oath:
2133:Badges
1631:Budget
1454:Africa
1176:Senate
1079:Legend
380:Hawaii
137:
130:
123:
116:
108:
2681:Flags
2654:Other
2488:other
2268:Other
2181:Ranks
2106:AF/SF
2024:AF/SF
1995:ASVAB
1970:AF/SF
1945:AF/SF
1906:AF/SF
1601:Media
1489:Cyber
1484:Space
1181:House
1112:CG =
1106:SF =
1100:AF =
1088:MC =
885:(PDF)
861:(PDF)
854:(PDF)
837:(PDF)
674:South
670:North
142:JSTOR
128:books
2739:WMDs
2734:Food
2722:Jack
2514:Land
2474:MC:
2101:MC/N
2002:(MC)
1990:MEPS
1940:MC/N
1930:ROTC
1911:prep
1899:prep
1894:MC/N
1887:prep
1786:Navy
1646:Wars
1617:and
1096:Navy
1094:N =
1084:Army
1082:A =
678:West
537:and
432:and
378:and
359:, a
286:The
256:for
114:news
2616:Air
2590:MSC
2545:Sea
2376:Pay
2298:NCO
521:),
97:by
2868::
2849:CG
2844:SF
2839:AF
2829:MC
2809:CG
2804:SF
2799:AF
2789:MC
2741::
2712:CG
2707:SF
2702:AF
2692:MC
2683::
2585:CG
2580:AF
2505:CG
2500:AF
2441:CG
2436:AF
2426:MC
2417::
2356:CG
2351:AF
2341:MC
2332::
2323:CG
2318:AF
2308:MC
2257:CG
2252:SF
2247:AF
2237:MC
2217:CG
2212:SF
2207:AF
2197:MC
2169:CG
2164:SF
2159:AF
2149:MC
2135::
2111:CG
2087::
2078:SF
2073:AF
2063:MC
2054::
2029:CG
2014:MC
1979::
1960:MC
1918:CG
1878::
1692:CG
1687:SF
1682:AF
1672:MC
1589:CG
1584:SF
1579:AF
1569:MC
1396:AF
1387::
1378:CG
1373:AF
1363:MC
1157::
974:.
563:,
559:,
517:,
513:,
509:,
59:.
2834:N
2824:A
2794:N
2784:A
2697:N
2687:A
2677:)
2673:(
2600:N
2565:N
2560:A
2537:)
2533:(
2495:N
2471:)
2467:(
2465:A
2431:N
2421:A
2393:/
2369:/
2365:/
2346:N
2336:A
2313:N
2303:A
2242:N
2232:A
2202:N
2192:A
2154:N
2144:A
2096:A
2068:N
2058:A
2019:N
2009:A
1983:A
1965:N
1955:A
1935:A
1913:)
1909:(
1901:)
1897:(
1889:)
1885:(
1882:A
1677:N
1667:A
1574:N
1564:A
1391:A
1368:N
1358:A
1061:e
1054:t
1047:v
998:.
984:.
894:.
870:.
839:.
716:)
218:)
212:(
200:)
196:(
190:.
164:)
158:(
153:)
149:(
139:·
132:·
125:·
118:·
91:.
66:)
62:(
20:)
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