One Tricare Prime option, called the US Family Health Plan (USFHP), is available in 16 states and the District of Columbia. If you live in New England, the Mid-Atlantic, the western Gulf Coast or the Puget Sound area, you may be eligible for the plan.
US Family Health Plan Overview
The US Family Health Plan began as part of the U.S. Public Health Service hospital program. It was made available to military members in 1993.
The program offers several benefits that Tricare does not, such as free vision exams and discounts on glasses, contact lenses and laser surgery; discounts for health clubs and gyms; alternative health care; and more.
Who Is Eligible
The following can enroll in the US Family Health Plan provided they live in a service area:
- Families of active-duty service members and of activated Guard and reserve members
- Retired service members and their families; and retired Guard and reserve members and their families at age 60
- Guard and reserve members and their families who qualify for the Transitional Assistance Management Program
- Survivors and other qualified former spouses
- Medal of Honor recipients and their families
Enrollment
You can enroll in the US Family Health Plan anytime, and coverage begins on the first day of the month following receipt of your application, when it is received by the 20th of the month. There's no waiting period for benefits. As with any Tricare Prime program, when you enroll in the US Family Health Plan, you commit to remaining enrolled for 12 months.
If you move to another region served by the US Family Health Plan, your enrollment can be transferred. If moving outside the plan's service area, you can transfer your enrollment to Tricare Prime, and any enrollment fees paid will be transferred.
Costs
Active-duty family members pay no enrollment fees and no out-of-pocket costs for any care as long as care is received from a US Family Health Plan provider organization.
Retirees pay an annual enrollment fee that is the same as the Tricare Prime enrollment fee. For Group A retirees and survivors, that amount is $363 per year for an individual or $726 per year for family enrollment in 2024. For Group B retirees and survivors, the fees are $438.96 per year for an individual or $879 per year for family enrollment.
Retirees who provide proof of Medicare Part B enrollment will have the fee waived.
| Service | Cost |
|---|---|
| Primary Care | $25 |
| Specialist | $37 |
| Ambulance | $50 |
| Emergency Room | $75 |
| Hospital | $188 |
Catastrophic Cap
The catastrophic cap is the maximum amount you have to pay in any given calendar year.
That amount is $1,000 for Group A active-duty family members or $1,256 for Group B active-duty family members. For retirees, it is $3,000 for Group A or $4,399 for Group B.
For More Information
For more information, call 800-748-7347, or visit the US Family Health Plan Web site at http://www.usfhp.com.
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