For Military Retirees and their Families
Why members give us top marks for satisfaction:
- Urgent care appointments on the same day you call
- A personal care civilian doctor who knows you and your health conditions
- Baby delivery at non-military hospitals
- A team of specialists who work together to keep you healthy
- Helpful and caring Member Services representatives and case managers
- No “balance billing”
- No red tape or confusing paperwork
- Fast, hassle-free referrals to specialists
Understand eligibility requirements for our plan.
US Family Health Plan is a permanent part of the Military Health System.
- Low enrollment fees: USFHP is the same cost as TRICARE Prime
- Low copayments for most services: USFHP is the same cost as TRICARE Prime
- Discounts on preventive health services that are not covered by TRICARE
- More Benefits Discount Program
You may be able to save money by switching to USFHP. Or you can keep your current employer’s insurance and use USFHP as a great supplement to help pay all your deductibles and cost shares. This works for most employers’ plans.
The Summary of Benefits is a list of healthcare services your family may need. The services are covered by the Plan as long as your USFHP primary care provider (PCP) provides or authorizes them. It is important to understand how to take advantage of your coverage and get the care you need. This will help you avoid unnecessary costs or paperwork.
How much does US Family Health Plan (USFHP) cost?
I am covered through my employer's plan. Why should I join USFHP?
Among other reasons, cost play a significant factor. If you are contributing a large amount from each paycheck for yourself and your family, USFHP may be the better deal for you. TRICARE offers a comparison tool where you do a side-by side comparison of TRICARE costs versus your employer's plan. The USFHP comprehensive coverage is a favorable advantage when compared to many of today's high-deductible health plans.
Even if you are not paying anything for your employer sponsored health insurance, USFHP can help you save because it can help pay your deductibles and cost shares as long as it is for a covered expense under TRICARE. This works for most employer-sponsored health plans.
One exception is Federal Employee Health Benefits (FEHB). USFHP cannot supplement FEHB because it is also a federal plan. If you are covered under FEHB you will either have to terminate or suspend your coverage before you join USFHP.
What is the difference between TRICARE Prime and the USFHP?
Your covered benefits under US Family Health Plan are the same as TRICARE Prime. The major differences are in how your TRICARE Prime benefit is administered and delivered. USFHP is local and we know our area. You can expect personal service from our team. For instance, they will advocate on your behalf to ensure you get your health care appointments when you need them. And, when you are referred to a specialist, authorizations are fast. With USFHP, you will always be referred to our network of civilian specialists. The Nurse Case Managers will step in to guide you through the health care system when you need extra help managing your health conditions. Finally, our Member Services representatives are ready to help you with questions about using your benefits.
What additional advantages and features does USFHP offer?
Our members receive discounts on a variety of lifestyle enriching services that are not covered TRICARE benefit. Included are discounted tickets for travel, family attractions, cultural, sporting, and recreational events. Members also get discounted eyeglasses and memberships at select fitness clubs. Plus, you can save on nutritional supplements, nutrition counseling, complementary and alternative medicine. This includes services like chiropractic, massage, acupuncture and naturopathic treatments. And much more!
I am a retiree. What if I have already paid my TRICARE Prime fees?
If you have already paid your TRICARE Prime enrollment fees, no problem. Our Enrollment team will coordinate with TRICARE to have them credited to your USFHP membership.
May I use a military treatment facility (MTF) while enrolled in USFHP?
US Family Health Plan provides you with all civilian providers—all the time. Our contract with the DOD requires you to only use our network civilian providers and pharmacies . You cannot use the MTF for non-emergency care. You cannot fill prescriptions at the MTF. However, if you experience an emergency that threatens your life or a limb, you may use the nearest emergency facility. In that situation, it can be a civilian or a military facility.
When can I join, and when will my coverage start?
If you currently have TRICARE Prime, you can transfer to US Family Health Plan at any time; enrollment is always open. Your coverage will take effect the day your application is processed.
Beneficiaries who have TRICARE Select can only switch their TRICARE plan options during Open Enrollment season. Open Season is an annual period when you can enroll in a health insurance plan for the next year. With TRICARE, Open Season will occur each fall, beginning on the Monday of the second full week in November to the Monday of the second full week in December. However, there is an exception to this rule when TRICARE Select beneficiaries experience a QLE (qualifying life event).