Going to College
While enrolled in college, children may be eligible for regular TRICARE benefits until their 23rd birthday or graduation, whichever comes first.
Attending a Service Academy? >>Learn More
Health Plan Options
Health plan options depend on where the school is and your sponsor's military status. Here are some questions to help you decide.
1. Where is the school located?
TRICARE Prime is available in Prime Service AreasGeographic areas in the U.S. where we offer TRICARE Prime. They ensure medical readiness of active duty by adding to the capability and capacity of military hospitals and clinics. Prime Service Areas were also built around the Base Realignment and Closure sites. (PSAs). You can check the school's ZIP Code online or call your regional contractor to see if the school is in a PSA.
- If so, your child may enroll in TRICARE Prime
- If not, your child can use TRICARE Standard and Extra
The US Family Health Plan is another Prime plan available in designated US Family Health Plan areas.
2. Is your child enrolled in TRICARE Prime now?
You should consider your child's options when they go to college, especially if the college is outside of your home PSA:
- Your child's primary care manager (PCM) provides most of his/her routine care. If far from home, it may not be easy to do.
- Talk to your child's PCM to see if they are willing to give you referrals for your child if they need care at school.
- Your PCM isn't required to do so, but they may work with you so you can stay enrolled at home.
- If your PCM won't give you referrals for care needed at school, your child can still stay enrolled, but will be charged point-of-services fees for any care received without a referral.
3. How will you get to the doctor?
If your child enrolls in TRICARE Prime, they’ll have an assigned PCM. They must make appointments with the PCM or have a referral from the PCM. If not, they will be charged point-of-service fees.
If it's not convenient to have an assigned PCM, you should consider TRICARE Standard and Extra. You can visit any TRICARE-authorized providerAn authorized provider is any individual, institution/organization, or supplier that is licensed by a state, accredited by national organization, or meets other standards of the medical community, and is certified to provide benefits under TRICARE. There are two types of TRICARE-authorized providers: Network and Non-Network. and have more flexibility when home during school breaks.
4. How much will we pay out-of-pocket?
TRICARE Prime has the fewest out-of-pocket costs, unless you use the point-of-service option.
With TRICARE Standard and Extra, you'll save money by visiting a network provider. You'll pay annual deductibles and cost shares. Most providers will bill TRICARE Standard, but you may need to pay the provider up front for care and file a claim with TRICARE later for reimbursement.
5. Are you signing up for a student health plan?
- Some colleges and universities offer a student health plan
- Student health plans are other health insurance. TRICARE always pays second after OHI
- If you plan to use a student health plan, then TRICARE Standard and Extra is the best TRICARE plan
Affordable Care Act Requirements
Your child has minimum essential coverageBasic health care coverage that meets the Affordable Care Act requirement. If you don’t have coverage, you may have to pay a fee for each month you aren’t covered. required under the Affordable Care Act with any of TRICARE's health plans. To keep minimum essential coverage after regular TRICARE coverage ends: