TRICARE Prime Option - US Family Health Plan

Who Can Participate

USFHP is available to the following beneficiaries who live in a USFHP service area:

• Active duty family members
• Retired service members and their family members
• Family members of activated National Guard and Reserve members
• Non-activated National Guard and Reserve members and their family members who qualify for care under the Transitional Assistance Management Program
• Retired National Guard and Reserve members ages 60 and older and their family members
• Survivors
• Medal of Honor recipients and their family members
• Qualified former spouses

Do you qualify for TRICARE Young Adult?

You may be able to choose USFHP as your TRICARE Young Adult option.

Are you Medicare-eligible?

You may be able to participate in USFHP in certain situations. Go to the “Medicare and USFHP” tab of this page to learn more.

Getting Healthcare

• You’ll choose a primary care provider from your USFHP’s network. 
• You’ll get most care from your PCP. Your PCP will help you get appointments with specialists and coordinate your care.
• You can’t get care at military hospitals and clinics. However, you can get emergency care at military emergency departments.
• You can’t use TRICARE network providers. 

Pharmacy Coverage

• You’ll get all prescriptions through your USFHP’s pharmacy network.
• You can’t use military pharmacies.

Dental and Vision Benefits

• Some USFHPs may offer dental and vision benefits. Contact your plan to learn more.
• If you’re eligible, you can also buy dental or vision coverage through:
  • The TRICARE Dental Program
  • The Federal Employees Dental and Vision Insurance Program

Care When Traveling

Your USFHP may cover care you get while traveling. Follow your plan’s rules for getting care.

Claims

You won’t need to file claims when you follow your plan’s rules for getting care.

Healthcare Costs

USFHP has the same out-of-pocket costs as TRICARE Prime. If you choose USFHP as your TRICARE Young Adult option, you’ll pay TYA-Prime costs.

See Healthcare Costs

Pharmacy Costs

USFHP out-of-pocket pharmacy costs are the same as TRICARE Pharmacy Program out-of-pocket costs.

See Pharmacy Costs

When You Can Enroll

If you’re eligible for USFHP, you can enroll during TRICARE Open Season or following a TRICARE Qualifying Life Event. Your coverage start date depends on when you enroll. To confirm your start date after enrolling, check with your plan.

Are you currently enrolled in another TRICARE Prime option? If you’re eligible for USFHP, you can transfer your TRICARE Prime enrollment to USFHP at any time. (You don’t have to wait for TRICARE Open Season or a QLE.)

How To Enroll

There are three ways to enroll in USFHP:

1. Online: Log in to milConnect and enroll through Beneficiary Web Enrollment.
2. By phone: Call your area’s plan.
3. By mail: Download the enrollment form for your plan and mail it to them.

Enrollment Forms

Do you want to enroll by mail? Download the correct enrollment form for your plan. You can find your plan’s mailing address on the form. 

• Johns Hopkins Health Plans enrollment form
• Martin’s Point Health Care enrollment form
• Brighton Marine Health Center enrollment form
• St. Vincent Catholic Medical Centers enrollment form
• CHRISTUS Health enrollment form
• Pacific Medical Centers (PacMed Clinics) enrollment form

Split Enrollment

Do you have family members who live in separate areas? You can split your enrollment with a USFHP in another location or with TRICARE Prime. This allows your family to enroll together and (when applicable) pay one enrollment fee. 

Here are some examples of split enrollment:

• You’re an active duty spouse living in a USFHP service area. One of your children is attending college in a state where USFHP isn’t available. Your child’s college is in a Prime Service Area. You can enroll yourself in USFHP and your child in TRICARE Prime. Because you’re active duty family members, you pay no enrollment fees.
• You’re a retired sponsor living in a USFHP service area. Your children live with your former spouse in a different USFHP service area. You and your children can enroll in USFHP. You’ll pay one enrollment fee for your whole family

Enrollment Fees

USFHP has the same enrollment fees as TRICARE Prime. If you choose USFHP as your TRICARE Young Adult option, you’ll pay TYA-Prime premiums.

See Enrollment Fees

Annual Increases

USFHP enrollment fees increase each year on Jan. 1. The basis of the increase is the annual cost of living adjustment for retired military pay.

You’re exempt from enrollment fee increases if you:

• Are a surviving family member of a sponsor who died on active duty or medically retired service member or their family member,
• Are in Group A, and
• Had at least one family member enrolled in US Family Health Plan or another TRICARE Prime option since your original enrollment

Do you meet the criteria above? Your enrollment fee will stay the same as long as you remain enrolled in USFHP or another TRICARE Prime option.

Can I enroll in USFHP if I’m Medicare-eligible?

It depends on your sponsor’s status, your age, and when you enrolled in USFHP.

Active Duty Service Members and Family Members

In many cases, Medicare allows active duty service members and active duty family members to delay Medicare Part B enrollment. Learn more about Medicare eligibility and TRICARE.

All Others Ages 65 and Older

If you enrolled in USFHP on or after Oct. 1, 2012

• Your TRICARE coverage will automatically change to TRICARE For Life if you have Medicare Part A and Part B.
• If you don’t have Medicare Part A and Part B, you’ll be disenrolled from USFHP.

If you enrolled in USFHP before October 2012

• When you become Medicare-eligible, you can stay enrolled in USFHP if you’ve been continuously enrolled in USFHP since before October 2012.
• You aren’t required to have Medicare Part B.
  • We strongly encourage you to enroll in Medicare Part B when you first become eligible. If you disenroll from USFHP or move to a non-USFHP area, you won’t be eligible for other TRICARE benefits if you don’t have Medicare Part B.
  • If you don’t enroll in Medicare Part B when you’re first eligible, you may be required to pay the Medicare Part B late-enrollment penalty. Learn more about Medicare costs.

All Others Under Age 65

• You can stay enrolled in USFHP until you turn age 65. At that time, you’ll transition to TRICARE For Life if you have Medicare Part A and Part B.
• Are you in TRICARE Group A? Your USFHP enrollment fees will be waived if you have Medicare Part A and Part B. Any enrollment fees you paid in advance will be refunded.