The US Family Health Plan is an additional TRICARE Prime option available through networks of community-based, not-for-profit health care systems in six areas of the United States.
Who Can Participate?
The US Family Health Plan is available to the following beneficiaries who live in a designated US Family Health Plan area:
- Active duty family members
- Retired service members and their families*
- Family members of ActivatedCalled or ordered to active duty service for more than 30 days in a row. National Guard/Reserve membersIncludes members of the:
- Army National Guard
- Army Reserve
- Navy Reserve
- Marine Corps Reserve
- Air National Guard
- Air Force Reserve
- U.S. Coast Guard Reserve
- Non-activated National Guard/Reserve members and their families who qualify for care under the Transitional Assistance Management Program
- Retired National Guard/Reserve membersat age 60and their families*
- Survivors
- Medal of Honor recipients and their families
- Qualified former spouses
Where Can You Use It?
You must live in the one of the designated US Family Health Plan service areas to enroll.
How it Works
You'll get all care (including prescription drug coverage) from a primary care provider that you select fromthe network of private physicians affiliated with one of the not-for-profit health care systemslisted above.Your primary careprovider assists you in getting appointments with specialists in the area and coordinates your care.
You won't get care at military hospitals and clinics or from TRICARE network providers when enrolled in the US Family Health Plan.
What You Pay
Active duty family members pay no enrollment fees and no out-of-pocket costs for any type of care as long as care is received from the US Family Health Plan provider. All others pay annual enrollment fees and network copayments. >>Learn more.
Is the US Family Health Plan Right for You?
If you live in one of the six designated areas, you may want to consider the US Family Health Plan. It's a robust Prime option that even offers enhanced coverage at each location.
How to Enroll
>>Visit the US Family Health Plan Enrollment Page to learn more.
For information on disenrolling or ending plan coverage, visit the Disenrolling in the US Family Health Plan page.
Can I enroll in the US Family Health Plan if I'm Medicare-eligible?
Before October 1, 2012, the US Family Health Plan was also available to all Medicare-eligible beneficiaries age 65 and older. On October 1, 2012, this rule changed for all new US Family Health Plan enrollees, but existing enrollees aren't affected.
If Enrolled Before October 1, 2012
If you're already enrolled in the US Family Health Plan when you become eligible for Medicare (US Family Health Plan coverage begins before September 2012), you can stay enrolled as long as there is no break in coverage.
However, we strongly encourage you to enroll in Part B when you first become eligible. If you disenroll from the US Family Health Plan or move to a non-US Family Health Plan area, you won’t be eligible for other TRICARE benefits if you don’t have Part B. And, if you don’t enroll in Part B when first eligible, you may be required to pay theMedicare Part B Late Enrollment Penalty.
New Enrollments on or After October 1, 2012
Beginning October 1, 2012, Medicare-eligible beneficiaries age 65 and older can no longer enroll in the US Family Health Plan. If you're under age 65 and using Medicare due to a disability or other reason, you can remain enrolled in the US Family Health Plan until you age out. At that time, you will transition toTRICARE For Life.
Last Updated 1/9/2024
FAQs
The US Family Health Plan is an additional TRICARE Prime option available through networks of community-based, not-for-profit health care systems in six areas of the United States.
What is the difference between TRICARE Prime and US Family Health Plan? ›
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.
Who is eligible for US family health? ›
US Family Health Plan is for retirees and their family members. The plan is also open to active duty family members. To enroll in the Plan, you must be: An eligible beneficiary of the Military Health System.
How does the US Family Health Plan work with Medicare? ›
If you enroll in Medicare at 65 with USFHP, you pay the Part B premium and USFHP fees and copays stop (except pharmacy copays). Staying with USFHP includes their pharmacy program.
Is a US Family Health Plan good? ›
The US Family Health Plan is regularly labeled as a model for exemplary patient satisfaction nationwide by the annual Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey, which gave the plan a 91.5 aggregate member satisfaction rating in 2017.
What is the US Family Health Plan lawsuit? ›
The United States filed a complaint alleging that six health plans participating in the Uniformed Services Family Health Plan (USFHP) program, as well as their trade group, the US Family Health Plan Alliance, violated the False Claims Act by knowingly retaining erroneously inflated payments for healthcare services the ...
What is the best TRICARE plan? ›
TRICARE Select offers the most freedom of choice. There's no required PCM. You manage your own health care and can receive care from any TRICARE-authorized provider. However, you'll pay higher out-of-pocket costs when you receive care outside the established network of providers.
Do spouses get TRICARE Prime or select? ›
New active duty family members are automatically enrolled in TRICARE Prime or TRICARE Select, depending on their location. If eligible for other plans, these family members have 90 days from the date of your marriage to change their plan. Family members of retirees aren't automatically enrolled in TRICARE.
How do I disenroll from the US Family Health Plan? ›
Disenrolling from the US Family Health Plan
- You can choose to disenroll from the US Family Health Plan at anytime. ...
- Contact your US Family Health Plan provider to initiate a voluntary disenrollment.
Medicaid and the Children's Health Insurance Program (CHIP) provide free or low-cost health coverage to some low-income people, families and children, pregnant women, the elderly, and people with disabilities. Some states expanded their Medicaid programs to cover all people below certain income levels.
In 2023, the average cost of health insurance for a family of four was approximately $23,968 per year. It's important to note that health insurance costs can vary significantly depending on factors such as location, plan type, and coverage options.
What kind of insurance is the US Family Health Plan? ›
The US Family Health Plan (USFHP) is a TRICARE Prime option. You must be TRICARE-eligible to enroll and live in a USFHP service area. If you're an active duty service member, you can't enroll. To learn more, visit the US Family Health Plan page.
How much does the average American pay for Medicare per month? ›
Cost for most: $174.70/month
Most Medicare beneficiaries pay a standard Part B premium of $174.70 every month in 2024—including those who have chosen to enroll in a Medicare Advantage plan. Many Medicare Advantage plans have $0 premiums, which means you'll pay the Part B premium (and nothing else) each month.
What happens to TRICARE when you turn 65? ›
TRICARE benefits include covering Medicare's coinsurance and deductible for services covered by Medicare and TRICARE. When retired service members or eligible family members reach age 65 and are eligible for Medicare, they become eligible for TRICARE For Life and are no longer able to enroll in other TRICARE plans.
What type of health insurance system does the US have? ›
There are two types of health insurances in the US, private and public. Most people use a combination of both. The US public health insurances are: Medicare, Medicaid, and Children's Health Insurance Program. Health insurance for dependents of international students.
What insurance model does the US use? ›
Americans who have commercial insurance through their employer are using the Bismarck model. Healthcare services are financed privately, through employer and employee contributions, and also delivered through private facilities. Americans who have Medicare or Medicaid are using the national health insurance model.
Is US Family Health Plan part of Tufts? ›
Tufts Health Plan is contracted with USFHP as a third-party administrator to process claims, referrals and authorizations, as well as offer care management and member service support.
Is TRICARE Prime an HMO or PPO? ›
Both. TRICARE has HMO (managed care) plan options (the various Prime plans, as well as US Family Health Plan) and PPO options (Select, Select Overseas, Reserve Select, and Retired Reserve).
