With private health insurance becoming ever more expensive, one of the main selling points for US Navy recruiters is the military health plan: TRICARE. TRICARE is an HMO-style health benefit program that offers very generous terms to US Navy sailors and officers, as well as their dependents.
Identification
TRICARE is the health benefits plan for all members of the US military. Therefore, the benefits available to members of the US Navy are effectively identical to those of equivalent eligibility in the Army, Marines, Air Force, and even the Coast Guard.
Eligibility
The following people are eligible for TRICARE through the US Navy: active duty servicemen; activated reservists; spouses and unmarried children of active duty servicemen; Navy retirees, their spouses and their unmarried children; spouses and unmarried children of reservists who activated for duty for more than 30 consecutive days or of reservists who die on active duty; spouse and unmarried children of those Navy servicemen who die while on active duty; Medal of Honor winners and their family members; children placed in the custody of an active Navy serviceman.
Three Levels of Coverage
There are three levels of TRICARE coverage. Standard coverage is a fee-for-service coverage that is meant for consideration by retirees and dependents, as it is not even available to active duty Naval personnel. Extra coverage is similar, but access is harder to get. Generally, prime coverage is used by active duty servicemen. For example, in an authorized civilian outpatient visit under TRICARE (i.e. one to a health service provider that is not a part of TRICARE's military network), the claimant is liable for 20 percent of the costs under Standard; 15 percent under Extra; and none of the costs under Prime. Deductibles are the same for Standard and Extra, and there are none for Prime.
Dental
TRICARE Dental is a voluntary program that offers current and former Navy personnel dental benefits. Under the terms of the program, TRICARE provides 100 percent coverage for diagnostic, emergency, and preventive dental services, except sealants. Sealants are covered at the 80 percent level with a 20 percent cost share paid by the beneficiary. The following services are provided with a member cost share: fillings, root canals, crowns, extractions, orthodontics and periodontics. The maximum annual benefit for routine dental care is $1,200; maximum lifetime orthodontic benefits are limited to $1,500.
Pharmacy
The Navy's TRICARE benefits are very generous in terms of purchasing drugs. Required and authorized drugs picked up at a military pharmacy are free. Those acquired at a retail pharmacy are covered under flat fees: $3 for generics, $9 for formula brand name drugs, and $22 for non-formula drugs.
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