Reimbursement Procedures Project and Methods

Tricare Insurance

Tricare Insurance, formerly known as the Civilian and Medical Policy of the Uniformed Service, is a military insurance plan. The CHAMPUS insurance policy was formerly known as CHAMPUS; the name was later changed to Tricare. The Tricare Management Operation is in charge of this military healthcare insurance scheme. The Assistant Secretary of Defense for Health Affairs is in the Tricare Management Activity (Draper et al., 2014).


The project, however, does not include all members of the uniformed services. The National Oceanic and Atmospheric Administration, the Army, Marine Corps, Air Force, Navy, and the Coast Guard are all eligible for this program. The members of this services who are active, their spouses and their children who have not married and the retirees from the military, their spouses, and children who have not married yet are all eligible for the Tricare insurance plan (Beik, 2012).

Conditions for Coverage

The children of the service members who are under this insurance plan have to meet some conditions so that this insurance policy can cover them. The child should be 21 years old or above, he or she has to have been adopted by the service member or be under his or her custody, the children that are born out of wedlock but belong to the service members are also eligible to be covered under this plan. The Tricare program can be classified into various classes which include; Tricare Extra, Tricare Standard, Tricare Prime, and Tricare Prime Remote. Tricare usually assigns the members of the military to military health facilities. In case one of the members of the army wants to seek medical services from a specialist, he or she has to be given a referral letter from the military health care facility that has been assigned to him or her.

Cost and Payment

The members of the army pay differently for the Tricare plans, for instance, members who want to be enrolled in the Tricare Prime program, they have to pay a yearly enrollment fee and add the cost share fees on top of it. The cost share prices are the expenses incurred by members of the military once they seek medical services from Tricare. Those paying for Tricare Extra will have more flexible plans for payment than the Tricare Prime. The Tricare Standard program allows one to choose from a wide range of treatment options but its more expensive than the rest.

Benefits of Tricare

Tricare program has many benefits to those who enroll on any of the insurance plans. One of the major advantages of the program is that it reduces the cost of treatment up to 85% and sometimes it reduces it to zero. The cost of medical procedures are substantially cut down, and one can be able to afford quality health care. Tricare plans also have provisions whereby the insured military officer can go for medical check-ups in the designated hospitals free of charge. The Tricare programs ensure that quality healthcare for the members of the army is accessible and cheap, the military members can work with full concentration knowing that they are well covered (Heath & Spain, 2016). The Tricare Insurance Plans are also designed to operate with the people in the military; they can be able to afford enrollment into the plans. The plans bring about diversity, and one can choose the one that fits him or her well.


Beik, J. I. (2012). Health Insurance Today: A Practical Approach. Elsevier Health Sciences.

Draper, D., Anderson, B., Bernstein, D., Hamilton, J., Mayhew, J., & Pachter, L. (2014). Defense Health Care: More-Specific Guidance Needed for Assessing Nonenrolled TRICARE Beneficiaries’ Access to Care (No. GAO-14-384). Government Accountability Office Washington DC.

Heath, W. M., & Spain, J. (2016). Role of Government as Regulator, Payer, and Provider of Care. Pharmaceutical Public Policy, 431.

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