Is Tricare a PPO or HMO?

Asked by: Maryse Schneider  |  Last update: February 11, 2022
Score: 4.3/5 (56 votes)

TRICARE Select (previously named TRICARE Standard) is a preferred provider organization (PPO) health plan. A PPO provides the greatest choice in health care providers in exchange for some extra costs.

Is TRICARE a PPO insurance?

TRICARE Select is a self-managed, preferred provider organization (PPO) plan available in the United States. You must show eligible for TRICARE in the Defense Enrollment Eligibility Reporting System. You need to register in DEERS to get TRICARE..


TRICARE Prime health plans are similar to a health maintenance organization (HMO) program. It generally features the use of military hospitals and clinics and substantially reduces out-of-pocket costs for authorized care provided outside military hospitals and clinics by TRICARE network providers.

What type of insurance plan is TRICARE?

What type of health insurance is TRICARE? TRICARE is a government-sponsored health insurance program for active duty, Reserves, retired military members, and eligible family members.

What type of plan is TRICARE Prime?

TRICARE Prime is your managed care option, like a health maintenance organization, or HMO. It usually features the use of military hospitals and clinics. It also greatly reduces out-of-pocket costs for authorized care provided outside military facilities by TRICARE-authorized network providers.

PPO or HMO? Choosing the Right Plan

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Is TRICARE Prime primary or secondary?

Ending Other Health Insurance Coverage

If you lose your other health insurance, TRICARE becomes your primary payer. If you have TRICARE for Life, TRICARE becomes the second payer.

Is United Concordia TRICARE a PPO or HMO?

United Concordia (group 740385001) is a dental HMO plan focusing on preventive care and the early diagnosis of dental problems. You select a primary dental office from a network of contracted dentists.

What are the two types of TRICARE?

TRICARE covers care offered by two types of TRICARE-authorized providers: network and non-network. To locate a provider, visit the TRICARE Find a Doctor Tool.

Is TRICARE considered a group health plan?

TRICARE (formerly known as CHAMPUS) is the Department of Defense's health care program for retired members of the uniformed services, as well as the spouses and children of active duty, retired and deceased service members. TRICARE is considered a group health plan for SEP and premium surcharge rollback purposes.

What is a HMO & PPO?

To start, HMO stands for Health Maintenance Organization, and the coverage restricts patients to a particular group of physicians called a network. 1. PPO is short for Preferred Provider Organization and allows patients to choose any physician they wish, either inside or outside of their network.

Is TRICARE East primary or secondary?

TRICARE is the secondary payer to all health benefits and insurance plans, except for Medicaid, TRICARE supplements, the Indian Health Service and other programs or plans as identified by the Defense Health Agency (DHA). ... Beneficiaries may not waive benefits from their primary plan.

What is the difference between TRICARE East and West?

TRICARE partners with regional contractors to help deliver the TRICARE benefit. ... TRICARE East is managed by Humana Military; TRICARE West is managed by Healthnet Federal Services. These arrangements are governed by contracts.

What is the PPO insurance?

A type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You can use doctors, hospitals, and providers outside of the network for an additional cost. ...

What is PPO good for?

A PPO is generally a good option if you want more control over your choices and don't mind paying more for that ability. It would be especially helpful if you travel a lot, since you would not need to see a primary care physician.

Is TRICARE Select East or West?

The TRICARE West Region includes the states of Alaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa (except the Rock Island Arsenal area), Kansas, Minnesota, Missouri (except the St. Louis area), Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Texas (Amarillo, Lubbock and El Paso areas ...

Is TRICARE good health insurance?

Is TRICARE Good Health Insurance. People often ask me if TRICARE is good insurance. The answer is yes, TRICARE is excellent insurance. Of course, nothing is perfect, or one size fits all but in general, TRICARE provides some of the most affordable health care in the U.S.

Is TRICARE primary or secondary to Medicare?

Medicare is your primary payer. TRICARE pays second to Medicare or last if you have other health insurance. ... 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.

Is TRICARE considered Medicaid?

In the case of Medicaid, however, TRICARE is the primary payer for TRICARE covered benefits that are also covered by Medicaid. If not a TRICARE covered benefit, Medicaid is responsible for reimbursement at prevailing Medicaid rates.

What are the three types of TRICARE coverage?

To learn more about each plan, select from the list below: TRICARE Plus. TRICARE Prime. TRICARE Prime Remote.

How do I know which type of TRICARE I have?

Get Proof of TRICARE Coverage
  1. Log in to milConnect.
  2. Click on the “Obtain proof of health coverage” button.
  3. Or click on Correspondence/Documentation and choose "Proof of Coverage."
  4. Your coverage letter will be generated and available for download.

Is TRICARE free for retired military?

Tricare Health Plans

All retirees have to pay a deductible amount of $150 per individual (no more than $300 per family). Tricare Retired Reserve - Retired Guard or Reservists and their family members can purchase Tricare Retired Reserve until they reach age 60, there is an enrollment fee, and copays for treatment.

Is TRICARE dental primary or secondary?

As your secondary plan, TDP will never pay more than your dentist charges. TDP also will never pay more than it would have paid as the primary insurance plan.

Is TRICARE and United Concordia the same?

United Concordia has administered dental benefits for TRICARE programs since 1996. ... It also includes comprehensive dental specialty care coverage. Active duty service members may find more information at or

What doesn't TRICARE cover?

In general, TRICARE excludes services and supplies that are not medically or psychologically necessary for the diagnosis or treatment of a covered illness (including mental disorder), injury, or for the diagnosis and treatment of pregnancy or well-child care.