Military and Veterans Health Care Coverage

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Military members, retirees, veterans, and their families may qualify for health care coverage through federal programs developed for those who have served.

Unlike employer-sponsored coverage or Marketplace plans, military-related coverage is specifically tied to military service. Eligibility depends on a person or family member’s active-duty status, reserve status, length of service, disability rating, discharge status, age, and sometimes income.

Two main systems provide coverage and care: TRICARE and the U.S. Department of Veterans Affairs (VA). Some service members, or former service members, and their families may qualify for only TRICARE, only VA, or both, depending on their circumstances.

TRICARE

TRICARE is the health care program for active-duty service members, National Guard and Reserve members, military retirees, and their families.

Active-duty service members and their families receive care at military treatment facilities or through community-based TRICARE network providers. Most do not pay premiums or out-of-pocket costs for covered services.

Retirees and their family members can choose from several TRICARE plan options. Costs and provider flexibility vary by plan.

Types of TRICARE Plans

TRICARE offers several plan options. The right plan depends on duty status, retirement status, age, and where a person lives.

TRICARE Prime

TRICARE Prime works much like an HMO. Enrollees have a primary care manager who coordinates care. Referrals are usually required to see specialists. Prime generally has lower out-of-pocket costs than other TRICARE plans but less provider flexibility.

There are several Prime-based options:

Active-duty service members are generally enrolled in a Prime option.

TRICARE Select

TRICARE Select offers more flexibility. Referrals are not usually required. Enrollees may see any authorized provider.

Costs are typically higher than Prime, but there is greater provider choice.

Select-based options include:

  • TRICARE Select – For eligible retirees, family members, and certain other beneficiaries living in the United States
  • TRICARE Select Overseas – For eligible retirees, family members, and certain other beneficiaries living outside the United States

TRICARE For Life

TRICARE For Life is available to military retirees and their spouses when these individuals become eligible for Medicare.

Enrollment in TRICARE For Life is not required; it is automatic for those with Medicare Parts A and B. Coverage begins the first day Medicare Parts A and B are in effect. TRICARE For Life enrollees must pay Medicare Part B premiums. TRICARE For Life functions similarly to civilian Medigap policies, in that it pays costs such as Medicare Parts A and B deductibles and coinsurance costs for Medicare-covered services. TRICARE for Life also covers medications, replacing the need for Medicare Part D coverage.

TRICARE For Life coverage is only for those who are Medicare and TRICARE-eligible. However, military family members and retirees who are not yet eligible for TRICARE for Life remain eligible for TRICARE Prime or TRICARE Select. Said another way, when a retiree or eligible family member qualifies for Medicare/TRICARE for Life, the other eligible family members are able to retain their regular TRICARE coverage.

TRICARE Reserve and Retiree Plans

Some TRICARE plans are designed specifically for members of the National Guard and Reserve.

  • TRICARE Reserve Select – For qualified Selected Reserve members and their families who are not on active duty and do not have access to certain other federal coverage
  • TRICARE Retired Reserve – For retired Reserve members under age 60 who are not yet eligible for Medicare or other TRICARE retiree coverage

These plans are not automatic. Eligible members must enroll and pay monthly premiums. Reserve Select enrollees may see authorized providers, and cost-sharing is similar to TRICARE Select. Retired Reserve plans generally have higher premiums than Reserve Select. Cost-sharing also applies when care is received.

TRICARE Young Adult

TRICARE Young Adult allows eligible adult children to purchase coverage after aging out of regular dependent coverage. TRICARE Young Adult plans are available to unmarried, adult children of:

  • Active duty service members
  • Retired service members
  • Activated Guard and Reserve members
  • Non-activated Guard and Reserve members using TRICARE Reserve Select
  • Retired Guard and Reserve members using TRICARE Retired Reserve

Other requirements for TRICARE Young Adult coverage include:

  • At least 21 years old, but not yet 26
  • Not eligible to enroll in an employer-sponsored health plan based on their own employment
  • Not otherwise eligible for TRICARE coverage

Monthly premiums apply, and plan options mirror Prime or Select.

For those enrolled in a TRICARE plan, coverage and costs can change when a service member retires, leaves active duty, or reaches Medicare eligibility.

Veterans Affairs (VA) Health Care

The U.S. Department of Veterans Affairs (VA) operates a nationwide health care system for eligible veterans. Veterans who have a service-related disability or who are low-income are prioritized for coverage under the VA program. Additional eligibility categories are available here. Those who received a dishonorable discharge are not eligible for VA benefits.

VA health care is different from private insurance; it is a health care delivery system. Veterans enroll and receive care directly at VA medical centers and clinics, or through approved community providers in certain cases.

Instead of choosing between plan types, veterans:

  • Apply and enroll
  • Are assigned to a priority group
  • Receive care based on eligibility and service history

Eligibility depends on military service, disability status, income, and other criteria.

Some veterans pay no premiums or copays. Others may pay copays for certain services or prescriptions.

Enrollment is required. Not all veterans are automatically enrolled.

CHAMPVA

The VA also administers the Civilian Health and Medical Program of the Department of Veterans Affairs, commonly called CHAMPVA.

CHAMPVA provides health care coverage for certain spouses, surviving spouses, and children of veterans who:

  • Died in the line of duty
  • Have a permanent and total service-connected disability
  • Died from a service-connected disability

CHAMPVA is different from VA health care. It is a health coverage program rather than a VA facility-based care system. Eligible family members may receive care from authorized civilian providers.

Cost-sharing, deductibles, and coverage rules apply. Enrollment is required.

CHAMPVA beneficiaries who become eligible for Medicare must enroll in Medicare Part B to maintain CHAMPVA coverage.

CHAMPVA is also different from TRICARE. In general, TRICARE serves active-duty members, retirees, and their families, while CHAMPVA serves certain family members of veterans who are not eligible for TRICARE.

Using Military or Veterans Coverage with Other Insurance

Some service members, retirees, and veterans qualify for more than one type of coverage. When this happens, rules determine which program pays first and how costs are shared.

TRICARE and Medicare

Military retirees and eligible family members who enroll in Medicare can keep TRICARE through TRICARE For Life.

In most cases:

  • Medicare pays first for covered services.
  • TRICARE pays second.
  • The individual may have little or no out-of-pocket cost for covered care.

Enrollment in Medicare Part B is required to keep TRICARE For Life. If someone does not enroll in Medicare Part B when first eligible, they can lose access to TRICARE coverage.

VA Health Care and Medicare

VA health care and Medicare do not coordinate in the same way as TRICARE.

VA coverage generally pays for care received at VA facilities or through VA-approved community providers. Medicare pays for care received from Medicare providers outside the VA system.

If a veteran receives care outside the VA system without VA authorization, the VA will usually not pay the bill. In that case, Medicare may pay, depending on coverage.

Because the two systems operate separately, many veterans enroll in Medicare when they become eligible, even if they primarily use VA services.

TRICARE or VA With Employer-Sponsored Coverage

Some veterans and military retirees continue working and receive employer-sponsored coverage.

When someone has both employer coverage and TRICARE, coordination rules determine which plan pays first. This often depends on:

  • Employment status
  • Age
  • Whether the person is retired from the military

VA health care does not usually coordinate payment with employer-sponsored insurance. Instead, each system generally pays for care delivered within its own network.

Why Coordination Matters

Having more than one type of coverage does not eliminate all costs. Each program has its own:

  • Enrollment rules
  • Provider networks
  • Referral requirements
  • Cost-sharing structure

Using the wrong provider, missing an enrollment deadline, or failing to enroll in required programs, such as Medicare Part B, can result in unexpected bills.

Eligibility can also change over time. Retirement, relocation, disability rating changes, or aging into Medicare may affect coverage.

Related Resources

These materials were supported by funds made available by the Kentucky Department for Public Health’s Office of Population Health from the Centers for Disease Control and Prevention, National Center for STLT Public Health Infrastructure and Workforce, under RFA-OT21-2103.​

​The contents of these materials are those of the authors and do not necessarily represent the official position of or endorsement by the Kentucky Department for Public Health or the Centers for Disease Control and Prevention.