Frequently Asked Questions

To view the appropriate frequently asked questions, please select which US Family Health Plan is right for your situation.

• Active-duty family members FAQ
• Military beneficiaries with Medicare Part B FAQ
• Military retirees without Medicare Part B FAQ

Active-duty family members FAQ

How much does US Family Health Plan (USFHP) cost?

For an active duty family member US Family Health Plan is free, you pay no enrollment fees.

I am covered through my employer’s plan. Why should I join USFHP?

Among other reasons, cost. If you are paying anything out of your paycheck for your healthcare costs, US Family Health Plan is a better deal since it is free. Also, USFHP can supplement the high-deductible health plans common in the marketplace today and help pay your deductibles and cost shares if the claim is for a covered expense under TRICARE.

What’s the difference between TRICARE Prime and US Family Health Plan?

Your covered benefits under US Family Health Plan are the same as TRICARE Prime. The major differences are in how your TRICARE Prime benefit is administered and delivered. For instance, with US Family Health Plan, you will receive same-day primary care appointments and specialist referrals without paperwork or referral authorization delays. With USFHP you will always be referred to our network of civilian specialists.

What additional advantages and features does USFHP offer?

In addition to a fully covered annual eye and annual physical exams, USFHP members receive discounts on an array of health services not covered by TRICARE, including fitness club memberships, eyeglasses, nutritional supplements and nutrition counseling, and access to complementary alternative health providers like chiropractors, massage therapists, acupuncturists and naturopaths.

May I use a military treatment facility (MTF) while enrolled in US Family Health Plan?

US Family Health Plan provides you with all civilian providers—all the time. You may not use a military treatment facility while enrolled in US Family Health Plan, unless you have a life-threatening medical emergency and the MTF is the closest medical facility.

When can I join, and when will my coverage start?

You can join US Family Health Plan at any time; enrollment is always open. For an active duty family member who is already covered under TRICARE Prime, coverage will take effect the day your application is processed; otherwise, your coverage begins on the first day of the month if we receive your application by the 20th of the prior month.

Military beneficiaries with Medicare Part B FAQ

How much does it cost?

Coverage is free to anyone enrolled in Medicare Part B

Is US Family Health Plan separate from TRICARE or part of TRICARE?

US Family Health Plan is one option under TRICARE. As a US Family Health Plan member you receive all the benefits offered by the TRICARE programs, plus additional advantages and features at no extra cost.

I am covered under TRICARE for Life. What’s the difference?

Once you become a US Family Health Plan member your care will be guided by a Primary Care Physician and a nurse practitioner that function as your personal-care managers. This arrangement provides you with a team of highly qualified healthcare professionals who coordinate your care and advocate for you to make sure you get all the care and services you need to remain healthy and independent. USFHP takes a pro-active approach to your health care and emphasizes disease prevention.

Why should I change from TRICARE for Life when I can go anywhere I want for care?

Most people want freedom of physician choice so they can access the best quality of care available, but not all doctors accept Medicare reimbursement. Pacific Medical Center provides you with an assurance of quality by individually selecting the physicians who practice within its medical group (100% are board Certified). Additionally, Pacific Medical Center’s providers are reviewed annually to ensure quality is maintained. Our goal is to provide you with all the health care services you need from physicians who are top in their fields and who will never turn you away because of your insurance.

How long is the enrollment commitment?

There is no long- term commitment to stay enrolled in USFHP. If for any reason you terminate your enrollment, your TRICARE For Life coverage is automatically and immediately activated if you have Medicare Part B.

Do I need Medicare Part B to enroll in US Family Health Plan?

No, unlike TRICARE for Life, Medicare Part B is not a requirement to become a US Family Health Plan member, but selecting Medicare Part B will eliminate your enrollment fees and office visit and hospital co-payments. Although we highly recommend Medicare Part B enrollment, if you do not enroll in Medicare Part B, you can still be enrolled under the TRICARE Prime benefit with USFHP.

What additional benefits does USFHP offer?

USFHP members have no paper work and receive same day primary care appointments, fully covered annual physical and eye exams, and no “spell of illness” benefit limitations for hospitalization or skilled nursing care. There are also no deductibles or cost shares for out of country coverage.

US Family Health Plan members receive benefit enhancements not covered by TRICARE like discounts on eyewear, chiropractic care, massage therapy, acupuncture, naturopathic care, nutrition supplements and nutrition counseling.

Military retirees without Medicare Part B FAQ

How much does US Family Health Plan (USFHP) cost?

Click here to see costs and fees.

I am covered through my employer’s plan. Why should I join USFHP?

Among other reasons, sticker shock. If you are contributing from your paycheck more than $260 annually for yourself or $520 for your family, US Family Health Plan is a better deal. The comprehensiveness of coverage offered by USFHP compares very favorably against the high-deductible health plans common in the marketplace today. Even if you are not contributing anything towards your employer sponsored health insurance, US Family Health Plan will help pay your deductibles and cost shares if it is for a covered expense under TRICARE.

I am currently covered under TRICARE Prime. What’s the difference?

Your covered benefits under US Family Health Plan are the same as TRICARE Prime. The major differences are in how your TRICARE Prime benefit is administered and delivered. For instance, with US Family Health Plan, you will receive same-day primary care appointments and specialist referral authorization without any red tape or delays.

What additional advantages and features does USFHP offer?

In addition to a fully covered annual eye and annual physical exams (rather than every 24 months with TRICARE Prime), USFHP members receive discounts on an array of health services not covered by TRICARE, including fitness club memberships, eyeglasses, nutritional supplements and nutrition counseling, and access to complementary alternative health providers like chiropractors, massage therapists, acupuncturists and naturopaths.

I am a retiree. What if I have already paid my TRICARE Prime fees?

If you have already paid your TRICARE Prime enrollment fees, we will coordinate with TRICARE to have them credited to your USFHP membership.

May I use a military treatment facility (MTF) while enrolled in US Family Health Plan?

You may not use a military treatment facility while enrolled in US Family Health Plan, unless you have a life-threatening medical emergency and the MTF is the closest medical facility.

When can I join, and when will my coverage start?

You can join US Family Health Plan at any time; enrollment is always open. If you are an active duty family member or a retiree who is already covered under TRICARE Prime, your coverage will take effect the day your application is processed; for others, your coverage begins on the first day of the month if we receive your application by the 20th of the prior month