US Family Health Plan, a TRICARE Prime® Option

The US Family Health Plan pairs all your TRICARE Prime benefits, including prescription drugs, with the convenience of a wide network of local civilian doctors to receive high-quality, low-cost health care. Plus, you’ll get additional services and discounts not available in other TRICARE® plans.

The US Family Health Plan is available to eligible military beneficiaries in Maine, New Hampshire, Vermont, upstate and western New York, and northern Pennsylvania.

Prime Benefits and Services

  • No deductibles or cost shares for in-network preventive services
  • Annual physicals, eye exams, laboratory tests, prenatal and postnatal maternity care at no additional cost
  • Comprehensive prescription drug coverage
  • Emergency and urgent care available anywhere in the world
  • Mental health and substance abuse care through the Behavioral Health Care Program
  • Patient advocates who will make sure you’re getting the best care possible during hospital stays
  • Point-of-Service benefit for medically necessary, non-emergency, non-urgent care outside of network without a referral from your PCP. For more information, please see the Point of Service Benefit page.
     

US Family Health Plan Extras

  • Large network of civilian doctors in your community
  • Easy referrals to specialists—your primary care provider will handle the paperwork
  • Excellent health care and customer service
  • Access to a 24-hour nurse line for health questions, with the option to call or send a secure message
  • Access to a Health Coach for information and guidance for healthy living and managing health conditions like diabetes and asthma
  • Discounts on eyewear and additional eye care services
  • Discounts on acupuncture, chiropractic massage therapy, naturopathy, nutrition, and more
  • Discounts on hearing aids and batteries
  • Discounts on fitness centers, yoga, tai chi, and more
     

Costs

  • No deductibles for all US Family Health Plan members
  • No enrollment fees for active-duty family members
  • Low enrollment fees for retirees and their families not in Medicare Part B
  • For Medicare Part B participants: Applicants who show proof that they pay monthly Medicare Part B premiums are exempt from the enrollment fees
  • Low out-of-pocket maximums for individuals and families
  • Point-of-Service benefit has a deductible and coinsurance

See Active-Duty Summary of Benefits or Retiree Summary of Benefits document on the right-hand side of this page for benefit/cost information.

Prescription Drugs (2021)

These costs are for prescription drugs included in the US Family Health Plan formulary (list of covered drugs). See if your prescriptions are covered.


Retail Network Pharmacies (e.g. Rite Aid, CVS, Walgreens) (up to a 30-day supply)*
Martin’s Point On-Site and Mail-Order Pharmacies (up to a 90-day supply)
Current Effective 1/1/22 Current Effective 1/1/22
Generic (Tier 1) $13 $14 $10 $12
Brand-Name (Tier 2) $33 $38 $29 $34
Nonformulary (Tier 3)
Brand and Generic
$60 $68 $60 $68
Non-Covered Drugs (Tier 4) 100% cost of the drug 100% cost of the drug 100% cost of the drug 100% cost of the drug

*For 90-day supply cost, multiply by three.

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Get details on how to enroll by phone or online—it’s fast and easy.