Understanding Your Coverage
How to get the most out of your US Family Health Plan and extra benefits.
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 benefits and services not available in other TRICARE® plans.
Get all the information you need on your plan’s coverage:
Where to Start: Your Primary Care Provider
Your primary care provider (PCP), is the best place to start when you need any type of health care services.
They can take care of your preventive care, diagnose diseases and illnesses, and help you find the right specialists when you need them. They’ll help you navigate the health care system so you can concentrate on your health. They can work with any specialists you have and put all the pieces together to get the “big picture” of your health.
Choosing a Primary Care Provider
Your PCP is your main point of contact for getting health care services, so it's important you find a doctor or provider who you trust, feel comfortable with, and who encourages you to be an active participant in your health care. Don't treat the decision of choosing a PCP lightly. Do some research and don't be afraid to meet with several doctors before you make a decision. Most health insurance plans allow you to switch PCPs whenever you want, so know that you can always change your mind, too.
- Find a doctor who works as part of a care team: Find a doctor who works as part of a "care team," where a dedicated group of doctors, nurses, educators, and other health care professionals work together to care for US Family Health Plan members.
- See which doctors have been designated as providing high-quality health care: If you're looking for a doctor in Maine, you can check physician ratings at Compare Maine to see which doctors have been designated as providing high-quality health care.
- Be sure to search your health plan's Provider Directory: Most health insurance plans have a network of providers you must use to get the best rates. Be sure to search your health plan's Provider Directory and use an in-network doctor when possible. You'll spend much less on your health care services when you do so.
Enrolling Your Newborn in the US Family Health Plan
How coverage works
A newborn infant is covered as a TRICARE Prime beneficiary in DEERS for the first 90 days after birth, as long as one additional family member is enrolled in the Martin’s Point US Family Health Plan, or a different TRICARE Prime or TRICARE Prime Remote plan. Your baby will be conditionally enrolled in the US Family Health Plan for the first 90 days of their life.
The US Family Health Plan will pay claims for covered services your newborn receives from Day 1 through Day 90 under this Conditional Enrollment. You must complete official enrollment on or before day 90 in order to guarantee continuous coverage.
How to enroll
- Register your newborn in DEERS to establish TRICARE eligibility.
- Submit a completed Enrollment Application to the Martin’s Point US Family Health Plan.
Call the Martin’s Point US Family Health Plan at 1-888-553-3461 as soon as possible after the baby’s birth to notify us of their date of birth. This will help ensure that your child will be conditionally enrolled so we can smoothly process any claims for services your baby receives in the first 90 days.
For additional information and details on enrolling your newborn see:
Additional Member Resources
Find additional information on using your benefits, after-hours and emergency care, prescription and pharmacies, reimbursements and other forms to help manage your health plan.
Have questions? We're here to help.
Call US Family Health Plan Member Services to speak with one of our health plan specialists today. We're here for you!