The U.S. Military Health System, with a budget of $48.7 billion in FY 2013, provides medical benefits to 9.7 million active duty servicemembers, National Guard and Reserve members, retirees, and dependents.

Specifically, the Military Health System provides services through Department of Defense (DOD) medical treatment facilities (MTFs) – 56 hospitals and 365 clinics – as space is available, private health plans, and civilian health care providers. Operating worldwide, it employs some 58,369 civilians and 86,007 military personnel.

It is designed to maintain the health of military personnel so they can carry out their military missions and to be prepared to deliver health care during wartime. The Military Health System also covers dependents of active duty personnel and military retirees and their dependents, including some members of the reserve components.

Civilian care to millions of dependents, retirees, and retirees’ dependents is provided through TRICARE.  TRICARE – which is still technically known as Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) – has four main benefit plans with different cost sharing and with availability varying based on the beneficiary’s duty status and location:

  1. TRICARE Prime: Health maintenance organization (HMO) option.
  2. TRICARE Standard: Fee-for-service (FFS) option.
  3. TRICARE Extra: A preferred provider option available for TRICARE Standard beneficiaries.
  4. TRICARE for Life: a Medicare wrap-around option for Medicare-eligible retirees.

Other TRICARE plans include:

  • TRICARE Young Adult: a premium-based health plan available for purchase by qualified dependents who have aged out of TRICARE at age 21, or age 23 for full-time college students.
  • TRICARE Reserve Select: A premium-based health plan that active status qualified National Guard and Reserve members may purchase.
  • TRICARE Retired Reserve: A premium-based health plan that qualified retired members of the National Guard and Reserve under the age of 60 may purchase for themselves and eligible family members.

TRICARE also includes a pharmacy benefit and optional dental plans.

A new 27-page brief from the Congressional Research Service (CRS) describes the military health care system, including the coverage and benefit designs, cost sharing, medical treatment facilities, TRICARE health plan contracting, medical research, budgeting, spending, staffing, operations, and management.  The CRS brief also describes how the Military Health System relates to health insurance changes made through the Affordable Care Act (ACA).  It is an excellent primer for anyone looking to understand the size, scope, and challenges of the military health care system from a health policy perspective.

Also, please also check out my earlier post on the high number of uninsured veterans under 65.