TRICARE Extra Email This Story Print This Story

Under this option, you will choose a doctor, hospital, or other medical provider listed in the TRICARE Provider Directory. If you need assistance, call the Health Care Finder (HCF) at your nearest TRICARE Service Center.

With this option, you don't have to enroll or pay an annual fee. You do have to satisfy an annual deductible for outpatient care, just as you do under TRICARE Standard. The deductible and cost sharing work the same way for TRICARE Extra. In the TRICARE Extra program, when you receive care from a TRICARE Extra network provider, you get a discount on cost sharing, and you don't have to file your own claims. You don't enroll and may use TRICARE Extra on a case-by-case basis just by using the network providers. TRICARE Extra is not available overseas or to active duty service members.

Who is Eligible for TRICARE Extra?

Anyone who is CHAMPUS eligible may use TRICARE Extra. (Active duty personnel are not CHAMPUS eligible and are enrolled in TRICARE Prime).

Advantages

  • Copayment 5% less than TRICARE Standard
  • No balance billing
  • No enrollment fee
  • No deductible when using retail pharmacy network
  • No forms to file
  • You may use also TRICARE Standard

Disadvantages

  • No Primary Care Manager
  • Provider choice is limited
  • Patient pays Deductible and Copayment
  • Nonavailability statement may be required for civilian inpatient care for areas surrounding MTFs
  • Not universally available

Summary -- Tricare Extra

  • Choose any doctor in Tricare Extra network
  • Less expensive than Tricare Standard
  • Still may be expensive
  • Enrollment not required
  • Can still seek space-available care in military hospital, but at low priority

TRICARE Extra summarized:

  1. Extra can be used by any TRICARE-eligible beneficiary, who is not active duty, not otherwise enrolled in Prime, and not eligible for TRICARE for Life.
  2. Extra goes into effect whenever a Standard beneficiary chooses to make an appointment with a TRICARE network provider. Extra, like Standard, requires no enrollment and involves no enrollment fee.
  3. Extra is essentially an option for TRICARE Standard beneficiaries who want to save on out-of-pocket expenses by making an appointment with a TRICARE Prime network provider (doctor, nurse practitioner, lab, etc.).
  4. The appointment with the in-network provider will cost 5% less than it would with a doctor who is a TRICARE authorized or participating provider.
  5. Also, the Extra option-user can expect that the network provider will file all claims forms for him. (The Standard beneficiary might have claims filed for him, but the non-network provider can decide to file on his behalf or not, on a case by case basis.)
  6. When using the Extra option, the Standard beneficiary must meet the same requirements to satisfy a deductible and pay a cost share for treatment.
  7. Under TRICARE Extra, because there is no enrollment, there is no Extra identification card. Your valid uniformed services ID card serves as proof of your eligibility to receive health care coverage from any TRICARE Prime provider.
  8. Your uniformed services ID card is, in effect, your insurance card, and you should have it with you whenever you seek medical care. It is your proof of eligibility and it should always be kept current-that is, you should check the expiration date and have it renewed before it expires, and you should make sure that all your personal information is correct and up to date in the Defense Enrollment Eligibility Reporting System (DEERS).

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TRICARE Links
TRICARE Overview
TRICARE Prime
TRICARE Standard
TRICARE Extra
 
TRICARE & American Association of Pediatrics
TRICARE & DEERS (Defense Enrollment Eligibility Reporting System)
TRICARE & WIC (Women, Infants, and Children)
TRICARE Claims How to file a TRICARE Claim
TRICARE Continued Health Care Benefits
TRICARE Dental
TRICARE Eligibility
TRICARE Family-Centered Care includes Obstetric Care
TRICARE for Life
TRICARE for Life and Medicare
TRICARE Generic Pharmacy Brochure
TRICARE Information - Puerto Rico
TRICARE Overseas
TRICARE Pharmacy
TRICARE Prime Enrollment Info
TRICARE Prime Remote
TRICARE Prime Travel and Non-Medical Attendant (NMA)
TRICARE Providers
TRICARE Reserve Select
TRICARE Standard vs Prime






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