The US Family Health Plan

The US Family health plan is a government-sponsored health care plan for military personnel, retired veterans and their dependants. It is one of the insurance options that are available under TRICARE, a civilian component of the U.S. Military Health System. While non-profit organizations provide the insurance policy itself, the federal government provides funding and regulations. The U.S. Family Health Plan is available in northeast United States, Southeast Texas, Southwest Louisiana region and specific regions of Washington state.

Understanding TRICARE

The military has historically provided health care for soldiers and their families. During World War II and the Korean War, the number of recruits increased sharply, putting the strain on the system. As a result, the US Congress passed a legislation that allowed the military health system to sub-contract it's services to civilian health care providers. The system was revamped in 1997, becoming known as TRICARE. The biggest difference was that members of the military were allowed to choose from several health care options. Those options include TRICARE Basic, TRICARE Extra and TRICARE Prime.

TRICARE Prime is structured similar to an HMO. Members of the military must choose a primary care physician. This is the physician they would visit for all their health care needs. If their problems fall beyond the physician's expertise, the doctor can refer them to another health care provider. As with HMOs, the insurance provider pays part of the resulting medical costs while the enrollee pays off the rest. However, unlike HMOs, members of the military who are enrolled in a TRICARE Prime plan get help from the federal government, which pays most of their share of the bill. The enrollees are only required to make small co-payments, which reduces their medical expenses significantly.

Understanding US Family Health Plan

The US Family Health Plan is one of the TRICARE Prime plans available and these plans do not have limits based on pre-existing conditions. As long as the enrollment fees are paid, the plan continues without interruption. Eligible members can enroll at any time and the benefits are extended quickly. The benefits include all medical treatments, including preventative care.

While other TRICARE Prime plans are provided by private organizations, this plan is provided by non-profit organizations and is only serviced in specific areas. They are:

  • John Hopkins Medicine, which provides coverage in Maryland, Washington D.C. and parts of Pennsylvania, Virginia, West Virginia and Delaware.
  • Martin's Point Health Care provides coverage in Maine, New Hampshire, Vermont and northeastern New York.
  • Brighton Marine Health Center covers Massachusetts and Rhode Island.
  • Saint Vincent Catholic Medical Centers network covers New Jersey, western Connecticut and parts of New York and Pennsylvania that the other plans do not cover. 
  • Christus Health covers southeast Texas and southwest Louisiana.
  • Pacific Medical Center covers Washington state's Puget Sound region.

Enrollees must choose a primary care physician from their region. If they move to another region covered by US Family Health Plan, they can request to be transferred to the local provider. If they move to an area that's not covered by US Family Health Plan, they can transfer to a local TRICARE Prime health care provider. In addition, if emergency medical treatment is required while on vacation, the US Family Health plan will cover a member of the military anywhere.

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