Military Healthcare FAQ
TRICARE is the US Department of Defense (DoD) health insurance program for US military personnel and their families. UK active duty personnel and their dependants are also entitled to healthcare coverage under TRICARE.
The entitlement for UK Active-Duty members and their dependents to receive health care under TRICARE is enshrined in a Memorandum of Understanding (MOU) between the Department of Defence of the United States of America and the Government of the United Kingdom of Great Britain and Northern Ireland. This entitlement is also reflected in the DoD TRICARE Policy Manual as summarised below:
TRICARE Policy Manual 6010.60-M, April 1, 2015 Chapter 1 General Policy and Responsibilities.
3.3.5 Non-DoD TRICARE Eligibles. TRICARE eligibles sponsored by non-DoD uniformed services (the Public Health Service (PHS), the U.S. Coast Guard (USCG), and the National Oceanic and Atmospheric Administration (NOAA) are eligible for TRICARE and may enrol in TRICARE Prime or TRICARE Select (beginning January 1, 2018).
3.3.6 North Atlantic Treaty Organization (NATO) And Partnership for Peace (PfP) Beneficiaries. The Department of Defense equates foreign military members and family members from PfP countries the same as those from NATO Status of Forces Agreement (SOFA) countries, in terms of access to outpatient medical and dental care from DoD medical and dental treatment facilities, and access to TRICARE Select (TRICARE Standard before January 1, 2018) civilian care.
A current list of NATO SOFA countries is at: LINK
A current list of NATO PfP countries is at: LINK
18.104.22.168 NATO or PfP ADSM. As specified in applicable SOFAs, active-duty members of the armed forces of NATO and PfP nations qualify for TRICARE outpatient services in similar fashion as their U.S. Armed Forces active-duty counterparts. However, there is no coverage for inpatient services under TRICARE. No enrolment in a TRICARE plan is required or authorized. As such contractors shall not use the government furnished web-based enrolment system/application to determine eligibility. See the TOM, Chapter 17, Section 3, and TRM, Chapter 4, Sections 2 and 4 for more information.
22.214.171.124 NATO or PfP Family Members. Family members of active-duty members of the armed forces of NATO and PfP nations are only eligible for outpatient care under TRICARE; there is no coverage for inpatient services under TRICARE. Effective January 1, 2018, TRICARE Select Group B cost-shares for Active-Duty Family Members (ADFMs) apply.
Prior to January 1, 2018, TRICARE Standard/Extra cost-shares for ADFMs apply. No enrolment in TRICARE plan is required or authorized. As such, contractors shall not use the government furnished web-based enrolment system/application to determine eligibility. See TOM, Chapter 17, Section 3; TRM, Chapter 2, Section 2, and Chapter 4, Sections 2 and 4; and TRICARE Systems Manual (TSM), Chapter 2, Addendum L for more information.
If you are active duty, you will be enrolled as ‘Direct Care’. Under the terms of the Reciprocal Healthcare Agreement (RHCA) between the UK and US governments, you have access to treatment at military facilities at the highest priority level.
If you are a dependant, you will be registered as ‘TRICARE Select’. However, under the terms of the RHCA, you are entitled to treatment at military facilities as though you are registered as ‘TRICARE Prime’. This gives you the second highest level of priority for care at military facilities, after active duty personnel. You will be registered as ‘TRICARE Select’ despite this agreement because the computer system will not allow non-Americans to be registered as ‘Tricare Prime’.
Your coverage under Tricare is referred to as TRICARE Prime. If you go to a civilian facility your coverage may be referred to as TRICARE Select. The coverage is the same.
In special circumstances Active Duty members and/or their dependents cannot be enrolled for TRICARE coverage. In such circumstances the member and/or their dependents will be enrolled in a civilian healthcare plan managed by Meritain Health. The plan name is Aetna Choice POS II. This plan is only for members and/or their dependents who for whatever reason cannot be enrolled under TRICARE.
For details on the benefit entitlements under this plan including what is covered and what is not covered, click on this LINK.
A FIN is a unique 9-digit number starting with 9 that you must ask for and make a note of when you receive your military ID card. It is used by the military healthcare system for international personnel, instead of a Social Security Number. Dependants are also issued FINs, however it is the active duty member’s FIN which must be provided when making appointments, receiving healthcare etc.
An MTF is a US military clinic/hospital. You must use MTFs as your primary source for all of your healthcare needs. Treatment at an MTF may be referred to as ‘on base’ care.
To make an appointment to see a doctor you should call the appointment line of your closest/preferred MTF. You do not need to obtain authorisation from the Healthcare Department at the British Embassy for any MTF appointments or for any treatment offered to you that will physically take place at the MTF.
If you are trying to make an appointment and you are told you are not eligible for care, please stress that you are UK NATO/a UK NATO dependant and therefore entitled to the same care as US military active duty personnel/ a US military dependant enrolled in TRICARE Prime, under the RHCA. If the MTF will still not schedule your appointment, please contact the Healthcare Department at the Embassy for assistance.
If you are active duty, your military doctor will coordinate the referral request with Tricare, who will provide you with an authorisation letter. You must receive care under the authorisation (following any specific instructions) before it expires. For care that is properly authorised, you should not receive any bills. The only exception is inpatient care with a civilian provider. This is not covered by Tricare; therefore you must contact the Healthcare Department at the Embassy if you are referred off base for an inpatient procedure, as additional insurance cover will need to be arranged.
If you are a dependant, you must contact the Healthcare Department at the Embassy before receiving any non- emergency care (outpatient or inpatient) with a civilian provider. Approval for your care off base is required from Defence Medical Services (DMS) in the UK. This is because Tricare will only cover a portion of the fees; therefore your treatment will need to be funded in part by the MOD. You must obtain authorisation from DMS for all off- base treatment and appointments, regardless if they have been authorised by Tricare.
No. If you have been referred to a civilian provider, and you’ve received authorisation for your appointment/ treatment (from DMS, via the Healthcare Department at the Embassy), you must locate a provider that is ‘in- network’ with Tricare. The MOD does not fund care with ‘out-of-network’ providers. To locate an ‘in-network’ provider, you must contact your Tricare regional contractor (see UKGOV.net for details of regional coverage):
South: or http://www.humana-military.com/south/provider/tools-resources/ProvSiteProvLoc.asp
West: or https://www.uhcmilitarywest.com/uhcmw/portal/search/providerbyname/
For both active duty and dependants, the US DoD should meet all medical costs for treatment obtained at an MTF. If you receive a bill for any treatment obtained on base, please contact the Healthcare Department at the Embassy for assistance.
If you are active duty, the US DoD should also meet all medical costs for treatment obtained from a civilian provider, with the exception of inpatient care. Information regarding billing for inpatient care will be provided when you contact the Healthcare Department at the Embassy to inform them of your requirement for inpatient care. If you receive a bill for any outpatient treatment obtained off base, please contact the Healthcare Department for assistance.
If you are a dependant, any time you use civilian care a bill will be generated by the medical provider. These bills are valid expenses. The MOD will fund any costs not covered by Tricare for all treatment received at a civilian Emergency Room. The MOD will also fund any costs not covered by Tricare for non-emergency treatment, provided you have received prior authorisation for your care from DMS via the Healthcare Department. If you have authorisation, you can submit a claim for any fees not covered by TRICARE.
Valid claims can be submitted to the Claims Processing Centre at the British Embassy using a Form 200. You must attach the invoice from the medical provider, an Explanation of Benefits for your visit (this is an itemised statement from TRICARE that shows what action has been taken on claims submitted by a civilian healthcare provider) and the email from the Healthcare Department authorising your treatment (unless you received care at an Emergency Room). The hardcopy form and supporting documents must be posted to the Embassy.
All prescriptions must be filled at a military pharmacy, where they will be free of charge.
If you are active duty and, as a result of an emergency, you need to have a prescription filled outside of base pharmacy hours, you do not have coverage off base for prescriptions. If you have to use a civilian pharmacy, you will have to pay for the prescription and request reimbursement of the cost.
If you are a dependant and, as a result of an emergency, you need to have a prescription filled outside of base pharmacy hours, you have coverage off base for prescriptions. If you have an urgent prescription requirement, you must locate a civilian pharmacy that is ‘in-network’ with TRICARE (call 1-877-363-1303). You should present your military ID to the pharmacist and inform them that you have Tricare Standard insurance. You will be charged a co-payment. You can claim back this co-payment (less the equivalent of an NHS prescription charge, unless you are exempt) through the Embassy.
If you are active duty, you are not covered for visits to UCCs unless referred to one by the MTF. If you use an UCC without a referral, it will not be funded Tricare or the MOD and all costs will be a personal expense. If you do not have a referral, you must use an ER.
If you are a dependant, you can use only use an UCC in two instances:
1. If referred to one by the MTF during their opening hours (due to unavailability of appointments)
2. If you require urgent care outside of MTF hours (weekends and evenings/nights)
The UCC must be ‘in network’ with Tricare. To locate an ‘in-network’ provider, you must contact your Tricare regional contractor. The MOD will not fund care received at an out of network provider.
If you are active duty, you must use a military dental clinic (on base/at an MTF). Your treatment will be funded in full by the US DoD, therefore you do not need authorisation from the Healthcare Department at the Embassy for any treatment offered/received, and you will not receive any bills for care.
If you are a dependant, your dental care will be facilitated through the MOD’s private healthcare plan, administered by Meritain Health. You will be enrolled in the plan three months after you arrive in the US. The plan is designed to mirror all clinically necessary treatment that would be available to you on the NHS in England. To obtain care, you must locate a dentist that is in the Aetna Dental Access network. Some procedures/treatments are automatically covered and require no authorisation; however others require approval before you receive treatment. It is important that you familiarise yourself with these before you receive any dental treatment.