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Understanding Military Medical Care


Depending upon their status, active duty members, retired members, members of the Guard/Reserves, family members, and certain veterans receive free or government subsidized medical and dental care. For the most part, this care falls under an overall program known as "Tricare." While the Tricare system may appear to be complicated at first glance, it's really not all that hard to understand.


Prior to the 1980s, there were basically two ways for military personnel, retirees, and family members to receive military health care. Military members received treatment at military medical facilities, and retirees and family members received free treatment (space available) at military medical facilities, or could use a program known as CHAMPUS (Civilian Health and Medical Program Uniformed Services) to receive government-substidized medical care from civilian providers.

The idea of military medical care for the families of active-duty members of the uniformed services dates back to the late 1700s. In 1884, Congress directed that the “medical officers of the Army and contract surgeons shall whenever possible attend the families of the officers and soldiers free of charge.” There was very little change until World War II. Most draftees in that war were young men who had wives of childbearing age. The military medical care system, which was on a wartime footing, couldn't handle the large number of births, nor the care of very young children. In 1943, Congress authorized the Emergency Maternal and Infant Care Program (EMIC). EMIC provided for maternity care and the care of infants up to one year of age for wives and children of service members in the lower four pay grades. It was administered by the “Children's Bureau,” through state health departments.

The Korean conflict again strained the capabilities of the military health care system. On Dec. 7, 1956, the Dependents Medical Care Act was signed into law. The 1966 amendments to this act created what would be called CHAMPUS beginning in 1967. The law authorized ambulatory and psychiatric care for active-duty family members, effective Oct. 1, 1966. Retirees, their family members, and certain surviving family members of deceased military sponsors were brought into the program on Jan. 1, 1967. The CHAMPUS budget for Fiscal Year 1967 was $106 million. Records don't indicate how many claims were filed in FY 1967, but the total probably wasn't more than a few thousand. In FY 1996, the TRICARE/CHAMPUS budget was more than $3.5 billion, and more than 20 million claims were received. Today, nearly 5.5 million people are eligible for TRICARE benefits.

In the 1980s, the search for ways to improve access to top-quality medical care, while keeping costs under control, led to several CHAMPUS “demonstration” projects in various parts of the U.S. Foremost among these was the “CHAMPUS Reform Initiative” (CRI), in California and Hawaii. Beginning in 1988, CRI offered service families a choice of ways in which they might use their military health care benefits. Five years of successful operation and high levels of patient satisfaction convinced Defense Department officials that they should extend and improve the concepts of CRI, as a uniform program nationwide. The new program, known as TRICARE, is now fully in place.

Types of Tricare

When Tricare was first instituted, there were only three types: Tricare Prime, Tricare Standard, and Tricare Extra. Over the past few years, more Tricare options have been established.

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