Term:
Civilian Health and Medical Program - Uniformed Services (CHAMPUS)

Description:
It is also known as CHAMPUS, but has recently been "revamped" to be known as TRICARE. CHAMPUS is a health and medical benefits program that is federally-funded and allows military personnel and their families to receive government-subsidized health care from civilian providers in a cost-shared environment. It covers seven services: the Army, Navy, Air Force, Marine Corps, Coast Guard, Public Health Service, and the National Oceanic and Atmospheric Administration.

CHAMPUS beneficiaries all transfer over to the program Medicare at age 65, in which both programs are similar in that the government makes a contract with private parties to help administer the program and keep it running successfully. However, they do not experience a break in TRICARE coverage because they are also switched over to TRICARE for Life. This plan pays secondary to Medicare. For more information, see TRICARE.

The original CHAMPUS program contained one plan which is now known as TRICARE Standard. This plan is a fee-for-service option which provides more flexibility than the other plans. The other two main plans are TRICARE Extra and TRICARE Prime. Extra is a preferred provider option that saves money and Prime mainly has Military Treatment Facilities as the main source of health care.

TRICARE is completely separate from the new civilian Obamacare. In order to change this military health care, a new legislation would have to be proposed. This means that dependent children's age limit for health care still remains at 21 or 23 depending on if the child is a full-time student. Overall, TRICARE does meet the minimum Obamacare standards, but there still is talk that copay for prescriptions may increase in 2014.

Applications:
CHAMPUS covers most medical bills for diagnosis, treatment, meals, and supplies for those who are eligible to receive them: Military personnel and their families, or more specifically: active duty dependents, retirees and their dependents, spouses and children of deceased personnel (who have not remarried), divorced spouses who have not yet remarried, and dependents of reservists on active duty for more than 30 days.

TRICARE Prime: All active duty service members are eligible for this plan. Most of the care provided is by military medical personnel along with the contracted civilian medical providers. These providers are called the Preferred Provider Network. It includes a primary care manager who can refer you to specialists if necessary.

TRICARE Extra: This plan has no enrollment fee or deductible when using retail pharmacy network. One can choose any doctor in the TRICARE Extra network but does not have a primary care manager. Care in a military hospital is dependent on space available, but one's availability is a low priority.

TRICARE Standard: This plan allows for the greatest choice of civilian health care providers. It is widely available, but the patient must pay a deductible and copayment. It is one of the minimalist health care plans. Some out of pocket expenses may include paying the balance of a bill if it exceeds the allowable charge.

Web Resources:
Federal Register
TRICARE
Military.com
TRICARE South

Related Terminology:
  • TRICARE
  • CHAMPVA
  • Military Medical Care
  • Defense Health Agency
  • Humana Military
  • MetLife

Citations/References:
Integrated Publishing's Source on CHAMPUS
Understanding Military Medical Care on About.com
MedicineNet's Medical Definition
Understanding Health Care Reform's Effect on TRICARE
TRICARE Benefits Explained
TRICARE Help

Graphics:

external image US-TRICARE-Logo.svgexternal image tricare-map-region-info.jpgexternal image TRICARE_Timeline.jpg