Frequently Asked Questions
What is the US Family Health Plan (USFHP)?
The Uniformed Services Family Health Plan is a managed care program developed by the Department of Defense (DoD). Its roots are tied to the Public Health Service, whose origins can be traced to the passage of an act in 1798 that directed the care and relief of sick and injured merchant seamen. Federal legislation in 1981, 1993, and 1997 consolidated the nation’s public health service hospitals, created a managed care health plan called the Uniformed Services Family Health Plan, and directed the DoD to include the USFHP as a healthcare option for the uniformed services. Since 1998, Johns Hopkins has held a sole-source contract with the DoD to provide TRICARE Prime benefits to eligible beneficiaries. As the top-rated private health insurance plan in Maryland*, we are honored to offer you and your family the comprehensive TRICARE Prime benefits and partner with you on your journey to optimal health.
*NCQA Private Health Insurance Plan Ratings 2017-2018
What is a “Qualifying Life Event (QLE)?”
Qualifying Life Events are times outside of the open enrollment period when you can enroll in a new TRICARE plan or change your coverage options*. These events include:
|Military Changes||Family Changes|
Injured on Active Duty
Separating from Active Duty
Having a Baby or Adopting
Children go to College
Children become Adults
Death in Family
Loss / Gain of Other Health Insurance
* TRICARE.mil website
What happens if I have a QLE during Open Season – how does that affect my coverage? What do I need to do?
If you have a QLE during Open Season, you have two options to choose from, which affects the start date of your coverage:
- If you enroll under your Open Season option, coverage starts 1 January.
- If you enroll within 90 days of your QLE, your coverage starts on the date of your event (backdated).
What you need to do:
- Do nothing if you want to continue with your current plan into the next year
- Enroll in a different plan during Open Season, making appropriate fee payment arrangements. Coverage under the new plan starts 1 January.
- Enroll in a different plan within 90 days of a QLE. If you do this, and make appropriate enrollment fee payments, your coverage starts on the date of the QLE.
What is an Open Season?
Open Season is the time of year when you are eligible to enroll in a health plan for the next year. For TRICARE, enrollment Open Season runs from Nov. 14 through Dec. 13.
Why is TRICARE having an Open Season?
Law requires beneficiaries to elect coverage. The Open Season allows you to change plans based on your own needs or personal choice. TRICARE now mirrors the open season approach used by other major commercial plans, market-based plans, and federal health plans.
Does Open Season affect every TRICARE option?
No. Open Season only affects those who want to enroll in TRICARE Select, TRICARE Prime, TRICARE Prime Remote, or the US Family Health Plan. Eligible beneficiaries who experience a change in military status (retire from Active Duty or draw their Reserve retired pay) can sign up within one year of that qualifying life event. All other eligible beneficiaries can enroll in these aforementioned options during Open Season or within 90 days after a qualifying life event. All other TRICARE options have continuous open enrollment at any time during the calendar year. TRICARE for Life requires Medicare Parts A & B for eligibility.
|Type of Enrollment for Each Plan||TRICARE’s Open Season||Qualifying Life Event||Continuous Open Enrollment||Other|
|TRICARE Prime / Prime Remote / USFHP||✓||✓|
|TRICARE Young Adult – Prime or Select||✓|
|TRICARE Reserve Select||✓|
|TRICARE Retired Reserve||✓|
|Continued Healthcare Benefits Program||✓|
|TRICARE For Life||Must have Medicare Parts A & B|
Must everyone in our family select the same TRICARE option?
No. Beneficiaries have the flexibility to select a TRICARE option that is best for each individual – this practice is commonly referred to as Split Enrollment. For example, one spouse could choose TRICARE Select, the other choose TRICARE Prime, and the children could be enrolled in the Johns Hopkins USFHP.
Why should I choose the USFHP over TRICARE Select or other TRICARE Prime coverage?
The US Family Health Plan offers members an unsurpassed level of choice, convenience, and access to an extensive network of doctors, specialists, and hospitals in the DC capital region and parts of five states. Unlike TRICARE Select, USFHP members don’t pay high deductibles or percentage copays. USFHP is the only TRICARE Prime option where you choose a network specialist and get referrals to locations you want to be seen for specialty care.
If I switch from TRICARE Select to USFHP during Open Season, when will my USFHP coverage start?
If you switch to USFHP before Open Season, your coverage starts on your enrollment date. If you switch to USFHP during Open Season, your USFHP coverage starts 1 January.
If I switch from TRICARE Prime to USFHP during Open Season, when will my coverage start?
Since USFHP is a TRICARE Prime option offered in just six areas of the country, you can switch between TRICARE Prime and USFHP anytime, if you meet USFHP eligibility requirements. Switching between TRICARE Prime and USFHP is considered a change in your Primary Care Provider. Once you switch to USFHP, you will have access to a vast network of providers in the DC Capital Region and five states, including Maryland and parts of Virginia, West Virginia, Pennsylvania, and Delaware. Enrolling is easy: (1) ensure your family information is updated in DEERS (800-538-9552), (2) select a Primary Care Provider, and (3) enroll over the phone in minutes by calling 410-424-4780.
If I join the Johns Hopkins USFHP, will I need to travel to Baltimore for care?
No. Johns Hopkins has partnered with an extensive network of doctors, specialists, and hospitals in the DC capital region and five states. USFHP members can choose trusted Johns Hopkins partners that serve areas close to home or work. Of course, you will also have access to Johns Hopkins Medicine, a world-renowned health system with over 125 years of health care experience.
I’m already a USFHP member. Do I need to sign up again for USFHP during Open Season?
No. Current USFHP members do not need to take any action: they will be automatically re-enrolled with Johns Hopkins USFHP. Your coverage continues without interruption, as long as you:
- Remain TRICARE eligible,
- Qualify for enrollment, and
- Pay your enrollment fees on time (if applicable)
I’m already a USFHP member. Will I be able to switch my primary care location and/or doctor after Open Season?
What if I enroll in TRICARE Select during Open Season and realize I want to go back to USFHP. What can I do?
During Open Season, you can switch between plans as many times as you want as long as you qualify to enroll in either plan. Your new coverage starts 1 January.
Will I be able to change between TRICARE Prime and TRICARE Select outside the Open Season period?
Yes, but only if one of the members in your family has a Qualifying Life Event.
I understand that the Johns Hopkins US Family Health Plan is a TRICARE Prime option. In the past, I’ve been able to switch between TRICARE Prime and the US Family Health Plan when I wanted. Will I be able to switch between these TRICARE Prime options after Open Season?
Yes. Switching between TRICARE Prime and USFHP is considered a change in your Primary Care Provider. Once you switch to USFHP, you will have access to a vast network of providers in the DC Capital Region and five states, including Maryland and parts of Virginia, West Virginia, Pennsylvania, and Delaware. Enrolling is easy: (1) ensure your family information is updated in DEERS (800-538-9552), (2) visit HealthLINK to select a Primary Care Provider, and (3) enroll over the phone in minutes by calling 410-424-4780.
Does USFHP offer dental insurance?
No. USFHP does not include dental insurance. However, USFHP does offer value-added dental services at no additional cost. Members receive two free dental cleanings annually. You also have access to select Concordia Advantage PPO dentists that offer great discounts*.
* Virginia law prohibits dental service discounts. USFHP Members can take advantage of discounted pay-as-you-go dental services if they visit participating sites throughout the network in Washington DC, Maryland, and portions of West Virginia, Pennsylvania, and Delaware. Participating dentists in Virginia will perform two free dental cleanings for members.
Does USFHP offer a vision plan?
No. USFHP is not a traditional vision plan. However, USFHP does offer value-added vision services at no extra cost that includes a free eye exam annually. In addition, the Johns Hopkins Wilmer Eye Clinic and partner vision centers in our network offer great discounts for USFHP members on eye wear.
USFHP members are encouraged to review vision plans offered by an employer. Military retirees are also eligible to select vision plans offered through the Office of Personnel Management’s Federal Employees Dental and Vision Insurance Program (FEDVIP).
More information about the TRICARE’s Vision coverage is available here.
What is the Federal Employees Dental and Vision Insurance Program (FEDVIP)?
FEDVIP is optional dental and vision insurance available through the Office of Personnel Management. It is NOT a TRICARE benefit and must be purchased separately if you want FEDVIP coverage.
- Vision: Eligible TRICARE beneficiaries have four vision plan options
- Dental: Ten dental plan options are available for retirees and their family members. NOTE: FEDVIP replaces the current TRICARE Retiree Dental Program (TRDP), effective 1 January 2019. If you currently have TRDP, you need to enroll in FEDVIP Dental or any other commercial plan to have dental coverage in 2019.