What is the US Family Health Plan (USFHP)? | TRICARE Guide

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## Definition The US Family Health Plan (USFHP) is a TRICARE Prime option offered through private, non-profit community health care systems in six specific geographic regions of the United States.

## What it means in practice When you enroll in the US Family Health Plan, you agree to receive all of your medical care—including primary care, specialty care, and prescriptions—from the local USFHP provider network instead of from military hospitals and clinics or the standard TRICARE network. Essentially, you trade access to military facilities for the convenience of a specific, high-quality civilian health system in your area.

For a beneficiary, this means your "Primary Care Manager" (PCM) will be a doctor within one of the six participating systems (such as Johns Hopkins or Brighton Marine). You cannot use military pharmacies; instead, you use the USFHP system's own pharmacy network and mail-order services. This plan is available to active duty family members, retirees, and their families, provided they live within a designated USFHP service area. However, it is important to note that if you are over age 65 and have Medicare Part B, you are generally not eligible to enroll in USFHP unless you were enrolled in the plan on September 30, 2012, and have remained enrolled continuously since then.

Financially, USFHP follows the same cost structure as TRICARE Prime. For the 2026 plan year, active duty family members have $0 enrollment fees and $0 out-of-pocket costs for covered services when coordinated through their PCM. For retirees and their families (Group A), 2026 enrollment fees and small co-pays apply, mirroring the standard TRICARE Prime rates. Because it is a "Prime" model, you must obtain referrals from your USFHP PCM for all specialty care to avoid point-of-service charges, which carry a 50% cost-share.

One unique aspect of USFHP is its "enhanced" benefits. Because these are private systems, they often offer additional "value-added" services not typically found in standard TRICARE, such as discounts on fitness clubs, eyewear, or specific wellness programs, depending on the regional provider.

## Related terms * **TRICARE Prime:** A managed care option similar to an HMO that provides the lowest out-of-pocket costs. * **Primary Care Manager (PCM):** The doctor responsible for coordinating your care and providing referrals to specialists. * **Designated Provider (DP):** The formal term for the six non-profit medical systems contracted to provide USFHP services. * **Point-of-Service Option:** An added cost incurred when a TRICARE Prime or USFHP member sees a specialist without a referral. * **Qualifying Life Event (QLE):** A change (like moving or marriage) that allows you to enroll in or change your TRICARE plan outside of Open Season.

## Sources * TRICARE.mil: US Family Health Plan Overview (https://www.tricare.mil/usfhp) * US Family Health Plan Alliance: Official Site (https://www.usfhp.com) * Defense Health Agency (DHA): TRICARE Plans and Costs (https://health.mil)