https://crsreports.congress.gov
Updated November 18, 2022
Defense Primer: Military Health System
The Department of Defense (DOD) administers a statutory
health entitlement (under Chapter 55 of Title 10, U.S.
Code) through the Military Health System (MHS). The
MHS offers health care benefits and services through its
TRICARE program to approximately 9.62 million
beneficiaries composed of servicemembers, military
retirees, and family members. Health care services are
available through DOD-operated hospitals and clinics,
referred to collectively as military treatment facilities
(MTFs), or through civilian health care providers
participating in the TRICARE program.
Purpose
The fundamental reason for an MHS is to support medical
readiness. The medical readiness mission involves
promoting “a healthy and fit fighting force that is medically
prepared to provide the Military Departments with the
maximum ability to accomplish their deployment missions
throughout the spectrum of military operations.” The MHS
also serves to “create and maintain high morale in the
uniformed services by providing an improved and uniform
program of medical and dental care for members and
certain former members of those services, and for their
dependents” (10 U.S.C. §1071). In addition, the resources
of the MHS may be used to provide humanitarian assistance
(10 U.S.C. §401) and to perform medical research (10
U.S.C. §4001).
Organization
The Under Secretary of Defense for Personnel and
Readiness (USD[P&R]) is the principal staff assistant and
advisor to the Secretary of Defense and to the Deputy
Secretary of Defense for Total Force Management as it
relates to readiness issues, including health affairs (see 10
U.S.C. §136).
Key MHS Organizations
Office of the Assistant Secretary of Defense for Health Affairs
(OASD[HA])
Defense Health Agency (DHA)
Army Medical Command, Navy Bureau of Medicine and
Surgery, and the Air Force Medical Readiness Agency
The Assistant Secretary of Defense for Health Affairs
(ASD[HA]) reports to the USD(P&R). The ASD(HA) is the
principal advisor to the Secretary of Defense on all “DOD
health policies, programs and activities” and has primary
responsibility for the MHS (see DOD Directive 5136.01).
Reporting to the USD(P&R) through the ASD(HA), the
Defense Health Agency (DHA) is a joint combat support
agency whose purpose is to enable the Army, Navy, and Air
Force medical services to provide a medically ready force
and a ready medical force to combatant commands in both
peacetime and wartime.
Beneficiaries
In FY2021, there were 9.62 million total MHS beneficiaries
(see Figure 1).
Figure 1. MHS Beneficiaries, FY2021
Source: Defense Health Agency, Evaluation of the TRICARE Program:
Fiscal Year 2022 Report to Congress, Washington, DC, 2022, p. 33.
Note: Numbers may not add up to total due to rounding.
Military Treatment Facilities (MTFs)
DHA administers all MTFs worldwide. Generally, these
facilities are located on or near a U.S. military base. There
are three types of MTFs that provide a range of clinical
services depending on facility size, mission, and level of
capabilities: (1) medical centers, (2) hospitals, and (3)
ambulatory care centers. MTFs are typically staffed by
military, civil service, and contract personnel. In FY2021,
there were 706 MTFs, with 144 located overseas.
TRICARE Options
With the exception of active duty servicemembers (who are
assigned to the TRICARE Prime option and pay no out-of-
pocket costs for TRICARE coverage), MHS beneficiaries
may have a choice of TRICARE plan options depending
upon their status (e.g., active duty family member, retiree,
reservist, child under age 26 ineligible for family coverage,
Medicare-eligible) and geographic location. Each plan
option has different beneficiary cost-sharing features. Cost
sharing may include an annual enrollment fee, annual
deductible, monthly premiums, copayments, and an annual
catastrophic cap. Pharmacy copayments are established
separately and are the same for all beneficiaries under each
option. The current major plan options are listed below.
