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Understanding TRICARE’s Long-Term Care Coverage: A Guide for Arizona Residents in 2025

Updated: Jan 8

As seniors age, access to quality health care services becomes increasingly important for managing chronic conditions and maintaining overall well-being. For U.S. military members, retirees, and their families, TRICARE is a vital resource. However, understanding what TRICARE covers—particularly in relation to long-term care options—can be confusing. In this updated guide, we’ll explore TRICARE’s offerings in 2025, including how it assists with skilled nursing, home health care, and hospice care, and its limitations regarding assisted living facilities. Additionally, we’ll examine how Arizona’s Medicaid program (ALTCS) can work alongside TRICARE to meet the needs of families in the state.

TRICARE long-term care logo

Overview of TRICARE Insurance in 2025

TRICARE is a health care program designed to provide comprehensive coverage for eligible members of the U.S. military, retirees, and their families. Managed by the Defense Health Agency (DHA) under the Department of Defense (DoD), TRICARE offers several plans to cater to varying needs:

  • TRICARE Prime: For those near military treatment facilities, offering low out-of-pocket costs.

  • TRICARE Select: Allows greater flexibility in choosing providers.

  • TRICARE for Life: Supplements Medicare for eligible beneficiaries.

TRICARE covers a wide range of medical services, including preventive care, mental health care, prescription medications, and specialized treatments. However, understanding its specific coverage for long-term care is essential for families planning ahead.


TRICARE Coverage for Long-Term Care in 2025

TRICARE’s long-term care benefits emphasize medical services rather than custodial care or housing costs. Below is an overview of how TRICARE supports seniors requiring long-term care:


Skilled Nursing Care

TRICARE covers skilled nursing care for beneficiaries who require medical attention from licensed professionals, such as registered nurses or physical therapists. This includes:

  • Care in skilled nursing facilities for short-term rehabilitation or recovery following a hospital stay.

  • Home-based skilled nursing services, provided they meet medical necessity criteria.

Note: Prior authorization from TRICARE is often required for skilled nursing care.

Home Health Care

TRICARE supports eligible beneficiaries with medically necessary home health care services, including:

  • Skilled nursing care.

  • Physical, occupational, and speech therapy.

  • Medical equipment and supplies (e.g., hospital beds, wound care items).

To qualify, beneficiaries must have a physician referral, and services must be provided by a TRICARE-authorized home health agency.


Hospice Care

TRICARE fully covers hospice care for terminally ill beneficiaries. Services may include:

  • Pain management and palliative care.

  • Counseling for patients and families.

  • Supportive services such as dietary counseling and grief support.

Hospice care can be provided at home, in hospice facilities, or in nursing homes.


Does TRICARE Cover Assisted Living in 2025?

TRICARE does not cover custodial care or the room-and-board costs associated with assisted living facilities. However, it may cover specific medical services provided within an assisted living setting, such as:

  • Short-term skilled nursing care for rehabilitation.

  • Physical and occupational therapy.

  • Hospice care for terminally ill residents.

These services must be deemed medically necessary, and prior authorization is usually required. For families seeking financial support for assisted living costs, exploring other options like Medicaid (e.g., Arizona’s ALTCS program) or private long-term care insurance may be necessary.


How TRICARE and Arizona Medicaid (ALTCS) Can Work Together

Arizona’s Medicaid program, the Arizona Long Term Care System (ALTCS), offers additional support for long-term care services, including custodial care and assisted living. Eligible Arizona residents can use ALTCS to supplement TRICARE benefits. Here’s how the two can work together:

  1. TRICARE for Medical Services: Covers skilled nursing, home health care, and hospice services.

  2. ALTCS for Custodial Care: Assists with room-and-board costs and non-medical assistance, such as help with daily living activities (bathing, dressing, eating).

Eligibility for ALTCS is based on income, assets, and medical need. Families should apply as early as possible due to the lengthy approval process.

Can You Keep TRICARE Benefits While on ALTCS?

Yes, TRICARE benefits can be retained while on ALTCS (Arizona Long Term Care System). Here’s how the programs work together:

  1. TRICARE Remains Primary for Medical Coverage:

    • TRICARE continues to cover medical services such as hospital stays, doctor visits, prescriptions, and skilled nursing care.

    • ALTCS complements TRICARE by covering custodial care services, such as assistance with daily living activities and long-term care facility costs.

  2. ALTCS as Secondary Coverage:

    • ALTCS primarily assists with costs not covered by TRICARE, such as room-and-board expenses in assisted living or nursing facilities and non-medical care.

    • Families should notify both programs about dual eligibility to ensure proper coordination of benefits.

  3. Coordination of Benefits:

    • When both TRICARE and ALTCS are in effect, ALTCS often serves as the payer of last resort. This means TRICARE covers eligible medical services first, and ALTCS may cover remaining costs, if applicable.

    • Notify TRICARE and ALTCS administrators to properly coordinate benefits.

  4. Medicare and TRICARE for Life:

    • If the individual also has Medicare (common with TRICARE for Life beneficiaries), Medicare typically pays first, TRICARE pays second, and ALTCS covers remaining costs.

It’s essential to coordinate benefits effectively and understand the rules of each program. For specific guidance, contact TRICARE and ALTCS representatives.

Contacting TRICARE in 2025

To verify TRICARE coverage and avoid unexpected expenses, beneficiaries should contact the appropriate TRICARE office based on their location:

  • TRICARE East: 1-800-444-5445

  • TRICARE West: 1-844-866-9378

  • TRICARE for Life: 1-866-773-0404

For beneficiaries outside the U.S., contact the TRICARE Overseas Program at 1-888-777-8343 or email TRICAREOverseas@internationalsos.com.

Visit the official TRICARE website for more details: www.tricare.mil.

Maximizing TRICARE Benefits for Long-Term Care

Planning for long-term care requires a clear understanding of TRICARE’s coverage and exploring additional resources to fill gaps. While TRICARE provides excellent medical care, programs like ALTCS or private long-term care insurance may help cover costs for custodial care or assisted living.


If you need assistance navigating these resources, contact SeniorVue for free guidance. Proper preparation ensures Arizona families receive the support they need for a comfortable and secure future.

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