Developing, cultivating, and sustaining medical interoperability strengthens the support we provide to the warfighter by presenting our Commanders options and efficiencies to the way we can enable their operations. As our national security and defense strategies change the way our forces are employed to address our security risks throughout the world, some military commands will find they cannot provide adequate medical care without working in concert with willing and available partners.This article proposes a tiered framework that allows medical personnel to further describe and organize their engagement activities around the concept and practicalities of medical interoperability. As resources become diverted to other theaters or missions expand beyond assigned capabilities, medical interoperability provides Commanders with options to medically enable their missions through their partnerships with others. This framework links and connects activities and engagements to build partner capacity with long-term or regional interoperability among our partners and challenges engagement planners to consider ways to build interoperability at all four tiers when planning or executing health engagements and global health development. Using this framework when planning or evaluating an engagement or training event will illuminate opportunities to develop interoperability that might have otherwise been unappreciated or missed.