Frequently Asked Questions

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Frequently Asked Questions

How do I ensure

my family is eligible for TRICARE?
A legal dependent of a Reserve component

member in one of the circumstances listed above who is registered in the Defense

Enrollment Eligibility Systems (DEERS) is eligible to receive medical treatment

in the Military Health Care System. A legal dependent is defined in Section 1072 of Title 10, United States

Code.

  • Spouse and unmarried children under

    21.

  • Older children with severe physical or

    mental handicaps are also entitled.

  • Children not yet 23 years old who are

    full-time students at an accredited college and must depend on the military

    parent for more than half of the support.

The family member must be enrolled in the Defense

Enrollment Eligibility Reporting System (DEERS). This is done when the family member is

issued an Identification Card.

What

if I have other health insurance? What does this mean to me?

If you have other health insurance in

addition to your TRICARE Standard benefits, be aware that TRICARE Standard pays

after all other plans you may have, except for Medicaid (a public assistance

program) and certain insurance policies that are specifically designated as

TRICARE supplements. This means

that if you have another health plan in addition to TRICARE Standard, the other

plan must pay whatever it covers before TRICARE Standard will make any type of

payment. You may have coverage for yourself and your family through an employer,

an association or a private insurer. This also includes the medical portion of

an auto insurance policy, or any coverage that students in the family may have

through their schools.

What are my health plan options

available under TRICARE?


For eligible beneficiaries, the TRICARE

program offers a triple-option healthcare plan. TRICARE Prime is the

managed care option offered by the Department of Defense. It integrates military

and civilian health care into a single delivery system. Beneficiaries who choose

this option agree to a one-year enrollment. Enrollees selecting this option

choose a primary care manager to provide or arrange for their healthcare needs.

The TRICARE Prime option offers additional wellness and preventive care

services. There is no annual deductible when you are enrolled in Prime.

TRICARE Extra is similar to TRICARE Standard but offers discounts to

patients when they use TRICARE network providers. This option allows

beneficiaries to receive their care from civilian network providers at a reduced

cost compared to TRICARE Standard. There are no claim forms to file; you just

pay your reduced cost share after satisfying the deductible. You may use a

combination of the TRICARE Extra and Standard programs at any time, depending on

whether you choose physicians inside or outside the network. There is no

enrollment requirement for this program. TRICARE Standard is a fee-for-service option that is the same as

the standard CHAMPUS benefit. Beneficiaries using this option have the greatest

choice of civilian physicians, but at a higher cost. The cost of having this

choice includes a deductible, plus a percentage of subsequent charges, called

cost shares, and possible balance billing, not to exceed 115 percent of the

allowable charge. Enrollment is not a requirement to participate.

What is General TRICARE For

Life?


Under legislation in the 2001 National Defense Authorization Act you will gain access to expanded medical coverage known as TRICARE For

Life, as long as you are a uniformed service beneficiary who has attained the

age of 65, are Medicare-eligible, and have purchased Medicare Part B. TRICARE

For Life is a permanent healthcare benefit. Please click on http://www.tricare.osd.mil/ndaa/faq.cfm to learn more about eligibility, benefits, enrollment

requirements, and costs associated with TRICARE For Life.

How

do I access TRICARE Provider list?
You can search for TRICARE providers worldwide at Provider

Search.

Where can I find more

information about TRICARE Medical Benefits?


You can access more information about

TRICARE at Medical Benefits.