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CAS3
03-21-04, 09:34 AM
DoD Temporarily Extends TRICARE Eligibility Following
Active Duty to 180 Days
Mar. 17, 2004
No. 04-07

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Under the National Defense Authorization Act and the Emergency Supplemental Appropriations Act for fiscal year 2004, TRICARE eligibility for some active duty and Reserve Component members separating from active duty service is temporarily extended under the Department of Defense Transitional Assistance Management Program (TAMP) from 60 or 120 days to 180 days.

The enhanced TRICARE provision, which began Nov. 6, 2003, and ends Dec. 31, 2004, is the first of three temporary programs the TRICARE program is implementing this spring under its "Temporary Reserve Health Benefit Program," to enhance access to care for active and Reserve Component sponsors separating from active military service and their family members. The only change to TAMP is the temporary extension for the eligibility period.

"We are pleased to implement these new benefits for separating service members and their families in order to assist the transition to civilian life," said Dr. William Winkenwerder Jr., assistant secretary of defense for health affairs. "TRICARE and contractor staff are working to make this temporary benefit work as smoothly as possible," he said.

Eligible sponsors and family members must be enrolled in the Defense Enrollment Eligibility Reporting System (DEERS). Former active duty sponsors and family members eligible for the transitional program may enroll in TRICARE Prime in locations where TRICARE Prime is available, or they may use the TRICARE Extra or TRICARE Standard benefits. Under TAMP, active duty sponsors and family members are not eligible for TRICARE Prime Remote.

Former active duty and Reserve Component members who are eligible for transitional benefits may receive dental care at military dental treatment facilities on a space-available basis only. Family members are not eligible for dental care at these facilities. Civilian dental care is not a covered benefit for sponsors or family members under the transitional program. Certain members of the Reserve Component and their family members may, however, receive dental care by enrolling in the TRICARE Dental Program (TDP). To determine eligibility and get additional information, contact the TDP administrator, United Concordia Companies, Inc. at (800) 866-8499 or at www.ucci.com.

All claims submitted to TRICARE for sponsors and family members eligible for transitional benefits are processed by the TRICARE claims processor at the TRICARE Standard or TRICARE Extra active duty family member rate. To apply for TRICARE reimbursement, sponsors or family members must submit a TRICARE claim form, a copy of the itemized bill, and an explanation of benefits and receipts (if available) to their regional managed care support contractor for processing.

The sponsor's Service branch determines whether the sponsor and family members are eligible for transitional benefits. Active duty and Reserve Component sponsors who are separating from active duty and need to verify eligibility for transitional TRICARE benefits for themselves and family members are encouraged to contact their nearest Service personnel office for assistance. DEERS eligibility may be verified by contacting the Defense Manpower Data Center Support Office toll free at (800) 538-9552.

On Jan. 1, 2005, TRICARE eligibility under the transitional program for active and Reserve Component sponsors who separate from active duty and have fewer than six years of total active federal service and their family members returns to 60 days upon the sponsor's separation. TRICARE eligibility for active and Reserve Component sponsors who separate from active duty and have six years or more of total active federal service and their family members returns to 120 days upon separation of the sponsor.

Sponsors and family members who need help understanding their TRICARE benefits or processing TRICARE claims, may contact their regional TRICARE beneficiary counseling and assistance coordinator for assistance. A list of BCAC names and telephone numbers for assistance is available at www.tricare.osd.mil/bcacdirectory.cfm. Additional information on TRICARE and the Temporary Reserve Health Benefit Program is available on the TRICARE Web site at www.tricare.osd.mil and the Reserve Component Web site at www.defenselink.mil/ra. A list of frequently asked questions is available at www.tricare.osd.mil/faqs by typing in keywords TAMP or Reserve.