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CAS3
07-29-04, 11:42 AM
Claims Processing Begins For Reserve Component Issued Delayed-Effective-Date Active Duty Orders
July 23, 2004
No. 04-15



Starting today, members of the National Guard and Reserve, collectively known as the Reserve Component (RC), who are issued delayed-effective-date active-duty orders for more than 30 days in support of a contingency operation may submit claims for medical and dental care to TRICARE.

Under the Department of Defense 2004 Temporary Reserve Health Benefit Program (Section 703 of the National Defense Authorization Act, Fiscal Year 2004), they will be reimbursed for TRICARE-covered medical and dental expenses incurred during the member's period of TRICARE eligibility. Eligibility for the "early" TRICARE benefit (up to 60 days prior to reporting to active duty) is recorded in the Defense Eligibility Enrollment Reporting System (DEERS).

Family members also are eligible for reimbursement for medical expenses for TRICARE-covered services incurred during this "early eligibility" period. Family members also may choose to enroll in the TRICARE Dental Program (TDP). To obtain additional information on the TDP, family members may contact the program administrator, United Concordia Companies, Inc. (UCCI) at www.ucci.com or at 800 866 8499.

TRICARE eligibility for RC members and their family members begins the later date of either: (a) the date their delayed-effective-date active-duty orders were issued or (b) 60 days before the member reported to active duty. In order to qualify for reimbursement, medical and/or dental services must be for a covered TRICARE benefit; received during this early eligibility period; and received between Nov. 6, 2003, through Dec. 31, 2004, the specified timeframe for this temporary program, unless further extended by law.

Eligible RC members will receive a letter from TRICARE Management Activity in July 2004 advising them of this temporary health care benefit. Members may verify their TRICARE eligibility through the Guard and Reserve secure Web portal at https://www.dmdc.osd.mil/Guard-ReservePortal, or they may contact their Service personnel office for more information. A link to Service contacts is available on the TRICARE Web site at www.tricare.osd.mil/reserve/reservepoc.cfm.

To apply for reimbursement for medical services covered under this temporary TRICARE benefit, RC members and/or family members must submit a TRICARE (CHAMPUS) claims form (DD Form 2642), a copy of their itemized bill, an explanation of benefits from other health insurance (if applicable) for services received, and proof of payment (if the bill was already paid) to their regional TRICARE claims processor. To identify their TRICARE medical claims processor, beneficiaries may go to the TRICARE Web site at www.tma.osd.mil and click on their state in the regional map on the home page. A downloadable TRICARE claims form and information on claims processing is available on the TRICARE Web site at www.tricare.osd.mil/claims/default.cfm.

To apply for reimbursement of dental expenses covered under the temporary benefit, eligible RC members must contact the Military Medical Support Office (MMSO) at http://mmso.med.navy.mil or 888 MHS-MMSO (888-647-6676). Family members who are already enrolled in the TDP will continue their enrollment, but at the lower premium share rate.

Family members who are not enrolled in the TDP become eligible to enroll in the TDP at the lower active duty family member premium share rate, but their enrollment in the TDP is not retroactive. Applications accompanied by a one-month premium payment must be submitted to United Concordia Companies, Inc. (UCCI), the program administrator, by the 20th of a given month for coverage to begin the first day of the following month. Claims for dental services received prior to enrollment in the TDP are not reimbursable.

To enroll in the TDP, or get help with a dental claim, family members may contact the program administrator, United Concordia Companies, Inc. (UCCI) at www.ucci.com or at 800 866 8499.

RC members and their families also may receive assistance by contacting their regional TRICARE contractor, visiting a local TRICARE service center (TSC), or by calling a beneficiary counseling and assistance coordinator (BCAC). Beneficiaries may click on the regional map located on the home page of the TRICARE Web site at www.tricare.osd.mil to find regional contractors, or select "TSC" or "BCAC" from the drop-down menu in the top right corner of the front page. The TRICARE Information Service, 888-DoD-CARE, (888 363-2273), also provides contact information for regional contractors.

Additional information on the "early" TRICARE benefit, under Section 703, for members of the RC and their families, including a fact sheet with Service personnel contact information, is available on the TRICARE Web site at www.tricare.osd.mil/Factsheets and on the Reserve Component Web site at www.defenselink.mil/ra.

A list of frequently asked questions on this temporary TRICARE benefit is also available by typing in the key word "Reserve" or "Early" at www.tricare.osd.mil/faqs.