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Thread: TriCare

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    Cool TriCare

    Date: Fri, 09 Aug 2002 14:33:24 -0700 Subject: (Medical matters) School physicals added to TRICARE benefits Under the 2001 National Defense Authorization Act, TRICARE will cover physical examinations required for school enrollment. The new benefit applies to all TRICARE-eligible beneficiaries ages 5 through 11. It does not cover sports physicals. The effective date for the benefit was Oct. 30, 2000. TRICARE advised beneficiaries to save all receipts and related paperwork for TRICARE reimbursement of school physicals received since Oct. 30, 2000. To file a claim for this reimbursement, beneficiaries should attach the receipt and paperwork to a claim form and send it to their regional managed care support contractor. TRICARE regards school physicals as preventive services. TRICARE Prime enrollees will not have co-payments or need referrals or authorizations from their primary care managers unless they go to a non-network provider. TRICARE Standard and Extra beneficiaries do not have to get referrals, but they will have to pay applicable cost shares and deductibles for the school physicals. Beneficiaries may download claim forms from the TRICARE Web site at or may contact a local TRICARE Service Center. (Worldwide TRICARE Service Center directory is available online at Date: Fri, 09 Aug 2002 14:35:38 -0700 Subject: [] DoD Provides Transitional Health Care Benefits for 60 or 120 Days {01} August 2, 2002 No. 02-20 Family members of active duty sponsors involuntarily separated from military service under honorable conditions, or family members of Reserve Component members separated after serving on active duty for more than 30 days in support of contingency operations, are eligible to receive transitional health care benefits for 60 or 120 days under the new Department of Defense (DoD) Worldwide TRICARE Transitional Health Care Demonstration Project if their sponsor was on active duty Jan. 1, 2002, or later. The new demonstration project provides medical benefits to certain eligible active duty and Reserve families when their sponsors depart from military service. Family members of sponsors with fewer than six years of active duty service are eligible for 60 days of transitional health care benefits; those with six years or more are eligible for 120 days. The transitional health care demonstration benefit is retroactive to Jan. 1, 2002, and remains in effect for two years, to allow DoD time to analyze the program and decide whether or not to make transitional health care a permanent TRICARE benefit for these family members. Under the demonstration project family members may use TRICARE Standard, the fee- for-service option with deductibles and cost shares; TRICARE Extra, the network option with deductibles and negotiated fees; or TRICARE Prime, the network option that is least costly for most people. Sponsors and family members who are enrolled in TRICARE Prime will be automatically disenrolled when the sponsor separates from active duty. To continue using the TRICARE Prime benefit during the transitional health care period, sponsors and family members must contact their TRICARE regional managed care support contractor, or their local TRICARE service center, and re-enroll in TRICARE Prime. There will be no break in TRICARE Prime coverage as long as the sponsor and family members re-enroll in TRICARE Prime. Dental benefits are available to former active duty and Reserve Component members, but under this demonstration, family members of former active duty and Reserve Component members are not entitled to dental benefits. However, Reserve Component members and their family members who are eligible and enrolled in the TRICARE Dental Program (TDP) would be eligible for dental benefits under the TDP, which is separate from this demonstration project. To be eligible for transitional medical and dental benefits, the family member's sponsor must be: (1) a service member involuntarily separated from active duty; (2) a member of the Reserves separated from active duty after serving more than 30 days in support of a contingency operation; (3) a service member separated from active duty after being involuntarily retained on active duty in support of a contingency operation; or (4) a service member separated from military service who voluntarily remained on active duty for one year or less in support of a contingency operation. Transitional health care is not an automatic TRICARE benefit. Sponsors must ensure that they and their family members are enrolled in the Defense Enrollment Eligibility Reporting System (DEERS). Active duty sponsors may verify or update DEERS information for themselves or their family members by contacting or visiting their local military identification (ID) card issuing facility. To locate the nearest military personnel office or ID card facility, sponsors may search the DEERS Web site at Claims for these family members will be processed using normal TRICARE claims processing procedures. Claims for family members with expired eligibility will be denied until eligibility is updated and verified in DEERS. If a member submits a claim and it is denied because of eligibility, the member should contact the Defense Manpower Data Center Support Office toll-free at 1-800-538- 9552. Sponsors and family members who have paid for health care expenses out of pocket, may submit a claim form (DD Form 2642) to TRICARE with a copy of their itemized bill to receive payment for these services. Family members who are eligible for care under the demonstration project and who have other health insurance (OHI), must submit all claims to their OHI provider first before submitting them for payment to TRICARE. Claim forms are available on the TRICARE Web site at or from the local beneficiary counseling and assistance coordinator (BCAC), TRICARE service center representative, or TRICARE managed care support contractor. Eligible sponsors or family members who require additional information on TRICARE may contact the Worldwide TRICARE Information Center toll-free at 1-888- DOD-CARE (1-888-363-2273). Additional information on TRICARE medical and dental benefits is available on the TRICARE Web site at or by visiting the TRICARE service center or BCAC at the local military treatment facility. For questions or assistance regarding claims, sponsors and family members may contact the managed care support contractor in their region, the nearest TRICARE service center or a BCAC at the nearest military treatment facility. NOTES: 1. Worldwide TRICARE Service Center directory is available online at 2. Worldwide beneficiary counseling and assistance coordinator (BCAC) directory is available online at



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