View Full Version : Reserve Component - Pay Bills But Save Your Receipts

03-21-04, 08:35 AM
Reserve Component - Pay Bills But Save Your Receipts
Mar. 19, 2004
No. 04-08

[Return to Table of Contents]

Last year, the President signed legislation for Fiscal Year 2004 that authorized three new temporary provisions to enhance access to TRICARE medical and dental benefits for eligible Reserve Component sponsors and their family members. Recently, the Department of Defense announced plans to implement the new provisions under its "2004 Temporary Reserve Health Benefit Program." Eligibility for some of the new temporary TRICARE enhancements began Nov. 6, 2003, and ends for all on Dec. 31, 2004.

Eligibility for two of the temporary provisions (sections 703 and 704) was effective Nov. 6, 2003, but TRICARE policy, data and contract changes were needed before either could be implemented and claims paid. The 704 provision, which was implemented by TRICARE Management Activity (TMA) earlier this week, temporarily extends TRICARE eligibility under the Transitional Assistance Management Program (TAMP) from 60 or 120 days to 180 days for Reserve Component sponsors who separate from active duty federal service Nov. 6, 2003, through Dec. 31, 2004. Effective March 17, 2004, TAMP-eligible sponsors and family members who were saving their receipts may apply for TRICARE reimbursement by submitting a TRICARE claim form, a copy of their itemized bill, an explanation of benefits and proof of payment if the bill was already paid to their TRICARE regional claims processor. Contacts and additional information on claims processing are available on the TRICARE Web site at www.tricare.osd.mil/claims/default.cfm.

TMA will soon be able to implement the second temporary provision (703). This provision authorizes TRICARE medical and dental benefits for Reserve Component sponsors activated in support of a contingency operation for more than 30 days and for their family members. TRICARE eligibility under this provision begins the day the sponsor receives delayed effective date active duty orders or 90 days before the date the active duty period begins, whichever is later. The effective date for benefits under this program was Nov. 6, 2003.

However, until TRICARE is able to make payments for claims under this provision, Reserve Component sponsors and eligible family members who receive medical and dental care from Nov. 6, 2003, to the present, are encouraged to pay those bills and save their receipts. Beneficiaries may apply for TRICARE reimbursement once implementation begins and claims filing procedures are announced by TMA.

The third and final temporary provision (702) is under development. This provision is limited to Reserve Component sponsors who are either unemployed or employed but not eligible for employer-sponsored health coverage and their family members. This provision will pay for medical care only. Claims under this benefit are not eligible for payment retroactive to Nov. 6, 2003. This provision, when it is implemented, will require an enrollment application and payment of a premium. TRICARE is working now to develop this provision, which requires many contract and personnel system changes. We anticipate that this effort cannot be completed for several months. The authority for this temporary provision expires on Dec. 31, 2004.

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 names and telephone numbers for assistance is available at www.tricare.osd.mil/bcacdirectory.cfm.

Future updates on the three temporary programs for Reserve Component families will be posted to the TRICARE Web site at www.tricare.osd.mil and the Reserve Affairs Web site at www.defenselink.mil/ra/.