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07-29-04, 10:41 AM
Certain Members of the Reserve Component and Family Members Are Eligible for Early TRICARE Benefit
July 23, 2004
No. 04-16

Today, the Department of Defense (DoD) announced the start of a new temporary program authorized under section 703 of the National Defense Authorization Act for Fiscal Year 2004 which provides members of the Reserve Component (RC) activated in support of a contingency operation for more than 30 days and family members "early" access to TRICARE medical and dental benefits. Benefits under this program are in effect Nov. 6, 2003, to Dec. 31, 2004, the date the temporary benefit ends, unless extended by law.

To be eligible for the temporary benefit, RC members and their family members must be registered in the Defense Enrollment Eligibility Reporting System (DEERS) and be TRICARE eligible. The member's Service personnel office is responsible for determining the member's eligibility for the early TRICARE benefit. TRICARE eligibility for the RC sponsor and family members begins either on the day the member receives delayed-effective-date active duty orders or 60 days before the member reports to active duty, whichever is later.

TRICARE Management Activity is sending a one-time letter to all affected RC members who were eligible Nov. 6, 2003, through July 31, 2004. After that time, RC members eligible for the early TRICARE benefit will be notified by their Service personnel office when they receive their delayed-effective-date active duty orders.

Members may verify their eligibility through the secure Guard and Reserve Web portal at www.dmdc.osd.mil/Guard-ReservePortal. Members who require assistance to verify eligibility for the "early" TRICARE benefit may contact their Service personnel office. A list of Service contacts is available on the TRICARE Web site at www.tricare.osd.mil/reserve/reservepoc.cfm.

Medical and Dental Care for RC Members

Members of the RC may receive medical and dental services at a military treatment facility (MTF) or dental treatment facility (DTF) from TRICARE-authorized providers reimbursed through supplemental care rules, or appropriate overseas programs (i.e., TRICARE Global Remote Overseas for urgent/emergency care).

RC members will not be enrolled into TRICARE Prime until they reach their final duty location. Upon arrival at their final duty location, activated RC members will receive guidance from their Service personnel office on whether to enroll in TRICARE Prime, TRICARE Prime Remote (TPR) or the TRICARE Overseas Program.

Cancellation of Member's Delayed-Effective-Date Active Duty Orders

RC members whose delayed-effective-date active duty orders are cancelled by their Service personnel office as a result of not meeting medical and dental requirements for mobilization, or for any other reason, will lose TRICARE eligibility and return to their previous reserve status. TRICARE eligibility for family members also end at the same time.

If the member's delayed-effective-date orders are cancelled by the Service prior to the date the member reports for active duty, TRICARE benefits for the member and family member end on the day the member's orders are cancelled. Should this occur, the RC member and family members will not be covered by protections under the Uniformed Services Employment Reemployment Rights Act (USERRA) that allows persons to be reinstated in their employer-sponsored health plan.

RC members and family members who have employer-sponsored health insurance are strongly encouraged to consider retaining the employer's health care coverage until the RC member actually reports for active duty, at which time the member and family member would be fully covered by USERRA.

Medical Benefits for Family Members

RC family members who are eligible for the "early" TRICARE benefit may receive care under TRICARE Standard, TRICARE Extra and the TRICARE Reserve Family Member Demonstration Project. Benefits under the demonstration, which waives the TRICARE Standard deductible and authorizes higher payments to nonparticipating civilian providers, will end Oct. 31, 2004.

Family members of RC members on active duty status within the 50 states may also enroll in TRICARE Prime or the TRICARE Prime Remote for Active Duty Family members (TPRADFM) program if they reside in a TPR ZIP code. To be eligible for the TPRADFM program, family members must have lived with the RC member when the member received his/her delayed-effective-date active duty orders, and must continue to reside at the same TPR location. RC family members who live outside of the 50 states will follow enrollment procedures for the TRICARE Overseas Program.

Family members needing to file a TRICARE medical claim may download a TRICARE claims form (DD Form 2642) at www.tricare.osd.mil/claims/default.cfm, or visit their nearest TRICARE service center to obtain a form and receive assistance filing a TRICARE claim or resolving a claims issue. They may also contact or visit their local beneficiary counseling and assistance coordinator (BCAC). To locate the nearest TRICARE service center or BCAC, family members may click on the TRICARE region on the map located at www.tricare.osd.mil, or call (888) DOD-CARE, (888) 363-2273.
Dental Benefits for RC Members

Dental care for eligible RC members is available at a military dental treatment facility (DTF). Members who live more than 50 miles from a DTF or have more than an hour's drive to a DTF may be covered under the TRI-Service Remote Dental Program administered by the Military Medical Support Office (MMSO). Eligible RC members must contact MMSO at http://mmso.med.navy.mil or (888) 647-6676 before receiving any dental services to determine covered benefits and guidelines for receiving dental care from civilian dental providers. Additional information for RC members who need to submit dental claims is available on the MMSO Web site at http://mmso.med.navy.mil.

RC members eligible for the "early" TRICARE benefit who are currently enrolled in the TRICARE Dental Program (TDP) will be disenrolled from the TDP upon receipt of their delayed-effective-date orders.

Dental Benefits for RC Family Members

Family members of RC members eligible for the "early" TRICARE benefit may enroll in the TDP and pay premiums at the active duty family member rate. To enroll, family members may contact the TDP administrator, United Concordia companies, Inc. (UCCI) at (800) 866-8499 or www.ucci.com.

Family members who were enrolled in the TDP will continue their enrollment at the lower active duty family member rate. Up-to-date information on the "early" TRICARE benefit and the 2004 Temporary Reserve Health Benefit Program is available on the TRICARE Web site at www.tricare.osd.mil/reserve/ or the Reserve Affairs Web site at www.defenselink.mil.ra. A list of frequently asked questions is also available by typing in the key word "Reserve" or "Early" at www.tricare.osd.mil/faqs.