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 Tyndall TRICARE
Tool Kit
1. Listed below, for your information and use, are web site addresses
for
TRICARE, TRICARE regions, and applicable contractors.
2. Once connected, links are available to enable you to connect to other
TRICARE related web sites, military treatment facilities, etc.
3. If you're unsure of your region, a map showing all of the regions is
available at http://www.tricare.osd.mil/tricare/trimap2.html
NOTE: Claim forms and other documentation are available at most of
the web sites. Adobe Acrobat Reader is usually required to view/print
the forms and some documents. The Adobe Acrobat Reader software is free
and may be downloaded from the following sites (file size is about 6.7MB):
ftp://139.232.17.15/acrobat4.exe
http://www.adobe.com/products/acrobat/readstep2.html
TRICARE HOME PAGE:
TRICARE ............... http://www.tricare.osd.mil
BCAC Info/Directory ..
http://www.tricare.osd.mil/tricare/beneficiary/bcac_dir.htm
Claim Forms .......... http://www.tricare.osd.mil/ClaimForms/
Claims (Where to file) http://www.tricare.osd.mil/ClaimForms/WheretoFile.htm
DCAO Info/Directory .. http://www.tricare.osd.mil/dcao/
Corrected information regarding updating DEERS, i.e., for the latest
information on how to update your information in DEERS, visit
www.tricare.osd.mil/DEERSAddress/
Dental Programs ......
http://www.tricare.osd.mil/tricare/beneficiary/supprog.html
Discussion Forum ..... http://www.tricare.osd.mil/forums/index.cfm?CFApp=7&
Enrollment Information
http://www.tricare.osd.mil/tricare/beneficiary/enrollment.html
Fraud & Abuse ........ http://www.tricare.osd.mil/fraud/
FAQs ................. http://www.tricare.osd.mil/tricare/news/market.html
Gulf War Illness ..... http://www.tricare.osd.mil/pgulf/gulfwar.html
Handbook (Standard) .. http://www.tricare.osd.mil/TricareHandbook/
Kids health for ages 8-12.... http://www.healthfinder.gov/kids/
Lead Agents .......... http://www.tricare.osd.mil/tricare/leadagent.html
Manuals (TRICARE) .... http://www.tricare.osd.mil/tricaremanuals/
TRICARE Beneficiaries
http://www.tricare.osd.mil/tricare/beneficiary/hptriben.html
TRICARE Phone Numbers http://www.tricare.osd.mil/tricare/phonenumbers.html
TRICARE Prime Remote . http://www.tricare.osd.mil/remote/
TRICARE Service Centrs
http://www.tricare.osd.mil/tricareservicecenters/default.cfm
Wellness & Health ....
http://www.tricare.osd.mil/tricareservicecenters/default.cfm
5. REGIONAL & CONTRACTOR WEB SITES:
REGION 3 (Southeast) ... http://tricare3.army.mil
Contractor (Humana) ... http://205.145.64.204/home.htm
REGION 4 (Gulf South) .. http://hsriv.keesler.af.mil
Contractor (Humana) ... http://www.humana-military.com/home.htm
REGION 6 (Southwest) ... http://www.tricaresw.af.mil
Contractor (Foundation) http://www.fhfs.com/region6.html
REGION 7/8 (Central) ... http://web01.region8.tricare.osd.mil
Contractor (Triwest) . http://www.triwest.com/
REGION 11 (Northwest) ... http://tricarenw.mamc.amedd.army.mil
Contractor (Foundation) http://www.fhfs.com/home.asp
REGION 12 (Pacific) ..... http://tricare-pac.tamc.amedd.army.mil
Summary of TRICARE
Prime Cost Sharing
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HMO Benefit
|
Active Duty Family Members |
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Before 1 Apr 01 |
Effective 1 Apr 01 |
Outpatient Cost Sharing
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Outpatient Visits, primary and specialty care. Includes most physician
office visits and other routine services. It does not apply to ancillary
health services or to preventive health services described in paragraph
(b)(2) of this section, or to maternity services under Sec. 199.4(e)(16) |
$6 / $12
E1-4 ADFMs/
E-5+ ADFMs |
$0 |
|
Outpatient Mental Health Visits:
a.
Individual
b.
Group |
a. $10 / $20
b. $6 / $12 |
a. $0
b. $0 |
|
Durable Medical Equipment, Prosthetic Devices, and other authorized supplies |
10% / 15% |
$0 |
|
Emergency Room Services |
$10 / $30 |
$0 |
|
Ambulatory Surgery Services – Primary Surgeon Services |
$25 / $25 |
$0 |
|
Prescription Medications |
National Mail Order Pharmacy (NMOP):
$4
(up to a 90-day supply)
Networks:
$5
(up to a 30-day supply)
Non-Network:
See POS |
NMOP: $3 /
$9*
(up to a 90-day supply)
Network: $3
/ $9*
(up to a 30-day supply)
Non-Network:
See POS
* Generic / Brand Name |
|
Ambulance Services |
$10 / $15 |
$0 |
|
Preventive Services (e.g., Pap smears, periodic health
promotion/disease prevention exams, hearing exams) |
$0 |
$0 |
Inpatient Cost
Sharing
|
|
Acute
Care Admissions -- Civilian |
$11 / $11 |
$0 |
|
Acute
Care Admissions -- Military Treatment Facility |
$11.45 / $11.45 |
$0 |
|
Mental Health/Substance Use Treatment Admissions and
for Partial Hospitalization Services |
$20 / $20 |
$0 |
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Point of Service (POS) Charges |
$300 / $600 Deductible*
plus 50% of allowables
* Individual/Family Deductible |
$300 / $600 Deductible*
plus 50% of allowables
* Individual/Family Deductible |
|
Program for Persons with Disabilities (PFPWD). This program is not affected
by this change. |
$25--$250 depending on AD Sponsor's rank
TRICARE Policy Manual Chapter 8, Section 1.16 |
$25--$250 depending on AD Sponsor's rank
These are not Prime copays |
| TRICARE Prime Beneficiaries Referred for
Specialty Care May be Eligible for Travel Reimbursement |
March 7, 2002
No. 02-07 |
|
[Return to Table of Contents] |
TRICARE Prime beneficiaries referred more than 100 miles from their
primary care manager for specialty care may be eligible to have their actual
travel expenses reimbursed by TRICARE.
Under provisions of the 2001 National Defense Authorization Act (NDAA),
travel reimbursement is retroactive to Oct. 30, 2000, for Prime enrollees
who are referred more than 100 miles from their primary care manager's
office for medically necessary specialty care.
To qualify for reimbursement, beneficiaries must have travel orders for
past referred specialty care prepared by a TRICARE representative at the
military treatment facility (MTF) where enrolled, or from a regional lead
agent representative, if their primary care manager (PCM) is a civilian
provider.
The MTF or regional lead agent representative is responsible for
ensuring that a valid referral exists before issuing travel orders. To file
a travel reimbursement claim, beneficiaries should submit the appropriate
original receipt(s) (keeping copies for themselves), a completed
reimbursement form, and the original copy of their orders issued by the MTF
or lead agent. Beneficiaries may receive reimbursement after completing and
submitting these items.
The new Prime enrollee travel entitlement does not apply to travel
expenses incurred by active duty uniformed services members, active duty
family members residing with their sponsors overseas, or to travel costs of
beneficiaries referred under DoD specialized treatment programs, which are
reimbursed by other travel entitlements; nor does it apply to transportation
expenses resulting from emergency care covered under the basic TRICARE
Standard benefit.
TRICARE Prime beneficiaries seeking reimbursement for travel expenses
incurred for obtaining referred specialty care may contact their local MTF
or lead agent beneficiary counseling and assistance coordinator (BCAC) for
assistance. Telephone numbers and addresses for BCACs are available on the
TRICARE Web site at
http://www.tricare.osd.mil/
The 2002 NDAA, signed into law by President Bush on Dec. 28, 2001,
authorizes travel orders and reimbursement for one non-medical attendant,
under certain conditions. TRICARE Prime enrollees who travel with a
non-medical attendant should save travel and lodging receipts for themselves
and the non-medical attendant. The new non-medical attendant travel benefit
will be implemented in the next several weeks and will be retroactive to
Dec. 28, 2001. Specific details of the non-medical attendant travel benefit
will be available soon at
http://www.tricare.osd.mil/.
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