https://learn.extension.org/events/2397

An Introduction to TRICARE®

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Asking Questions: • To ask a question, you can type your questions into the

chat pod to the left of the screen.

• You can also tweet your questions to @MFLNMC

• Submit questions at any time during the presentation.

• We will try to answer questions in real-time or at the end of the presentation in the order they are received.

• Please make your questions concise to allow other participants a chance to have their questions answered.

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Introduction to TRICARE®February 2016

““Medically Ready Force…Ready Medical ForceMedically Ready Force…Ready Medical Force”” 5

Presenter: Lennya Bonivento

∎ Communications Division, Defense Health Agency

∎ Services as subject matter expert on the Assistance Reporting Tool

∎ Provides oversight & training to customer service staff responding to TRICARE beneficiaries, providers and Military Health System staff.

““Medically Ready Force…Ready Medical ForceMedically Ready Force…Ready Medical Force”” 6

Today’s Agenda

• What is TRICARE?• TRICARE Eligibility• TRICARE Program Options• Other Important Information• For Information and Assistance

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What is TRICARE?

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TRICARE Stateside Regions

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Beneficiary Categories

• Active duty service members• Active duty family members• Retired service members (including retired reserve members) and

their families• National Guard and Reserve members and their family members• Medal of honor recipients and their family members, survivors, and

eligible former spouses

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DEERS & TRICARE

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TRICARE Health Plans

Beneficiary Type TRICARE Health Plan OptionsActive duty service members • TRICARE Prime®

• TRICARE Prime Remote

Active duty family members • TRICARE Prime• TRICARE Prime Remote• TRICARE Standard® and TRICARE

Extra• TRICARE For Life• TRICARE Young Adult

Retired service members and their family members, Medal of honor recipients and their family members, survivors, and eligible former spouses

• TRICARE Prime• TRICARE Standard and TRICARE Extra• TRICARE For Life• TRICARE Young Adult

National Guard and Reserve members and their family members

• TRICARE Reserve Select®• TRICARE Retired Reserve®• TRICARE Young Adult

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Provider Types

• Military hospitals and clinics

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TRICARE Prime

Eligibility• ADSMs, ADFMs, retirees and their families, survivors, certain former spouses, and

others in Prime Service Areas (PSAs)

Enrollment

• Online via the Beneficiary Web Enrollment Website (https://www.dmdc.osd.mil/appj/bwe/indexAction.do)

• Phone• Mail the TRICARE Prime Enrollment Application and PCM Change Form (DD Form

2876) to the regional contractor

Costs

ADSMs and ADFMs:• No enrollment fees/deductibles• ADFMs only have copays for

prescriptions

All Others:• FY16 annual enrollment fee:

• $282.60 for individuals• $565.20 for families

• Copays for healthcare services and prescriptions

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TRICARE Prime - Moving Made Easy

• Moving within the same region– Active duty family members– Retirees and their family members

• Moving to another region– Active duty family members– Retirees and their family members

Moving Made Easy Fact Sheet: http://www.tricare.mil/Publications.aspx15

TRICARE Standard and Extra

Eligibility• Active duty family members, retired service members and their family

members, eligible survivors, eligible former spouses, Medal of Honor recipients and their family members

Enrollment • Not required

Costs

• Annual outpatient deductible:• ADFMs (sponsor rank E-4 and below): $50/Individual, $100/Family• All others: $150/Individual, $300/Family

• Cost-shares:• ADFMs: 20% TRICARE Standard; 15% TRICARE Extra• All others: 25% TRICARE Standard; 20% TRICARE Extra

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TRICARE & Other Health Insurance

• TRICARE pays after all other health insurance, except for:– Medicaid– TRICARE supplements– State Victims of Crime Compensation Programs– Other Federal Government Programs identified by the Director,

Defense Health Agency (i.e. Indian Health Service)

• Coordination of benefits• Active duty service members and other health insurance

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TRICARE For Life

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TRICARE For Life and Other Health Insurance

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TRICARE For Life Region

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TRICARE Young Adult

• Qualified young adult dependents until age 26

• TRICARE Prime and TRICARE Standard options

• Monthly premiums:– TRICARE Prime option: $306 per month– TRICARE Standard option: $228 per month

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TRICARE Reserve Select & TRICARE Retired Reserve

TRICARE Reserve Select •A premium-based plan•Available worldwide•For qualified Selected Reserve members and their families•Monthly premiums:

– Member Only: $47.90 per month

– Member + Family: $210.83 per month

TRICARE Retired Reserve •A premium-based plan•Available worldwide•For qualified retired reserve members, their families and survivors who qualify. Monthly premiums:

– Member Only: $388.79 per month

– Member + Family: $957.44 per month

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TRICARE Pharmacy Program

TRICARE Formulary Search Tool: https://www.express-scripts.com/static/formularySearch

Costs in the U.S and U.S Territories (Guam, Puerto Rico, the Northern Mariana Islands, American Samoa, and the U.S. Virgin Islands)

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TRICARE & The Affordable Care Act

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TRICARE Healthcare Claims

Who Files?• Network providers• Non-network providers

Filing Deadlines• United States and U.S. Territories • Active duty service members’ claims

Submitting Claims

• TRICARE For Life - send claims to the TRICARE For Life contractor

•All other plans - send claims to the claims address for the region where the beneficiary lives

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Resources

Stateside Regional ContractorsTRICARE North RegionHealth Net Federal Services1-877-TRICARE (1-877-874-2273)www.hnfs.com

TRICARE South RegionHumana Military Healthcare Services1-800-444-5445www.humana-military.com

TRICARE West RegionUnitedHealthcare Military & Veterans1-877-988-WEST (1-877-988-9378)www.uhcmilitarywest.com

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Resources (cont.)

Overseas Regional ContractorInternational SOS Assistance, Inc. Eurasia-Africa Area+44-20-8762-8384Stateside: 1-877-678-1207

Latin America & Canada Area+1-215-942-8393Stateside: 1-877-451-8659

Pacific AreaSingapore: +65-6339-2676Stateside: 1-877-678-1208Sydney: +61-2-9273-2710Stateside: 1-877-678-1209

www.tricare-overseas.com

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Resources (cont.)

TRICARE For Life Contractor

Express Scripts, Inc.1-877-363-1303www.express-scripts.com/TRICARE

TRICARE Pharmacy Program

Wisconsin Physicians Service1-866-773-0404www.tricare4u.com

TRICARE Web sitewww.tricare.mil

TRICARE Contacts www.tricare.mil/contacts

TRICARE Universitywww.tricare.mil/tricareu

www.tricare.mil/mediacenter

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*Type your response in the chat pod.

What more would you like to learn about TRICARE®?

““Medically Ready Force…Ready Medical ForceMedically Ready Force…Ready Medical Force”” 29

Questions?

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Evaluation and Certificate of Completion

MFLN Military Caregiving is offering Continued Education Credits as well as a certificate of completion for today’s webinar.

To receive certificate of completion, please complete the evaluation and post-test at: https://vte.co1.qualtrics.com/SE/?SID=SV_1yHyRRfZ5HKuNSZ

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Military Caregiving Upcoming Event

Test Your Caregiver IQ• Date: Wednesday, March 9, 2016 • Time: 11:00 a.m. Eastern• Location: https://learn.extension.org/events/2490

For more information on MFLN Military Caregiving go to: http://blogs.extension.org/militaryfamilies/military-caregiving/

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