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1 TRICARE Overview for Retired Reserve Members and Their Eligible Family Members Presenter Name Month DD, YYYY Updated October 2011 TRICARE ® Your Military.

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Presentation on theme: "1 TRICARE Overview for Retired Reserve Members and Their Eligible Family Members Presenter Name Month DD, YYYY Updated October 2011 TRICARE ® Your Military."— Presentation transcript:

1 1 TRICARE Overview for Retired Reserve Members and Their Eligible Family Members Presenter Name Month DD, YYYY Updated October 2011 TRICARE ® Your Military Health Plan

2 2 2 Todays Agenda TRICARE Overview Medical Coverage Other Important Information For Information and Assistance Photo courtesy of the National Guard

3 3 3 What Is TRICARE? TRICARE is… … the health care program serving active duty service members, National Guard and Reserve members, retirees, family members, survivors, and certain former spouses worldwide. … a network of military and civilian health care professionals working together to foster, protect, sustain, and restore health for those entrusted to their care.

4 4 4 TRICARE Stateside Regions (United States and Washington, DC) What Is TRICARE? TriWest Healthcare Alliance Humana Military Healthcare Services, Inc. Health Net Federal Services, LLC

5 5 5 TRICARE Overseas Program (TOP) The TRICARE Overseas Program is managed through three geographic areas What Is TRICARE? Latin America and Canada Central and South America, the Caribbean Basin, Canada, Puerto Rico, and the U.S. Virgin Islands Eurasia-Africa Europe, Africa, and the Middle East Pacific Asia, Guam, Australia, New Zealand, and Western Pacific remote countries International SOS Assistance, Inc. administers the TRICARE Overseas Program

6 6 6 Register Your Family in DEERS Register your family members in the Defense Enrollment Eligibility Reporting System (DEERS) – In person at a uniformed services identification (ID) card-issuing facility: www.tricare.mil/deers – By sending changes and required documentation to: Defense Manpower Data Center Support Office 400 Gigling Road Seaside, CA 93955-6771 TRICARE Eligibility Registration in DEERS is key to TRICARE eligibility

7 7 7 Register Your Family in DEERS To register your family in DEERS, proper documentation is required and can include: – Marriage certificate – Divorce decree – Adoption papers – Birth certificate You can verify eligibility in one of three ways: – Go to www.dmdc.osd.mil/appj/address/ – Visit your local military treatment facilitys (MTFs) Patient Administration Office – Contact your services personnel office TRICARE Eligibility

8 8 8 Remember to register/update in DEERS whenever there is a change in the family (marriage, birth, adoption, divorce, death, etc.) or when you move Keep your contact information up to date: – Online: www.dmdc.osd.mil/appj/address/ – By phone: 1-800-538-9552 – By fax: 1-831-655-8317 – By visiting an ID card-issuing facility: www.dmdc.osd.mil/rsl – More information: www.tricare.mil/deers Updating DEERS TRICARE Eligibility

9 9 9 TRICARE Retired Reserve (TRR): Qualifying Members Medical Coverage –A member of the Retired Reserve who is qualified for non-regular retirement –Under age 60 –Not eligible for or enrolled in the Federal Employees Health Benefits (FEHB) program Photo courtesy of the National Guard A member may qualify to purchase TRR coverage if he or she is:

10 10 TRR: Qualifying Survivors The deceased sponsor was covered by TRR on the date of his or her death Survivors are immediate family members of the deceased sponsor (spouses cannot have remarried) TRR coverage would begin before the date the deceased sponsor would have reached age 60 Medical Coverage Survivors may qualify to purchase TRR coverage if all of the following apply:

11 11 TRR: Changes in Family Composition Adding a family member: Newborns and newly adopted children must be registered in DEERS and TRR within 60 days for TRICARE to provide coverage retroactive to the date of birth or the date of adoption. Removing a member: Log on to the DMDC Reserve Component Purchase TRICARE Application at https://dmdc.osd.mil/appj/reservetricare and follow instructions to disenroll. Medical Coverage

12 12 TRR: Purchasing Medical Coverage Log on to the Defense Manpower Data Center (DMDC) Reserve Component Purchase TRICARE Application at https://www.dmdc.osd.mil/appj/reservetricare To access the Web site, you will need to use a Department of Defense (DoD) Self Service Logon (DS Logon) premium account or Common Access Card (CAC) Complete, print, and sign the Reserve Component Health Coverage Request form (DD Form 2896-1) Mail the completed form with the first two months premium payment to your regional or overseas contractor

13 13 TRR: Getting Care Medical Coverage See any TRICARE-authorized provider for care – Network provider = lower costs – Non-network provider = higher costs Find a network provider: www.tricare.mil/findaprovider No referrals are necessary for care, but certain services require prior authorization In the event of an emergency, call 911 or go to the nearest emergency room Care is available at military treatment facilities (MTFs) on a space-available basis only

14 14 Priority for Access to Military Treatment Facility Care Other Important Information 1 Active duty service members, including National Guard and Reserve members on active duty status 2 Active duty family members enrolled in a TRICARE Prime option 3 Retired service members, their dependents, and all others enrolled in a TRICARE Prime option 4 Active duty family members not enrolled in a TRICARE Prime option, and TRICARE Reserve Select beneficiaries 5 Retired service members and their dependents not enrolled in a TRICARE Prime option, TRICARE Retired Reserve beneficiaries, and all other eligible beneficiaries not enrolled in a TRICARE Prime option

15 15 TRICARE Pharmacy Program Other Important Information Express Scripts, Inc. Web site: www.express-scripts.com/TRICARE Phone number: 1-877-363-1303

16 16 TRR: Costs Medical Coverage TRR Member-Only:TRR Member-and-Family: Monthly Premiums $408.01 $1,020.05 Annual Deductibles (per fiscal year, Oct. 1-Sept. 30) $150$300 Cost-Shares (after annual deductible is met) Network Provider: 20% Non-Network Provider: 25% Catastrophic Cap (per fiscal year) $3,000 per fiscal year

17 17 TRICARE Retiree Dental Program (TRDP) Other Important Information Voluntary, premium-based program Premiums depend on sponsors location and number of family members enrolled Enroll in three ways: –Online at TRDP Web site: www.TRDP.org –By toll-free telephone: 1-888-838-8738 –By mail: Delta Dental of California Federal Government Programs PO Box 537008 Sacramento, CA 95853-7008

18 18 TRICARE serves as the secondary payer, if you have other health insurance (OHI). If you have OHI: – Fill out a TRICARE Other Health Insurance Questionnaire (www.tricare.mil/mybenefit/Forms.do) – If you have OHI, you must follow your OHIs rules – Tell your provider about your OHI and TRICARE coverage TRICARE and Other Health Insurance Other Important Information

19 19 Social Security Number Removal from ID Cards TRICARE Health Benefit In an effort to protect the privacy of TRICARE beneficiaries, the Department of Defense (DoD) is removing Social Security numbers (SSNs) from military ID cards, including the Common Access Card. Your new ID card will have one or both of the following: –A 10-digit DoD ID Number –A DoD Benefits Number (DBN), if you are eligible for DoD benefits You will not need a new ID card until your old card expires. For more information, visit www.tricare.mil/ssn

20 20 Stateside Regional Contractors TRICARE North Region Health Net Federal Services, LLC 1-877-TRICARE (1-877-874-2273) www.hnfs.com TRICARE South Region Humana Military Healthcare Services, Inc. 1-800-444-5445 www.humana-military.com TRICARE West Region TriWest Healthcare Alliance 1-888-TRIWEST (1-888-874-9378) www.triwest.com General Contact Information TRICARE Web site: www.tricare.mil Contacts: www.tricare.mil/contacts Military Medical Support Office: www.tricare.mil/tma/mmso For Information and Assistance Connect with TRICARE Online! www.tricare.mil/mediacenter PP4372BET09112W Overseas Regional Contractor International SOS Assistance, Inc. Eurasia-Africa: +44-20-8762-8384 (overseas) 1-877-678-1207 (stateside) Latin America and Canada: +1-215-942-8393 (overseas) 1-877-451-8659 (stateside) Pacific: Singapore: +65-6339-2676 (overseas) 1-877-678-1208 (stateside) Sydney: +61-2-9273-2710 (overseas) 1-877-678-1209 (stateside) Web site: www.tricare-overseas.com


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