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TRICARE Overview for Retired Reserve Members and Their Eligible Family

Members

Presenter NameMonth DD, YYYY

Updated October 2011

TRICARE®

Your Military Health Plan

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Today’s Agenda

• TRICARE Overview

• Medical Coverage

• Other Important Information

• For Information and Assistance

Photo courtesy of the National Guard

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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.

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TRICARE Stateside Regions (United States and Washington, DC)

What Is TRICARE?

TriWest Healthcare Alliance

Humana Military Healthcare Services, Inc.

Health Net FederalServices, LLC

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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

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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 RoadSeaside, CA 93955-6771

TRICARE Eligibility

Registration in DEERS is key to TRICARE eligibility

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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 facility’s (MTF’s) Patient Administration Office

– Contact your service’s personnel office

TRICARE Eligibility

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• 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 DEERSTRICARE Eligibility

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TRICARE Retired Reserve (TRR): Qualifying MembersMedical 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:

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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:

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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

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TRR: PurchasingMedical 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

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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

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Priority for Access to Military Treatment Facility CareOther Important Information

1Active duty service members, including National Guard and Reserve members on active duty status

2Active duty family members enrolled in a TRICARE Prime option

3Retired service members, their dependents, and all others enrolled in a TRICARE Prime option

4Active duty family members not enrolled in a TRICARE Prime option, and TRICARE Reserve Select beneficiaries

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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

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TRICARE Pharmacy ProgramOther Important Information

Express Scripts, Inc. Web site: www.express-scripts.com/TRICARE Phone number: 1-877-363-1303

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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

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TRICARE Retiree Dental Program (TRDP)Other Important Information

• Voluntary, premium-based program

• Premiums depend on sponsor’s 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 ProgramsPO Box 537008 Sacramento, CA 95853-7008

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• 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 OHI’s rules

– Tell your provider about your OHI and TRICARE coverage

TRICARE and Other Health Insurance Other Important Information

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Social Security Number Removal from ID CardsTRICARE 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

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Stateside Regional Contractors

TRICARE North RegionHealth Net Federal Services, LLC1-877-TRICARE (1-877-874-2273)www.hnfs.com

TRICARE South RegionHumana Military Healthcare Services, Inc.1-800-444-5445www.humana-military.com

TRICARE West RegionTriWest Healthcare Alliance1-888-TRIWEST (1-888-874-9378)www.triwest.com

General Contact InformationTRICARE Web site: www.tricare.mil Contacts: www.tricare.mil/contactsMilitary Medical Support Office: www.tricare.mil/tma/mmso

For Information and Assistance

Connect with TRICARE Online!

www.tricare.mil/mediacenter

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Overseas Regional ContractorInternational 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