Informed DecisionInformed Decision

Briefers: A1C CironeBriefers: A1C Cirone

SSgt SwiftSSgt Swift

HealthCare OptionsHealthCare Options

TRICARE PrimeTRICARE Prime

TRICARE StandardTRICARE Standard

TRICARE ExtraTRICARE Extra

Continued Health Care Benefit Plan Continued Health Care Benefit Plan (CHCBP)(CHCBP)

TRICARE PrimeTRICARE Prime

No Enrollment Fee for Active Duty & No Enrollment Fee for Active Duty & Family Members enrolledFamily Members enrolled

No Annual DeductiblesNo Annual Deductibles

No co-paysNo co-pays

TRICARE StandardTRICARE Standard

No Annual Enrollment FeeNo Annual Enrollment Fee

Annual Deductibles:Annual Deductibles:

For E1-E4 $50 Individual/or $100 FamilyFor E1-E4 $50 Individual/or $100 Family

For E5 & above $150 Individual/ or $300 For E5 & above $150 Individual/ or $300 FamilyFamily

Cost Shares for Outpatient Visit 20% of Cost Shares for Outpatient Visit 20% of allowed charges AFTER deductible is metallowed charges AFTER deductible is met

TRICARE ExtraTRICARE Extra

No Annual Enrollment FeeNo Annual Enrollment Fee

Annual Deductibles:Annual Deductibles:

For E1-E4 $50 Individual/or $100 FamilyFor E1-E4 $50 Individual/or $100 Family

For E5 & above $150 Individual/ or $300 For E5 & above $150 Individual/ or $300 FamilyFamily

Same as Standard, difference is using a Same as Standard, difference is using a Network Provider you pay 15% for Civilian Network Provider you pay 15% for Civilian Outpatient Visit (saves you 5%)Outpatient Visit (saves you 5%)

Coverage EndsCoverage Ends

On 0001 on the day after you separate On 0001 on the day after you separate your Medical Coverage ends…your Medical Coverage ends…

CHCBPCHCBP

Continued Health Care Benefit Plan Continued Health Care Benefit Plan (CHCBP)(CHCBP)Transitional Benefits from 18-36 months Transitional Benefits from 18-36 months after separationafter separationBenefits Similar to TRICARE StandardBenefits Similar to TRICARE StandardQuarterly Premiums $933 Quarterly Premiums $933 Individual/$1,996 for Family Individual/$1,996 for Family Must enroll within 60 days of separationMust enroll within 60 days of separation1-800-444-54451-800-444-5445

Pharmacy BenefitsPharmacy Benefits

Choices:Choices:

Military Treatment Facility $0Military Treatment Facility $0

TRICARE Mail Order Pharmacy $3 TRICARE Mail Order Pharmacy $3 Generic/$9 Brand Name (upto 90 days Generic/$9 Brand Name (upto 90 days supply)supply)

Retail Network Pharmacy (upto 30 days Retail Network Pharmacy (upto 30 days supply)supply)

Non-network Pharmacy Non-network Pharmacy

Dental BenefitsDental Benefits

Active Duty Members seen at the Dental Active Duty Members seen at the Dental ClinicClinicFamily Members can be enrolled with Family Members can be enrolled with United ConcordiaUnited ConcordiaSingle premium $9.32, Family Premium Single premium $9.32, Family Premium $23.31 a/o 1 Feb 05 $23.31 a/o 1 Feb 05 2 Dental Cleanings a Year2 Dental Cleanings a YearFollows 20 day of the month ruleFollows 20 day of the month rule1-888-866-84991-888-866-8499

Website ResourcesWebsite Resources

www.tricare.osd.milwww.tricare.osd.mil

www.humana-military.comwww.humana-military.com

www.tricareonline.comwww.tricareonline.com

www.ucci.comwww.ucci.com

How to contact us?How to contact us?

14 Medical Group Clinic 14 Medical Group Clinic

Beneficiary Services OfficeBeneficiary Services Office

434-2137/2138434-2137/2138