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*** OCCUPATIONAL REFERENCES - SEPT 2014 *** > ***2019***TRICARE CHOICES > Flashcards

***2019***TRICARE CHOICES Flashcards

1
Q

WHAT IS A MANAGED CARE OR HEALTH MAINTENANCE ORGANIZATION (HMO) OPTION AVAILABLE IN SPECIFIC GEOGRAPHIC AREAS?

A

TRICARE PRIME

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2
Q

WHAT IS A TRICARE PRIME LIKE BENEFIT FOR ACTIVE DUTY FAMILIES LIVING AND WORKING IN REMOTE LOCATIONS?

A

TRICARE PRIME REMOTE

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3
Q

WHAT IS A FEE FOR SERVICE OPTION AVAILABLE WORLDWIDE?

A

TRICARE STANDARD

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4
Q

WHAT IS A PREFERRED PROVIDER OPTION (PPO) IN AREAS WITH ESTABLISHED TRICARE NETWORKS?

A

TRICARE EXTRA

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5
Q

WHAT IS A PREMIUM BASED HEALTH PLAN THAT QUALIFIED NATIONAL GUARD AND RESERVE MEMBERS MAY PURCHASE?

A

TRICARE RESERVE SELECT (TRS)

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6
Q

WHAT IS A MEDICARE WRAPAROUND COVERAGE AVAILABLE TO ALL MEDICARE ELIGIBLE TRICARE BENEFICIARIES, REGARDLESS OF AGE, PROVIDED THEY HAVE MEDICARE PART A, AND MEDICARE PART B.

A

TRICARE FOR LIFE (TFL)

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7
Q

WHAT IS A TRICARE PRIME MANAGED CARE OPTION AVAILABLE THROUGH NETWORKS OF COMMUNITY BASED NOT FOR PROFIT HEALTH CARE SYSTEMS IN SIX AREAS OF THE UNITED STATES?

A

US FAMILY HEALTHY PLAN (USFHP)

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8
Q

FOR WHAT WILL YOU RECEIVE MOST CARE FROM PRIMARY CARE MANAGER (PCM) AT A MILITARY TREATMENT FACILITY (MTF) OR WITHIN TRICARE NETWORK?

A

TRICARE PRIME

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9
Q

FOR WHAT WILL YOU RECEIVE CARE FROM TRICARE NETWORK PROVIDERS (OR A TRICARE AUTHORIZED PROVIDER IF NETWORK PROVIDER IS UNAVAILABLE)?

A

TRICARE PRIME REMOTE

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10
Q

FOR WHAT WILL YOU RECEIVE CARE FROM ANY TRICARE AUTHORIZED (NETWORK OR NON–NETWORK)?

A

TRICARE RESERVE SELECT (TRS)

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11
Q

FOR WHAT WIL YOU RECEIVE CARE FROM MEDICARE PROVIDERS?

A

TRICARE FOR LIFE (TFL)

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12
Q

FOR WHAT WILL YOU RECEIVE CARE FROM PRIMARY CARE PHYSICIAN IN THE HEALTH CARE SYSTEM TO WHICH YOU ARE ENROLLED?

A

US FAMILY HEALTH PLAN (USFHP)

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13
Q

IF YOU ENROLL IN WHAT YOU MAY NOT ACCESS CARE AT AN MTF, INCLUDING MTF PHARMACIES?

A

USFHP

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14
Q

CHANGES TO TRICARE PROGRAMS ARE CONTINUALLY MADE AS WHAT IS AMENDED?

A

PUBLIC LAW

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15
Q

WHO ARE NOT REQUIRED TO HAVE MEDICARE PART B TO REMAIN ELIGIBLE FOR TRICARE?

A

ADFMs

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16
Q

UPON SPONSOR’S RETIREMENT, WHAT MUST BE IN EFFECT NO LATER THAN THE SPONSORS RETIREMENT DATE TO AVOID A BREAK IN TRICARE COVERAGE?

A

MEDICARE PART B

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17
Q

NATIONAL GUARD AND RESERVE MEMBERS WHO MAY HAVE RETIRED FROM THEIR SERVICE ARE NOT ELIGIBLE FOR TRICARE COVERAGE UNTIL THEY REACH WHAT AGE?

A

TRADITIONAL RETIREMENT AGE

18
Q

Determines TRICARE eligibility?

A

DEERS

19
Q

SELRES activated for how long get eligibility?

A

30 days

20
Q

Eligible age ends ___ unless child is in college, then it is ___

A

21

23

21
Q

Dependent parents only eligible for?

A

TRICARE PLUS

22
Q

Allows beneficiaries to self refer to specialists?

A

TRICARE standard

23
Q

Catastrophic cap?

A

$1,000 of charges for AD

$3,000 everyone else

24
Q

Under TRICARE standard AD family members pay ___% and retirees pay ___%

A

20

25

25
Q

What program allows TRICARE prime enrollees to see specialists without a referral from their PCM?

A

Point-of-Service-Option

26
Q

Cost share for POS option is?

A

50%

27
Q

Enrollment fee for retired TRICARE PRIME candidates is ___ for individual and ____ for fam

A

$230

$460

28
Q

Distance to qualify for TRICARE REMOTE?

A

50 miles or 1 Hour

29
Q

What three overseas areas is TRICARE PRIME offered?

A

Europe Pacific, Latin America, Canada

30
Q

STANDARD members are required to pay for?

A

Deductible, co-pay, meds, care

31
Q

What is TRICARE for Life?

A

Medicare wrap around coverage

32
Q

Who is eligible for TRICARE for Life?

A

Medicare entitled uniform members

33
Q

To be eligible for TRICARE for Life you must?

A

Enroll in Medicare Part B

34
Q

SELRES entitled up to how many days of benefits prior to mobilization?

A

90 days

35
Q

Coverage after separation?

A

180 days

36
Q

TRICARE is an enhancement to what?

A

CHAMPUS

37
Q

Must enroll by what day of the month?

A

20th

38
Q

Must enroll in dental for how many months?

A

12

39
Q

Met life pays what %

A

60

40
Q

File claim in how many days?

A

60

*** OCCUPATIONAL REFERENCES - SEPT 2014 *** (32 decks)

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