***2019***TRICARE CHOICES Flashcards
WHAT IS A MANAGED CARE OR HEALTH MAINTENANCE ORGANIZATION (HMO) OPTION AVAILABLE IN SPECIFIC GEOGRAPHIC AREAS?
TRICARE PRIME
WHAT IS A TRICARE PRIME LIKE BENEFIT FOR ACTIVE DUTY FAMILIES LIVING AND WORKING IN REMOTE LOCATIONS?
TRICARE PRIME REMOTE
WHAT IS A FEE FOR SERVICE OPTION AVAILABLE WORLDWIDE?
TRICARE STANDARD
WHAT IS A PREFERRED PROVIDER OPTION (PPO) IN AREAS WITH ESTABLISHED TRICARE NETWORKS?
TRICARE EXTRA
WHAT IS A PREMIUM BASED HEALTH PLAN THAT QUALIFIED NATIONAL GUARD AND RESERVE MEMBERS MAY PURCHASE?
TRICARE RESERVE SELECT (TRS)
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.
TRICARE FOR LIFE (TFL)
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?
US FAMILY HEALTHY PLAN (USFHP)
FOR WHAT WILL YOU RECEIVE MOST CARE FROM PRIMARY CARE MANAGER (PCM) AT A MILITARY TREATMENT FACILITY (MTF) OR WITHIN TRICARE NETWORK?
TRICARE PRIME
FOR WHAT WILL YOU RECEIVE CARE FROM TRICARE NETWORK PROVIDERS (OR A TRICARE AUTHORIZED PROVIDER IF NETWORK PROVIDER IS UNAVAILABLE)?
TRICARE PRIME REMOTE
FOR WHAT WILL YOU RECEIVE CARE FROM ANY TRICARE AUTHORIZED (NETWORK OR NON–NETWORK)?
TRICARE RESERVE SELECT (TRS)
FOR WHAT WIL YOU RECEIVE CARE FROM MEDICARE PROVIDERS?
TRICARE FOR LIFE (TFL)
FOR WHAT WILL YOU RECEIVE CARE FROM PRIMARY CARE PHYSICIAN IN THE HEALTH CARE SYSTEM TO WHICH YOU ARE ENROLLED?
US FAMILY HEALTH PLAN (USFHP)
IF YOU ENROLL IN WHAT YOU MAY NOT ACCESS CARE AT AN MTF, INCLUDING MTF PHARMACIES?
USFHP
CHANGES TO TRICARE PROGRAMS ARE CONTINUALLY MADE AS WHAT IS AMENDED?
PUBLIC LAW
WHO ARE NOT REQUIRED TO HAVE MEDICARE PART B TO REMAIN ELIGIBLE FOR TRICARE?
ADFMs
UPON SPONSOR’S RETIREMENT, WHAT MUST BE IN EFFECT NO LATER THAN THE SPONSORS RETIREMENT DATE TO AVOID A BREAK IN TRICARE COVERAGE?
MEDICARE PART B
NATIONAL GUARD AND RESERVE MEMBERS WHO MAY HAVE RETIRED FROM THEIR SERVICE ARE NOT ELIGIBLE FOR TRICARE COVERAGE UNTIL THEY REACH WHAT AGE?
TRADITIONAL RETIREMENT AGE
Determines TRICARE eligibility?
DEERS
SELRES activated for how long get eligibility?
30 days
Eligible age ends ___ unless child is in college, then it is ___
21
23
Dependent parents only eligible for?
TRICARE PLUS
Allows beneficiaries to self refer to specialists?
TRICARE standard
Catastrophic cap?
$1,000 of charges for AD
$3,000 everyone else
Under TRICARE standard AD family members pay ___% and retirees pay ___%
20
25
What program allows TRICARE prime enrollees to see specialists without a referral from their PCM?
Point-of-Service-Option
Cost share for POS option is?
50%
Enrollment fee for retired TRICARE PRIME candidates is ___ for individual and ____ for fam
$230
$460
Distance to qualify for TRICARE REMOTE?
50 miles or 1 Hour
What three overseas areas is TRICARE PRIME offered?
Europe Pacific, Latin America, Canada
STANDARD members are required to pay for?
Deductible, co-pay, meds, care
What is TRICARE for Life?
Medicare wrap around coverage
Who is eligible for TRICARE for Life?
Medicare entitled uniform members
To be eligible for TRICARE for Life you must?
Enroll in Medicare Part B
SELRES entitled up to how many days of benefits prior to mobilization?
90 days
Coverage after separation?
180 days
TRICARE is an enhancement to what?
CHAMPUS
Must enroll by what day of the month?
20th
Must enroll in dental for how many months?
12
Met life pays what %
60
File claim in how many days?
60
