TRICARE CHOICES: At a Glance 2014 Flashcards
Eligibility for TRICARE is determined by the services and information is maintained in the Defense Enrollment Eligibility Reporting System (DEERS).
The Continued Health Care Benefit Program (CHCBP) is a premium-based health care program available to former TRICARE-eligible members and their eligible family members, former spouses who have not remarried, emancipated children, and unmarried children by adoption or legal custody.
CHCBP offers transitional coverage after TRICARE eligibility ends for up to 18 months for former service members and their family members, and up to 36 months for former spouses who have not remarried and for adult dependents.
TRICARE Reserve Select (TRS)
Program Costs:
•Monthly premiums, annual deductibles, and cost-shares apply
•2014 TRS member-only monthly premium: $51.68
•2014 TRS member-and-family monthly premium: $204.29
TRICARE Retired Reserve (TRR):
•Premium-based health care plan that qualified Retired Reserve members may purchase for themselves and/or their family members until reaching age 60.
TRICARE Retired Reserve (TRR) continued:
•Monthly premiums, annual deductibles, and cost-shares apply
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2014 TRR member-only monthly premium: $390.99
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2014 TRR member-and-family monthly premium: $956.65
TRICARE Young Adult (TYA)• TYA includes medical and pharmacy benefits, but excludes dental coverage. •Monthly premiums apply •2014 TYA Prime monthly premium: $180 •2014 TYA Standard monthly premium: $156
If you are entitled to Medicare Part A, you generally must have Medicare Part B to remain TRICARE-eligible, regardless of age or place of residence.
If you are eligible for TRICARE and have Medicare Part A and Medicare Part B, you are automatically covered by TRICARE For Life (TFL).
By law, TRICARE can only pay up to 20 percent of the TRICARE-allowable amount.
There are two types of TRICARE-authorized providers: network and non-network.
Non-network providers are either “participating” or “nonparticipating.” Participating providers have agreed to accept payment directly from TRICARE and accept the TRICARE-allowable charge (less any applicable patient cost-shares paid by you) as payment in full for their services.
Nonparticipating providers have not agreed to accept the TRICARE-allowable charge or file your claims and may charge up to 15 percent above the TRICARE-allowable charge.
If a non-network provider does not participate on a claim, he or she may bill no more than 115 percent of the TRICARE-allowable charge. Note: Non-network providers may choose to participate on a claim-by-claim basis.
When using TRICARE Standard and TRICARE Extra, TRS, and TRR, you are responsible, under law, to pay an annual deductible and cost-shares associated with your care.
The law prohibits health care providers from waiving the deductible or cost-shares, and providers who offer or advertise that they will do so can be suspended or excluded as TRICARE-authorized providers.
