Tricare for Life or Tricare Plus

Since 03-18-04

Updated for killing dead links 12-06-04

http://www.tricare.osd.mil/factsheets/viewfactsheet.cfm?id=268

All,

A new fact sheet titled "TRICARE For Life and Dual Eligibility" has been uploaded to the TRICARE Web site.  This fact sheet replaces the TRICARE For Life fact sheet and the Dual Eligibility fact sheet.  The fact sheet, can be viewed on the TRICARE Web site by clicking on the following link:

http://www.tricare.osd.mil/factsheets/viewfactsheet.cfm?id=268

The fact sheet titled "The Defense Enrollment Eligibility Reporting System (DEERS)" has been  updated to include DEERS Verification Changes for
Unremarried Former Spouses.  The fact sheet, can be viewed  on the TRICARE Web site by clicking on the following link:
http://www.tricare.osd.mil/Factsheets/viewfactsheet.cfm?id=126

Remember, we have a Fact Sheet list serve!  Receiving  these updates are a great way to keep abreast of changes made to our fact sheets.  Anyone can subscribe to receive fact sheet updates at the following link:
http://www.tricare.osd.mil/Factsheets/mail/mailsub.cfm
   Pass it along!
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http://www.mytricare.com/Internet/tric/tri/tricare.nsf/PGS/TRCRBscs_Prgrms _7?OpenDocument&Start=1&Count=1000&ExpandView

http://www.dcmilitary.com/tricare/2_1/news/11071-1.html

TRICARE Plus is a military treatment facility primary care enrollment program that is offered at selected local military treatment facilities. All beneficiaries eligible for care in military treatment facilities (except those enrolled in TRICARE Prime, a civilian HMO, or Medicare HMO) can seek enrollment for primary care at military treatment facilities where enrollment capacity exists. Non-enrollment in TRICARE Plus does not affect TRICARE For Life benefits or other existing programs.

TRICARE Plus Benefits:

  o Enrollees will use their designated primary care provider at the military
treatment facility as their principal source of health care.

  o Persons enrolled in TRICARE Plus can continue to obtain care from
civilian and/or Medicare providers; TRICARE Standard/Extra or Medicare rules apply.  TRICARE will be second payer to Medicare for TRICARE-covered services.

  o Enrollees are not locked into a health maintenance organization (HMO)-like program.

  o There are no enrollment fees.

  o TRICARE Plus enrollees will receive primary care appointments with the
same access standards as TRICARE Prime enrollees.

  o TRICARE Plus enrollment is noted on beneficiary records in Defense
Enrollment Eligibility Reporting System (DEERS).

  o Eligible beneficiaries with existing relationships with primary care
providers at military treatment facilities will have the first opportunity to
enroll as long as the facility has the capacity (space) and capability
(resources). Remaining enrollment capacity will be made available to other
beneficiaries through a fair process.

TRICARE Plus Limitations:

  o TRICARE Plus will not be available at all military treatment facilities. Local commanders will retain discretion to continue or discontinue TRICARE
Plus at individual military treatment facilities depending on their capacities/ capabilities and missions.

  o TRICARE Plus is a military treatment facility primary care access program, not a health plan. For care from civilian providers, TRICARE Plus has no effect and TRICARE Standard/Extra rules will apply for most enrollees. For
services payable by Medicare, Medicare rules will apply, with TRICARE as second payer for TRICARE covered services and supplies.

  o TRICARE Plus does not guarantee access to specialty care at the military
treatment facility where the beneficiary is enrolled.

  o Prospective enrollees will apply for enrollment in TRICARE Plus. Enrollment may be determined, in part, by the specific missions and needs of
each military treatment facility (for example, GME, existing TRICARE Senior
Prime program, etc.).

  o TRICARE Plus is not a portable benefit. Enrollment at one facility will
not guarantee access at another facility.

  o TRICARE Plus enrollees are discouraged from obtaining nonemergency
primary care from sources outside the military treatment facility where they are enrolled.

  o Beneficiaries enrolled in an HMO or similar program of another sponsor (TRICARE Prime, employer-sponsored HMO, Medicare Choice) are not eligible for TRICARE Plus because they have an established primary care relationship.

  o Continued enrollment in TRICARE Plus is reviewed annually by the local military treatment facility; beneficiaries may be disenrolled if capacity is no longer available.

For more information about TRICARE Plus, call 1-888-DOD-LIFE
(1-888-363-5433).

SOURCE:  TRICARE Fact Sheet at
http://www.tricare.osd.mil/factsheets/viewfactsheet.cfm?id=91
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Contributed,
YNCS Don Harribine, USN(Ret)