NOTES FROM MCPON: FAMILYGRAM 01-10: MEDICAL BENEFITS

[Sonya Ansarov]

From: CNO Washington DC//N1//

To: NAVADMIN

Info: CNO Washington DC//N1//

UNCLAS//N06000//

NAVADMIN 072/10

MSGID/GENADMIN/CNO Washington DC/N1/FEB//

SUBJ/Familygram 01-10: Medical Benefits //

RMKS/1. This NAVADMIN is the first in a series of monthly "Familygrams" designed to enhance the preparedness and resiliency of our families as they face the daily challenges associated with the expeditionary nature of our total force. Each NAVADMIN will focus on a different topic, providing basic information and updates to the many benefits and support services available.

2. This month's NAVADMIN highlights one of the cornerstone entitlements of military service: medical benefits for military families.

3. TRICARE basics. TRICARE is the department of defense worldwide health care program available to active duty and reserve personnel and their families. TRICARE has several health plan options to meet the needs of its beneficiary population.

4. DEERS. The key to receiving timely and effective TRICARE benefits is proper registration in the Defense Enrollment Eligibility Reporting System (DEERS). DEERS is a worldwide, computerized database of uniformed service members (sponsors), their family members, and others who are eligible for military benefits, including TRICARE.

a. Sponsor data is reported to DEERS by the branch of service. However, the sponsor must register eligible family members.

b. Unreported changes and inconsistent data in the DEERS database can cause problems with TRICARE claims and lead to large medical expenses owed to TRICARE, so it is critical to continually update DEERS information. DEERS information should be updated if there is a change in the sponsor's status, such as marriage or divorce, birth of a child, relocation to a new area, or death of sponsor or family member. Additionally, expired identification cards (ID) could affect your ability to be seen by a physician.

Reviewing the expiration date of dependent identification cards must be a part of every pre-deployment checklist.

c. DEERS information can be verified by contacting a regional TRICARE managed care support contractor, local TRICARE service center, or the nearest uniformed services Personnel office (ID card facility). Sponsors or registered family members (with valid power of attorney) may make changes in DEERS. Two forms of identification are required prior to the issuance of all ID cards. All documents to determine eligibility, such as a marriage certificate, divorce decree, or birth certificate must be original or state certified copies.

To update your DEERS information:

(1) Visit the local uniformed services Personnel office or contact the Defense Manpower Data Center Support Office (DSO) at1-800-538-9552. The nearest uniformed services Personnel office can be found at http://www.dmdc.osd.mil/rsl/owa/home

(2) Fax address changes to DEERS at 1-831-655-8317.

(3) Mail address changes to:

The Defense Manpower Data Center Support Office

ATTN: COA

400 Gigling Road

Seaside, CA 93955-6671

(4) Go online to TRICARE at http://TRICARE.osd.mil/DEERS.

5. TRICARE coverage choices.

There are three main coverage choices for TRICARE:

a. TRICARE Prime. TRICARE Prime is a managed care option offering the most affordable and comprehensive coverage. Under TRICARE Prime, Military Treatment Facilities (MTF) are the primary source of health care where available. Active duty members are required to enroll in TRICARE Prime. Family members may choose to enroll in Prime or continue to use TRICARE standard or TRICARE extra. Under TRICARE Prime, there is no enrollment fee, deductible or co-payments for active duty members or their family members.

Upon enrollment in TRICARE Prime, active duty members and their dependents are assigned a Primary Care Manager (PCM) who provides most of the care. Active duty members are assigned a PCM at a MTF, while family members may choose a PCM either at a MTF, when capacity permits, or from the TRICARE Prime network providers.

TRICARE Prime offers enhanced clinical preventive services, access to care standards, priority access to care at MTFs, and a Prime travel benefit when referred by a PCM for authorized provider specialty care at a location more than 100 miles from the referring PCM. TRICARE Prime remote is available to active duty members and their family members who live and work in remote stateside locations.

b. TRICARE Standard. TRICARE Standard is a fee-for-service option, available worldwide, that provides the most flexibility.

Beneficiaries can see any TRICARE approved provider, no enrollment is required and there is no annual enrollment fee. Annual deductibles and cost-shares apply and beneficiaries are responsible for ensuring claims are submitted for payment.

Active duty members may not use TRICARE Standard as they are required to enroll in TRICARE Prime.

c. TRICARE Extra. TRICARE Extra is similar to TRICARE Standard but the cost share is less expensive when beneficiaries use TRICARE Prime network providers. Prime network providers file claims on the beneficiary's behalf. TRICARE Extra is not available overseas and may not be used by active duty members.

d. TRICARE Overseas Program-Prime. Active duty members and their command-sponsored family members when stationed overseas are eligible to enroll in TRICARE Overseas Program-Prime in areas supported by a MTF, or TRICARE global remote overseas in remote locations not supported by a MTF.

e. More information and assistance can be found at:

http://www.TRICARE.mil and

http://www.military.com/benefits/tricare/understanding-your-tricare-benefits

To receive helpful updates regarding your TRICARE benefits automatically, go to the TRICARE website above and click "e-mail updates" under "media center" in the right column, then choose the TRICARE topics on which you desire updates.

6. The challenges of Navy life whether deployed or not deployed extend from the Sailor to his or her family. We recognize and truly appreciate the support and sacrifices our families make every day.

7. Released by VADM Mark Ferguson, N1.//