TRICARE’ Choices: At a Glance AK Ne ‘TRICARE is the Department of Defense’s worldwide health care program available to cligible beneficiaries from any of the seven uniformed services—the U.S. Army, U.S. Navy, U.S. Air Foree, U.S. Marine Corps, U.S, Coast Guard, U.S. Public Health Service Commissioned Corps, and the ‘National Oceanic and Atmospheric Administration TRICARE Choices: At a Glance provides an overview of TRICARE's programs, including medical, pharmacy, and dental options. Eligibility for TRICARE is determined by information in the Defense Enrollment Eligibility Reporting System (DEERS). It is important for sponsors to keep DEERS records up to date. Por eligibility, enrollment, cost, and coverage details, visit www.tricare.mil or contact your regional contractor. See the For Information and Assistance section for contact information. What TRICARE program options are available? Depending on your beneficiary category and location, you may be eligible for different program options. Use the chart below to determine your available options. Additional program details are listed inside. ‘Your options may change when you move or when you become entitled to Medicare Part A. For assistance with health care coverage when moving or traveling, contact your regional contractor. TRICARE Program Options ‘Active duty service members (ADSMs) ‘TRICARE Prime (Uncludes National Guard and Reserve memberst | TRICARE Prime Remote ‘activated for more than 30 consecutive days) ‘TRICARE Active Duty Dental Program ‘Active duty family members (ADFMs)? ‘TRICARE Prime (Uncludes family members of National Guard | TRICARE Prime Remote for Active Duty and Reserve members! activated for more than | Family Members (TPRADFM) 30 consecutive days and certain survivors) TRICARE Standard ‘TRICARE Extra ‘TRICARE For Life (TFL) (ADFMs must have Medicare Part B to participate in TFL) US Family Health Plan ‘TRICARE Dental Program Retired service members and eligible family _ | TRICARE Prime ‘members, survivors, Medal of Honor recipients, | TRICARE Standard qualified former spouses, and others TRICARE Extra ‘TFL (f entitled to premium-free Medicare Part A based on age, disabitity, or end-stage renal disease, the beneficiary ‘must have Medicare Part B to keep TRICARE eligibility) Us Family Health Plan ‘TRICARE Retiree Dental Program National Guard and Reserve members and | TRICARE Reserve Select (members of the Selected Reserve) their family members ‘TRICARE Retired Reserve (members of the (Qualified, non-active duty members of the Retired Reserve under age 60) Selected Reserve, Retired Reserve, and certain | TRICARE Dental Program ‘members of the Individual Ready Reserve) TRICABA Ties Deal 1 The National Guard and Reserve includes the Army National Guard, the Army Reserve, the Navy Reserve, the Marine Corps Reserve the Air National Guard the Air Farce Reserve, andthe US. Coat Guard Reserve. For move information about benefits Jorthe National Guard and Reserve visi htplra defenseor 2.-ADFMs are mot requted to have Medicare Part B10 remain eligible for TRICARE. Once the sponsor reaches age 65, Medicare Par B must be in efet mo later tha dhe sponsors retiroment date 10 avoid a break in TRICARE: coverage ‘August 2010TRICARE Program Options TRICARE Program Descriptions Program Bien Creeks TRICARE | «Sinilartoa managed care or healt» | «Earoment equited sredeneet any fees ner eine mnaintenanee erganiatin option |“ Rtiees te amis, suvvrs,| ate manager (POND aa iary tvallbe im specie geographic areas | end qualifying frmer spouses” | teament city (TP) or vin pay sna enalnen ee the TRICARE network «Dt owt oureFporet casts | + PM era routed or mest ‘posi onc TRICARE | = Benet simiarto TRICARE Prine | Envolinen equa ~Recrve care fom TRICARE Prime | "foractve day service members ving | No nm envaiment ee rework prvi or TRICARE- Remote and working in remote locations and | + Offers same low out-of-pocket | authorized provider if a network Gindudes | | ‘hecighictmiymemtcssaing | cost wTRICARE rine, | prmuer novell Petree TRICARE | = Fee forservie pion aailabie | "No ewolinen required ~ Rez cr from TRICARE. banded | picuise ‘oe samen os ‘ihinod ww cok pvr Sucameaagieacs |oNeatinangian satan taseemesead cos. | sSeapeerckentonie mx ‘shares apply! authorization + Mayen nTRICARE Phs where available? WaCARE | Pint vier optonn en wah | No catia aud “Receive cre rom TRICARE beta tiublshes TRICARE netwaks | No uma! enralien ee nerwodk provider mae ee wenrahaeat apices | +N els und + kota detain * Somesercenegane le momaraaamegey | meee WOM | Tkabalndiacda |-Marediicnnpused | temmaehan uy Reserve | tharqulitea Nationa! Guardand | “TRS ch parapae TRICARE sthrized poider Select (TRS) | Reverie members may purchne | +Monhly premiums, annual | factenk ov nonncraoey + Aral wordvie ects an cette apply | «No rete equines ~ Offers member-only and member = Soe es alr noon aun TweanE | -Premion Seed neath care pan tat |+Miat qualify xan patase | “Reeve eo Hom map Retired | qalfid Rotred Reserve members | “TR o pacipate TTRICARE authorized prover fevws || ony puna + Monty preter, anual | (network or nom acted tran) | + ave werkwide Aesuciben and coe stures apply | +No retort equine pvt maby sata + Some services requ pir alsa aage trzaton TRICARE | -TRICARE's Mecicae-wrapaound | =No enrolment fees OR ics ec Serie | aoeeeerchane wil Moser eligible TRICARE beneficiaries, regardless of age, provided they have ‘Medicare Part A and Medicare Part B + Must be entitled to premium: free Medicare Part A and have purchased Medicare Part B providers + Can use TRICARE Pharmacy Home Delivery option to meet prescription needs + May enroll in TRICARE Plus Where available? ‘Auinoried providers who are not part ofthe TRICARE network of civilian providers ma charge beneficiaries using TRICARE Standard upto TS perce ‘above the TRICARE-cllowable charge for services, Beneficiaries are responsible for that additonal TS percent, cons with appteable cost share nd ‘deduce amounts. Note that overseas, authorized providers maybe allowed to charge more than 1S percent above lie TRICARE allowable charge ‘that anplies inthe United States and U.S. territories. You may earn ore by contacting & TRICARE Overseas Program (TOP) Regional Call Centr, TRICARE Area Office, or @ TRICARE Service Center, TRICARE Plus iso program that allows beneficiaries who normally are ony able 1 get care at MTF ona space-avuilable basis and who are not ‘enroed ina TRICARE Prime onion, to enrol und receive primar care appointment tthe MTF within the same primary care eecess wands ‘a benefitries enrolled in a TRICARE: Prime option.TRICARE Program Descriptions (continued) fea Type of Program Eien Reeaeemomie US Family | « TRICARE Prime managed care option Health Plan | ailable through nesworks of community. (USFHPP | based, not-for profit health care systems in six areas ofthe United States + Enrollment required ‘Depending on the health care system, enrollment fees may apply + Receive care from primary care providers inthe health care system to which you are enrolled + Primary care providers will refer you for specialty care {5 Ifyou choose to enroll in USFHP, ou may no access care at military treatment failies (MTF) including MTF pharmacies Additionally, you ‘are not eligible o re the other program options listed inthis Brochure. If ou decide to dvenroljrom USF or move out of ome ofits devignated Service areas, you regain eligi for other TRICARE: prograns. Note: Non-active duty beneficiaries may also seek care at military treatment facilities on a space-available basis. pX-Tale-1 me) o)atolary TRICARE Active Duty Dental Program | ‘The TRICARE Active Duty Dental Program (ADDP) is administered by United Concordia Companies, Inc. (United Concordia) and is available to eligible active duty service members (ADSMs) who are either referred for care by a dental treatment facility (DTF) to a civilian dentist or have a duty location and live greater than 50 miles from a DTF. ADSMs enrolled in TRICARE Prime Remote are automatically eligible to use the Remote ADDP. National Guard and Reserve members are eligible only if they have active duty orders issued for a period of more than 30 consecutive days. ADDP Benefits * Provides demtal care to ADSMSs who are unable to receive required care from a military DTF + Ensures dental health and deployment readiness * United Concordia will coordinate appointments for ADSMs * Within 21 days of request for routine dental care (c.g. examinations, cleanings, fillings) + Within 28 days of request for specialty dental care (c.g. crowns, bridges, dentures, periodontal treatment) TRICARE Dental Program ‘The TRICARE Dental Program (TDP), administered by United Concordia, is available to eligible active duty family members (ADFMs) and National Guard and Reserve members and their eligible family members, TDP Benefits + Voluntary enrollment + Worldwide, portable coverage * Single and family plans available + Affordable monthly premiums + Lower specialty care cost-shares for El-E4 pay grades * Comprehensive coverage for most dental services + 100 percent coverage for most preventive and diagnostic services TRICARE Retiree Dental Program ‘The TRICARE Retiree Dental Program (TRDP), administered by Delta Dental® of California, is available ‘oretired service members and their eligible family members, including retired National Guard and Reserve members. Fach new enrollee must fulfill an inital enrollment period of 12 consecutive months. After the intial 12-month period, you become eligible forthe full scope of benefits offered under the Enhanced TRDP and will continue your enrollment in the program on a montheto-month basis. If you are a new retiree who elects to enroll within four months after your retirement from active duty or transfer to Retired Reserve status, you are eligible for a waiver ofthe I2-month waiting period forthe Full scope of benefits. Otherwise, services including crowns and. ‘onlays, bridges and partial/fall dentures, implants, and ‘orthodontics will not be covered until after the 12-month waiting period. TRDP Benefits * Voluntary enrollment + Worldwide, portable coverage * Single, dual, and family plans available + Monthly premiums vary regionally by ZIP code; minimal deductibles and cost-shares apply + Comprehensive coverage for most dental services; visit any dentist within the TRDP service area