TRICARE Resources: Go to www. tricare

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Presentation transcript:

TRICARE Resources: Go to www. tricare TRICARE Resources: Go to www.tricare.mil/publications to view, print or download copies of TRICARE educational materials. Suggested resources include: Separating from Active Duty briefing, Retiring from Active Duty briefing, TRICARE Plans Overview and Costs and Fees sheet.

TRICARE Coverage Options Your health care options may be different depending on whether you: This presentation will provide an overview of TRICARE options. Visit the TRICARE Plan Finder at www.tricare.mil/planfinder to learn about specific program options based on your status. Retire from active duty Separate from active duty Are released from active duty Your health care options may be different depending on whether you retire from active duty, or if you separate, or are released from active duty. This presentation will provide an overview of TRICARE options. You can always visit the TRICARE Plan Finder at www.tricare.mil/planfinder to learn about specific program options based on your status, including TRICARE options for retirees. The Plan Finder allows you to enter specific information, answers questions and explains your options.

Retirees and Their Family Members Your TRICARE eligibility as a retired service member begins the day you retire. You can submit a request to enroll in a qualifying retiree TRICARE health plan up to 90 days prior to your retirement date. Certain family members also remain eligible for TRICARE benefits when you retire. For more information, visit www.tricare.mil/retiring. If you retire from active duty or if you are a Retired Reserve member turning age 60 and you have submitted your retirement application to your Reserve Component, your TRICARE eligibility as a retired service member begins the day you retire. You may submit a request to enroll in a qualifying retiree TRICARE health plan up to 90 days prior to your retirement date. Certain family members also remain eligible for TRICARE benefits when you retire, including your spouse and unmarried dependent children, among others. For more information, visit www.tricare.mil/retiring.

Terminal Leave Status If you go on terminal leave prior to retirement, you and eligible family members remain covered by your current TRICARE program until your retirement date. If covered under TRICARE Prime: Active duty service members (ADSMs) cannot enroll with another military hospital or clinic. ADSMs cannot switch their primary care manager (PCM). If you move to a new area: Coordinate all care with your current PCM. Family members may be able to change their PCMs. Remember to update your information in the Defense Enrollment Eligibility Reporting System (DEERS). If you go on terminal leave prior to retirement, you and eligible family members remain covered by your current TRICARE program until your retirement date. If covered under TRICARE Prime, you are considered part of your current unit until your retirement date. Active duty service members cannot switch their military hospital or clinic or primary care manager, or PCM. If you go on leave and move to a different area: You must coordinate all care with your current PCM. Your family members may be able to switch to a military hospital or clinic or civilian network PCM in your new area before your retirement date if your new location is in a Prime Service Area, or PSA. To see if you live in a PSA, use the PSA ZIP code search tool available at www.tricare.mil/psa. Remember to update your information in Defense Enrollment Eligibility Reporting System, or DEERS.

TRICARE Changes for 2018 As of Jan. 1, 2018, retirees and their eligible family members must enroll in either TRICARE Prime or TRICARE Select by the effective date of retirement to be eligible for continuous health care coverage. TRICARE Select replaced TRICARE Standard and TRICARE Extra. TRICARE Select is similar to the former TRICARE Standard. You must enroll in TRICARE Select to qualify for coverage. Beneficiaries who don’t enroll in TRICARE Prime or TRICARE Select will only be eligible for space-available care at military hospitals and clinics. TRICARE health plans changed January 1, 2018. Retirees and their eligible family members must enroll in either TRICARE Prime or TRICARE Select by the effective date of retirement to be eligible for continuous health care coverage. Note: TRICARE Select replaced TRICARE Standard and TRICARE Extra. TRICARE Select is very similar to the former TRICARE Standard; however, the significant difference is you must be enrolled in TRICARE Select to qualify for coverage. Beneficiaries who fail to enroll in TRICARE Prime or TRICARE Select will only be eligible for space-available care coverage provided in a military hospital or clinic. Any other health care delivered outside of a military facility will not be covered.

TRICARE Health Plans If you are under age 65 when you retire, you may be eligible for: TRICARE Prime (depending on your location) TRICARE Select US Family Health Plan (depending on your location) TRICARE Young Adult If you are retired and age 65 or older and have Medicare Part A and Part B, you have: TRICARE For Life If you are under age 65 when you retire, the following TRICARE health plans are available to you, if eligible: TRICARE Prime: You must enroll and pay an annual enrollment fee. TRICARE Prime is only available if you reside in a Prime Service Area. TRICARE Select: You must enroll and there is no annual enrollment fee. Currently, there is no enrollment fee. TRICARE Select is available worldwide. US Family Health Plan: You must enroll and pay an annual enrollment fee. This is a TRICARE Prime option and only available in designated locations. TRICARE Young Adult: This is available for purchase for qualifying young adults. You must enroll and pay monthly premiums. It is available with TRICARE Prime or TRICARE Select plans. If you are retired and age 65 or older and have Medicare Part A and Part B, you have: TRICARE For Life: This is a Medicare-wraparound coverage option for TRICARE beneficiaries who have Medicare Part A and Medicare Part B, regardless of age or place of residence. For more information about each plan, go to www.tricare.mil/plans/healthplans.

TRICARE Enrollment Changes You may only change plans following a Qualifying Life Event (QLE) or during the annual open season. QLE: A QLE is a life event (such as having a baby, getting married, becoming Medicare-eligible, and certain others) experienced by you or any of your eligible dependents that may mean different TRICARE options are now available. If eligible, you and your eligible dependents have 90 days after a QLE to change your enrollment or to enroll in a health plan. Visit www.tricare.mil/lifeevents for more information and a list of QLEs. Annual Open Season: Each fall during the open season, you will have an opportunity to change your enrollment or enroll in a health plan. If eligible, do nothing and you will keep your current coverage. In 2018, the open season will be Nov. 12–Dec. 10 for coverage effective Jan. 1, 2019. You may only change plans following a Qualifying Life Event (QLE) or during the annual open season. A QLE is a life event (such as having a baby, getting married, becoming Medicare-eligible, and certain others) experienced by you or any of your eligible dependents that may mean different TRICARE options are now available. If eligible, you and your eligible dependents have 90 days after a QLE to change your enrollment or to enroll in a health plan. Visit www.tricare.mil/lifeevents for more information and a list of QLEs. Each fall during the open season, you will have an opportunity to change your enrollment or enroll in a health plan. If eligible, do nothing and you will keep your current coverage. In 2018, the open season will be Nov. 12–Dec. 10 for coverage effective Jan. 1, 2019.

Transitional Assistance Management Program Overview If you are separating from active duty or from the uniformed services, you may be eligible for the Transitional Assistance Management Program (TAMP). The TAMP provides 180 days of premium-free transitional health care benefits. You have 90 days from the start of TAMP to enroll or reenroll in a TRICARE plan. All beneficiaries are covered as active duty family members, including the sponsor. If you are separating from active duty or from the uniformed services, you may be eligible for the Transitional Assistance Management Program, or TAMP. TAMP provides 180 days of premium-free TRICARE transitional health care benefits after regular TRICARE benefits end. This is so service members and families have ample time to make arrangements for ongoing health care coverage while transitioning to civilian life. If you’re eligible, the 180-day TAMP period begins the day after you separate from active duty. You have 90 days from the start of TAMP to enroll or reenroll in a TRICARE plan. You may choose to enroll or reenroll in TRICARE Prime, if you live in a Prime Service Area. You may also enroll in TRICARE Select or in the US Family Health Plan, if available. For more information on how to enroll in a TRICARE health plan, visit www.tricare.mil/enroll. Under TAMP, you and your eligible family members are covered as active duty family members. For more information, go to www.tricare.mil/tamp. Another transitional health care option is the Continued Health Care Benefit Program, which is a premium-based plan that gives you temporary health coverage for 18-36 months when you lose all eligibility for TRICARE. For more information, visit www.tricare.mil/chcbp. Note: You should attend the Veterans Benefits Briefing I and II, at which time you will have the opportunity to talk with a professional Veterans Affairs, or VA, liaison in more detail on benefits, programs and resources available through VA.

TAMP Eligibility You and your eligible family members may get TAMP health care benefits after active duty if you: Involuntarily separate from active duty under honorable conditions. This includes service members who receive a voluntary separation incentive or voluntary separation pay and aren’t entitled to retirement pay. Are a National Guard or Reserve member separating from a period of active duty that was more than 30 consecutive days in support of a contingency operation Separate following involuntary retention (stop-loss) in support of a contingency operation Separate following a voluntary agreement to stay on active duty for less than one year in support of a contingency operation Separate and agree to immediately become a member of the Selected Reserve with no gap in service Separate due to a sole-survivorship discharge You and your eligible family members may get TAMP health care benefits after active duty if you: Involuntarily separate from active duty with an SPD Code that designates transitional benefits. This includes service members who receive a voluntary separation incentive or voluntary separation pay and aren’t entitled to retirement pay. Are a National Guard or Reserve member separating from a period of active duty that was more than 30 consecutive days in support of a contingency operation Separate following involuntary retention (stop-loss) in support of a contingency operation Separate following a voluntary agreement to stay on active duty for less than one year in support of a contingency operation Separate and agree to immediately become a member of the Selected Reserve with no gap in service Separate due to a sole-survivorship discharge You aren’t eligible for TAMP while still on: Terminal leave Authorized excess leave Permissive temporary duty You must make sure that you and your family members are enrolled in TAMP and that your status reflects eligibility for TAMP in DEERS. Contact your personnel office and/or command unit if you have questions regarding eligibility. Note: In this instance, a member may not have a qualifying SPD Code that conveys TAMP benefits. The member must work with their gaining Reserve unit to obtain this transitional benefit and there can be no break in service. The Reserve unit must update the member’s Selected Reserve status in the Military Personnel Data System, or MilPDS, for the Defense Enrollment Eligibility Reporting System, or DEERS. DEERS conveys the transitional health care based on the MilPDS Selected Reserve update as the TA-180 is reflected on the ID card for qualifying members and family members.

Keep DEERS Information Up To Date Go to an ID card office. Find an office at www.dmdc.osd.mil/rsl. Note: You must use this option to add family members in DEERS. Log on to http://milconnect.dmdc.osd.mil. Call 1-800-538-9552. While you are on active duty, you may verify or update DEERS information for yourself or your family members by contacting or visiting a local identification, or ID, card issuing facility. To locate the nearest personnel office or ID card facility, visit the www.dmdc.osd.mil/rsl. To verify eligibility and update information, log on to the milConnect website at http://milconnect.dmdc.osd.mil. MilConnect is the Defense Manpower Data Center’s online portal that provides access to DEERS information. Information can also be updated by phone, fax, or by visiting a uniformed services ID card issuing facility. If your TAMP eligibility isn’t reflected in DEERS within 90 days of your separation date, please check with your Uniformed Service or Reserve Component to make sure the appropriate information has been transmitted to DEERS. For more information, visit www.tricare.mil/deers. Fax 1-831-655-8317.

Dental Options Retirees Your dental plan option is the TRICARE Retiree Dental Program (TRDP). The TRDP will end Dec. 31, 2018. Eligible beneficiaries will have the opportunity to sign up for the Federal Employees Dental and Vision Insurance Program starting in November 2018 for coverage effective Jan. 1, 2019. Visit http://tricare.benefeds.com throughout 2018 for more information. Non-Retirees Your dental options during the 180-day TAMP period are based on who you are and the reason you’re covered. Service members and their family members may seek space-available care at military dental clinics. However, space-available care is very limited. For retirees, your dental plan option is the TRICARE Retiree Dental Program (TRDP). The TRDP will end December 31, 2018. Eligible beneficiaries will have the opportunity to sign up for the Federal Employees Dental and Vision Insurance Program starting in November 2018 for coverage effective January 1, 2019. Visit http://tricare.benefeds.com throughout 2018 for more information. For non-retirees, your dental options during the 180-day TAMP period are based on who you are and the reason you’re covered. Service members and their family members may seek space-available care at military dental clinics. However, space-available care is very limited.

The Affordable Care Act TRICARE meets the minimum essential coverage requirement under the Affordable Care Act (ACA). The Affordable Care Act, or ACA, requires most Americans to maintain basic health care coverage, called minimum essential coverage. The TRICARE program meets the minimum essential coverage, or MEC, requirement under the ACA. If you do not have minimum essential coverage, you may have to pay a penalty for each month you are not covered. The penalty will be collected each year with federal tax returns. Each tax year, you will get an IRS Form 1095 from your pay center. It will list your TRICARE coverage status for each month. If your military pay is administered by the Defense Finance and Accounting Service, or DFAS, you can opt in to get your tax forms electronically through your DFAS myPay account. For more information, visit https://mypay.dfas.mil. Effective January 1, 2019, you’ll no longer be required to have MEC. You’ll still get an IRS Form 1095 from your pay center listing the coverage you had during calendar year 2018. For more information about the IRS tax forms, visit www.irs.gov. Note: The IRS will use information from DEERS to verify your coverage. It is important for sponsors to keep their information and their family members’ information up to date in DEERS, including Social Security numbers. It is also important to update DEERS when personal eligibility information changes, including military career status and family status (for example, marriage, divorce, birth or adoption). If you are losing TRICARE or are not TRICARE-eligible, you can find other health care coverage options through the Health Insurance Marketplace at www.healthcare.gov. Premium assistance or state Medicaid coverage may be available based on income, family size and the state you live in. For more information, visit www.tricare.mil/aca. Each tax year, you will get an Internal Revenue Service (IRS) Form 1095 from your pay center. It will list your TRICARE coverage for each month. Your Social Security number (SSN) and the SSNs of each of your covered family members should be included in DEERS for your TRICARE coverage to be reflected accurately.

This slide shows contact information for stateside and overseas regional contractors, as well as other important information sources. Remember, your regional contractor is based on where you live.