1. TRICARE: Your Military Health Plan – Separating from Active Duty
ATTENTION PRESENTER: To ensure that TRICARE beneficiaries receive the most up to-date information about their health benefits, you must visit for the latest version of all briefings before each presentation. Briefings are continuously updated as benefit changes occur.
Target Audience: Service members who are separating from active duty with less than 20 years of service and their eligible family members
Notes to Presenter:
For National Guard and Reserve members, use the TRICARE Overview for the National Guard and Reserve briefing.
For retiring service members, use the Retiring from Active Duty Service briefing.
To increase audience understanding, avoid using acronyms during the presentation.
Recommended Handout(s):
Your TRICARE Resources Overview
TRICARE Choices At a Glance brochure
Briefing Objective: To inform TRICARE beneficiaries about transitional benefits
Optional Presenter Comments: Welcome to TRICARE’s Separating from Active Duty briefing. First and foremost, we want to thank you for your service to our country. The goal of today’s presentation is to give you information about the health care benefits that are available to you as you transition back to civilian life. This presentation is primarily focused on beneficiaries living in the United States. If you plan to move overseas, visit TRICARE.mil or your regional contractor’s Web site for overseas information.

2. Today’s Agenda
Welcome to TRICARE’s Separating from Active Duty briefing. First and foremost, we want to thank you for your service to our country. The goal of today’s presentation is to give you information about the health care benefits that are available to you as you transition back to civilian life. This presentation is primarily focused on beneficiaries living in the United States. If you plan to move overseas, visit TRICARE.mil or your regional contractor’s Web site for overseas information.

3. TRICARE Stateside Regions
TRICARE is available worldwide and managed regionally. There are three TRICARE regions in the United States—TRICARE West, TRICARE North, and TRICARE South—and one overseas region. Your benefits are the same regardless of where you live, but you will have different customer service contacts based on your region.
TriWest Healthcare Alliance administers the benefit in the West Region, Health Net Federal Services administers the benefit in the North Region, and Humana Military administers the benefit in the South Region. All three regional contractors partner with the Military Health System to provide you with health, medical, and administrative support, including customer service, claims processing, and authorizations for certain health care services.
Contact information for each region will be provided at the end of this presentation.

4. Terminal Leave
If you have accrued leave during your full-time military career, you may have the opportunity to take terminal leave prior to your separation.
When you are on terminal leave, you continue to receive care as an active duty service member.
If you stay in same area, you should continue to get care as you did while on active duty.
You can seek care at any military treatment facility, or MTF, but you must remain enrolled in TRICARE at your current duty station.
If you move, contact your primary care manager for referrals prior to receiving any nonemergency care. Note: If you choose to move outside the TRICARE Prime Service area where you are enrolled, you may be able to obtain a single prior authorization for any necessary routine and urgent care from the Department of Veterans Affairs. Contact your primary care manager prior to leaving your final duty location to seek authorization.
During your terminal leave, your family members will remain covered by their current programs—TRICARE Prime, TRICARE Standard, or TRICARE Prime Remote for Active Duty Family Members—as long as they do not move.
Unlike service members who must remain enrolled at their current duty station, family members can transfer TRICARE Prime enrollment to a new location—if you move to a location where TRICARE Prime is available.

5. Transitional Health Care Coverage
The transition from military life back to civilian life can be challenging, so TRICARE provides transitional health care coverage to protect you and your family between military coverage and civilian health care coverage.
If eligible, you may be entitled to two different programs:
The Transitional Assistance Management Program, or TAMP, and/or
The Continued Health Care Benefit Program, or CHCBP
We’ll discuss both programs in greater detail later in this presentation.
If you are not eligible for TAMP and do not purchase CHCBP, TRICARE benefits end for you and your family members your last day of active duty—even if you are receiving ongoing treatment and/or have a valid authorization dated later than your last day of active duty service.
If you are transitioning from active duty to the National Guard or Reserve, visit TRICARE.mil or your regional contractor’s Web site for more information about your health care benefits.

6. TAMP: Eligibility
TAMP coverage is only available to you, the sponsor, and your eligible family members if you meet one of the following requirements:
Involuntarily separate from active duty under honorable conditions
Separate from active duty following involuntary retention, or 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
Receive a sole survivorship discharge, similar to Saving Private Ryan
Agree to become a Selected Reserve member of the National Guard and Reserve upon your separation from active duty service
Your service personnel branch determines eligibility for TAMP, and your Defense Enrollment Eligibility Reporting System, or DEERS, record will reflect your eligibility status. If you have questions concerning eligibility, contact your command unit representative.
Note: National Guard or Reserve members following more than 30 consecutive days of active duty service in support of a contingency operation are also eligible for TAMP.

7. TAMP Overview
The Transitional Assistance Management Program provides 180 days of transitional health care benefits to help certain uniformed service members and their families transition to civilian life.
If you qualify, the 180-day TAMP period begins the day after you separate from active duty.
During TAMP, you and your family are covered as active duty family members. There are no enrollment fees, but, depending on which TRICARE program you choose, you will be responsible for any applicable deductibles, cost-shares, and copayments.

8. Program Options
This chart provides an overview of TRICARE Prime versus TRICARE Standard and TRICARE Extra and can help you determine which program is right for you.
TRICARE Prime is only available in areas around military hospitals or clinics and other designated areas.
Visit your regional contractor’s Web site to determine whether you are in a TRICARE Prime Service Area.
If not, your only option is coverage through TRICARE Standard and TRICARE Extra.
Enrollment or reenrollment is required for TRICARE Prime, whereas you will be automatically covered by TRICARE Standard and TRICARE Extra once your TAMP eligibility is shown in DEERS.
TRICARE Prime is a managed care option, meaning you will have a primary care manager who provides most of your care. TRICARE Standard and TRICARE Extra beneficiaries may see any TRICARE-authorized provider for care.
Under TRICARE Prime, you will need a referral from your primary care manager for specialty care, such as seeing a cardiologist for heart issues. Referrals are not required under TRICARE Standard and TRICARE Extra, but prior authorization from your regional contractor may be required for certain services.
There are no enrollment fees under either program during the 180-day TAMP period. TRICARE Prime enrollees do not have to pay deductibles or cost-shares for covered services, as long as you follow TRICARE Prime referral and authorization rules. TRICARE Standard and TRICARE Extra beneficiaries are responsible for a fiscal-year deductible and cost-shares.

9. TRICARE Prime: Enrollment
You are automatically covered by TRICARE Standard and TRICARE Extra during the Transitional Assistance Management Program.
If you want to be covered by TRICARE Prime and it is available in your location, you must enroll or reenroll, even if you and/or your family members had TRICARE Prime while you were on active duty.
There are two ways to enroll:
You can enroll online through the Beneficiary Web Enrollment site, which allows you to update your DEERS information at the same time.
You can also pick up and submit a TRICARE Prime Enrollment, Disenrollment, and Primary Care Manager (PCM) Change Form (DD Form 2876) at your local TRICARE Service Center, or download one on the TRICARE Web site shown here or your regional contractor’s Web site, and mail it to your regional contractor.
If you, the sponsor, and your family members were enrolled in TRICARE Prime while you were on active duty, TRICARE Prime coverage will continue without interruption, as long as your enrollment form is received before the TAMP period expires. If you move, you will need to select a new primary care manager.

10. US Family Health Plan (USFHP)
A TRICARE Prime option that may be new to you is the US Family Health Plan, or USFHP.
As indicated by the stars on the map, USFHP is available to beneficiaries living in six specific areas across the United States.
USFHP provides comprehensive coverage, but it’s important to note that beneficiaries enrolled in the US Family Health Plan are not eligible for any other TRICARE benefits, including pharmacy, dental, and military treatment facility care.
Visit the USFHP Web site to find out if you are in a designated USFHP area or to enroll in USFHP.

11. Continued Health Benefit Program (CHCBP)
Once regular TRICARE coverage or TAMP benefits end, eligible beneficiaries may purchase temporary, transitional health care coverage under the Continued Health Care Benefit Program. CHCBP is a Department of Defense program administered by Humana Military and is not a TRICARE program.
CHCBP is available immediately following the loss of TRICARE coverage, including TRICARE Prime, TRICARE Standard, and the Transitional Assistance Management Program, for beneficiaries who are no longer eligible for TRICARE benefits.
In most cases, CHCBP requires enrollment within 60 days after becoming eligible. Note: CHCBP premiums must be paid from the point of initial eligibility—not the point of enrollment.
CHCBP benefits are similar to TRICARE Standard, but with premium payments. The program covers most care that is medically necessary, uses TRICARE-authorized providers, and follows most of the referral and authorization rules of TRICARE Standard.
CHCBP is available for up to either 18 or 36 months after your previous coverage ends depending on your eligibility category. Coverage may be purchased in 90-day increments.

12. CHCBP Eligibility
You may be eligible to purchase CHCBP if you are ineligible for TRICARE, including TAMP, and fall into one of these four categories:
Sponsors who separate from active duty under honorable conditions and their eligible family members
Certain unremarried former spouses who had TRICARE or TAMP coverage on the day before the marriage ended
Note: Service branch determines eligibility.
Children who had TRICARE or TAMP coverage until they lost eligibility due to age or marriage
Certain unmarried children who were placed in the sponsor’s custody as a result of a court order or through an adoption agency
CHCBP provides up to 18 months of coverage for eligible sponsors and family members and up to 36 months of coverage for all other eligible beneficiaries.

13. Enrolling in CHCBP
To remain eligible for CHCBP, you must enroll within 60 days after your previous TRICARE coverage ends.
To enroll, fill out the Continued Health Care Benefit Program Application, which you can access by visiting the Humana Military Web site or by calling Humana Military.
Make sure to provide the premium payment for the first 90 days.
The fiscal year 2013 premium for individual coverage is $1,138 per quarter, and the premium for family coverage is $2,555 per quarter.

14. Transitional Coverage Timeline
This chart illustrates the timeline for transitional benefits.
If eligible, the 180-day TAMP period begins the day after you separate from active duty.
For continuous TRICARE Prime coverage during TAMP, you must reenroll in TRICARE Prime before the end of the TAMP period.
If you qualify, CHCBP eligibility begins the day after you separate from active duty service, or, if applicable, the day after your TAMP period ends.
Remember, enrollment in CHCBP must occur within 60 days of qualifying for coverage.

15. TRICARE and Medicare
TRICARE For Life serves as Medicare-wraparound coverage for TRICARE beneficiaries entitled to Medicare Part A and who have Medicare Part B coverage.
Most beneficiaries entitled to premium-free Medicare Part A, regardless of age, must have Medicare Part B coverage to remain eligible for TRICARE benefits. The only exceptions are active duty service members, active duty family members, USFHP enrollees, TRICARE Reserve Select enrollees and TRICARE Retired Reserve enrollees.
If you do not enroll in Part B when you are first eligible, or during a special enrollment period, you may only enroll during the general enrollment period (January 1—March 31 each year).
Your Part B coverage will be effective July 1 of the year you enroll and you will pay an additional 10 percent for each 12-month period that you were eligible to enroll but did not.

16. TRICARE and Other Health Insurance
You may acquire other health insurance, or OHI, during your transition.
If you gain other health insurance, TRICARE becomes the secondary payer. Note: This does not apply to state programs such as Medicaid.
That means when you go to the doctor, the doctor will file a claim with your other health insurance first and TRICARE or CHCBP will pay what is left, up to the TRICARE-allowable charge.
If your other health insurance runs out, or if you need care that is covered by TRICARE but not covered by your OHI, TRICARE or CHCBP becomes the primary payer.
If you gain other health insurance during the TAMP period:
Fill out a TRICARE Other Health Insurance Questionnaire and follow the guidelines for submission. You can download the questionnaire at TRICARE.mil, or you can pick one up at your TRICARE Service Center.
Since your other health insurance will pay first, you should follow those rules for getting care.
Make sure your provider knows you have both TRICARE and other health insurance.
Supplemental insurance plans are specifically designed to supplement TRICARE benefits. Unlike other health insurance plans, TRICARE supplemental plans pay after TRICARE pays its portion of the bill. According to its policies, the supplemental insurance reimburses you for out-of-pocket medical expenses paid for civilian care.

17. TRICARE Pharmacy Program
The TRICARE pharmacy benefit is available to you regardless of which TRICARE program option you choose, unless you are enrolled in the US Family Health Plan.
To fill a prescription, you will need the prescription, a valid uniformed services ID card, and up-to-date information in DEERS.
Note: Pharmacies are legally permitted to copy military and dependent ID cards to verify TRICARE eligibility.
There are four pharmacy options:
Where available, MTF pharmacies are often the least costly option.
TRICARE Pharmacy Home Delivery is your least expensive option when not using an MTF pharmacy.
If you need a prescription filled immediately, your best option is a TRICARE retail network pharmacy.
TRICARE has partnered with Express Scripts, Inc. to provide home delivery and retail network pharmacy services. For more information, visit Express Scripts, Inc. at the Web site on the screen.
Special notes regarding TRICARE Pharmacy Home Delivery:
There is no cost for home delivery for ADSMs.
Stateside TRICARE Pharmacy Home Delivery prescriptions cannot be shipped to a P.O. box.
Overseas TRICARE Pharmacy Home Delivery prescriptions can be shipped only to APO/FPO addresses and must be written by a provider licensed in the United States. Additionally, TRICARE Pharmacy Home Delivery prescriptions cannot be delivered to an overseas civilian address. Beneficiaries residing in Germany cannot use the home delivery option due to country-specific legal restrictions. If you live in Germany, you should fill prescriptions at MTF pharmacies or host nation pharmacies.
Note: Currently, there are no TRICARE retail network pharmacies in American Samoa.

18. TRICARE Pharmacy Program
The fourth and most costly option is a non-network pharmacy.
At non-network pharmacies, you will pay the full price of your medication up front and file a claim for reimbursement. Reimbursements are subject to deductibles, out- of-network cost-shares, and TRICARE-required copayments.
All deductibles must be met before any reimbursement can be made.

19. Dental Coverage
Service members on terminal leave continue to receive active duty dental benefits.
You may continue to seek care at military dental treatment facilities, or DTFs, and are eligible for care in private dental offices through the Active Duty Dental Program, or ADDP.
You must have a DTF referral to use the ADDP.
If you see a civilian dentist without a referral, you will be responsible for the complete cost of dental services.
Visit the ADDP Web site for more information.
If your family members are enrolled in the TRICARE Dental Program, they can remain enrolled and continue to pay active duty benefits until the end of your terminal leave period.
All care must be completed before the end of your terminal leave.
During the 180-day TAMP period, you may seek space-available care at military dental treatment facilities. However, space-available care is very limited.
If you will remain in the Selected Reserve or Individual Ready Reserve after TAMP, you and your family may be eligible for the TRICARE Dental Program, or TDP.
Visit the TDP Web site for more information.
There are no dental benefits under the Continued Health Care Benefit Program.

20. Certificate of Credible Coverage
You should receive a certificate of creditable coverage that shows you were covered by TRICARE when you lose TRICARE eligibility.
When you apply for civilian insurance, the insurance company may ask to see this certificate.
If you do not receive your certificate, you can send a written request to the Defense Manpower Data Center, or DMDC.
For questions regarding the certificate of creditable coverage, sponsors and family members may call the DMDC Support Office.

21. Social Security Numbers
In an effort to protect the privacy of TRICARE beneficiaries, the Department of Defense (DoD) is removing Social Security numbers (SSNs) from military identification (ID) cards, including the Common Access Card.
Your new ID card will have one or both of the following:
A 10-digit DoD ID Number instead of your SSN
A DoD Benefits Number (DBN), if you are eligible for DoD benefits
Not all ID card holders are eligible for DoD benefits.
You will not need a new ID card until your old card expires.
For more information, visit

22. For Information and Assistance
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.