1. TRICARE® Your Military Health Plan: Using TRICARE and Medicare
Visit for the latest version of all briefings; briefings are continuously updated as benefit changes occur.
Briefing Objectives:
Provide an overview of using TRICARE and Medicare.
Inform beneficiaries about TRICARE For Life.

2. What Is TRICARE? TRICARE Stateside Regions
TRICARE is available worldwide and managed regionally. There are three TRICARE regions in the United States—TRICARE North, TRICARE South, and TRICARE West. Your benefits are the same regardless of where you live, but you will have different customer service contacts based on your region.
Health Net Federal Services, LLC administers the benefit in the North Region; Humana Military, a division of Humana Government Business, administers the benefit in the South Region; and UnitedHealthcare Military & Veterans administers the benefit in the West 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 prior authorizations for certain health care services.
Contact information for each region will be provided at the end of this presentation.

3. What Is TRICARE? Keep DEERS Information Up To Date
The Defense Enrollment Eligibility Reporting System, or DEERS, is a database of service members and dependents worldwide and is used to track eligibility for military benefits including TRICARE.
Sponsors can register family members in DEERS in person at a uniformed services identification, or ID, card-issuing facility.
To verify eligibility and update information, log on to the milConnect Web site at milConnect is the Defense Manpower Data Center’s online portal that provides access to DEERS information.
Information can also be updated by phone or fax or by visiting a uniformed services ID card-issuing facility.
When making changes, proper documentation, such as a marriage certificate, divorce decree, birth certificate, and/or adoption papers, is required.
Note: Only sponsors or sponsor-appointed individuals with valid power of attorney can add a family member. Family members age 18 and older may update their own contact information.
Remember, providers are legally permitted to copy military and dependent ID cards to verify TRICARE eligibility.
For more information, visit

4. TRICARE and Medicare Eligibility: Eligible for Medicare Part B at Age 65
Four months before your 65th birthday, you will receive a notification from the Defense Manpower Data Center, or DMDC, informing you of the requirement to sign up for Medicare. Call the DMDC Support Office at for more information or if you do not receive notification.
If your birthday falls on the first of the month, your initial enrollment period begins four months before the month you turn 65. Enroll no later than two months before the month you turn 65 to avoid a break in TRICARE coverage. You are eligible for Medicare on the first day of the month before you turn 65.
If your birthday falls on any day other than the first of the month, your initial enrollment period begins three months before the month you turn 65. Enroll no later than one month before your birth month to avoid a break in TRICARE coverage. You are eligible for Medicare on the first day of the month you turn 65.
If you miss the initial enrollment period, your next opportunity is the general enrollment period (January 1–March 31). Your coverage will begin in July and you may be responsible for a Medicare Part B late-enrollment premium surcharge. There may be a lapse in your TRICARE coverage until your Medicare Part B is effective.
The Social Security Administration, or SSA, provides an annual Social Security Statement, which provides an estimate of your Social Security benefits. Read this very carefully. If you have earned enough credits to qualify for Medicare at age 65, there will be a statement that tells you to contact the SSA three months before your 65th birthday to enroll in Medicare.
After you sign up for Medicare, you will receive a Medicare card indicating coverage for Part A and Part B. You will be given the option to decline Part B coverage.
If you decline Medicare Part B, you may not be eligible for TRICARE. Remember, in most cases, you must have Medicare Part B to remain eligible for TRICARE, so look at all of your options before declining Part B coverage.

5. TRICARE and Medicare Eligibility: Not Eligible for Premium-Free Medicare Part A
If you sign up for Medicare and are not eligible for premium-free Medicare Part A under your or your spouse’s (including divorced or deceased spouse’s) Social Security number, or SSN, you will receive a “Notice of Award” and/or “Notice of Disapproved Claim” from the SSA.
If you are not eligible for premium-free Medicare Part A under your own SSN when you turn 65, you must file for benefits under your spouse’s (including divorced or deceased spouse’s) SSN if he or she is 62 or older. If your spouse (or divorced spouse) is not yet 62, you must file for benefits under his or her SSN when he or she turns 62.
If you will be eligible under your spouse’s SSN in the future, you should sign up for Medicare Part B during your initial enrollment period to avoid paying a monthly Part B premium surcharge for late enrollment. Even if you are not eligible for premium-free Medicare Part A, you are eligible for Part B at age 65.

6. TRICARE and Medicare Eligibility: Reflecting Medicare Eligibility in DEERS
DMDC receives weekly updates from the Centers for Medicare & Medicaid Services that identify TRICARE beneficiaries who are entitled to Medicare.
To confirm that your DEERS record has been updated to reflect your Medicare entitlement and/or enrollment, contact the DMDC Support Office at
If you are not eligible for premium-free Medicare Part A under your own SSN based on work history or your current, divorced, or deceased spouse’s SSN, you may take your “Notice of Award” and/or “Notice of Disapproved Claim” to the nearest ID card-issuing facility to update your DEERS record.
You may be issued a new uniformed services ID card when you update DEERS with your Medicare information.

7. TRICARE and Medicare Eligibility: TRICARE Prime® and Medicare Entitlement
Regardless of age, ADFMs who have Medicare Part A may enroll in TRICARE Prime if they live in a Prime Service Area, or PSA.
With TRICARE Prime, you will receive care from an assigned primary care manager and he or she will provide referrals for specialty care. TRICARE Prime enrollment fees are waived for any TRICARE Prime enrollee who has Medicare Part B, regardless of age.
If one family member has Medicare, the individual fee is waived.
If two or more family members have Medicare, the family fee is waived regardless of the total number of family members.
With TRICARE Prime, you will not need to file claims in most cases. However, when you need to file a claim, file with Medicare first. Medicare pays and transfers the claim to Wisconsin Physicians Service, or WPS. Enroll in TRICARE Prime with your regional contractor.
Overseas, you should be prepared to pay up front for services and submit claims to the TRICARE Overseas Program, or TOP, claims processor. Claims for care received overseas are submitted directly to the TOP claims-processing address for the area where you received care and must include proof of payment. For overseas claims mailing addresses, visit
For more information, visit or contact your TRICARE regional contractor.

8. TRICARE and Medicare Eligibility: TRICARE For Life
TRICARE For Life, or TFL, is Medicare-wraparound coverage for TRICARE beneficiaries who have Medicare Part A and Medicare Part B, regardless of age or place of residence.
With TFL, you can receive care from any Medicare-participating or nonparticipating provider. Care is also available at military hospitals and clinics on a space-available basis. There are no enrollment fees for TFL. Medicare-participating providers file your claims with Medicare. After Medicare pays its portion, Medicare forwards the claim automatically to TRICARE, and TRICARE pays the provider directly (unless you have other health insurance, or OHI).
WPS is the contractor for TFL claims-processing and customer service in the United States and U.S. territories, so, if you are using TFL, you will contact WPS if you need assistance—not your regional contractor.
Overseas, contact the TOP claims processor for assistance. For more information, visit

9. TRICARE For Life: Medicare Card
TRICARE does not issue a health insurance card for TFL. To get care, show your Medicare card along with your uniformed services ID card. Here is a sample Medicare card. If you have misplaced your Medicare card, contact Medicare for assistance using the contact information presented on the slide.

10. TRICARE For Life: How TFL Works
When using TFL in the United States or the U.S. territories (American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands), you should not have to file a paper claim. This is usually how the process works:
Visit any Medicare provider for care. You pay nothing at the time of service.
Your provider files a claim with Medicare.
Medicare pays its portion and then electronically forwards the claim to WPS (unless you have OHI. We will discuss this later).
WPS pays the remaining amount directly to your provider for services covered by Medicare and TRICARE.
You receive a Medicare Summary Notice, or MSN, from Medicare and an Explanation of Benefits, or EOB, from TRICARE. The MSN and EOB provide details regarding dates of service, as well as amounts billed, allowed, paid, and owed by patients.
Note: Unless you have OHI, TRICARE is the primary payer for TRICARE-covered services you receive in areas where Medicare is not available, for example, overseas. When obtaining health care from host nation providers, expect to pay for your care at the time of service. You are responsible for filing claims with the TOP claims processor for reimbursement. For more information, contact the TOP Regional Call Center or visit

11. TRICARE For Life: What You Pay
Here’s a snapshot of your out-of-pocket costs when using TFL. For a more detailed breakdown of costs associated with TFL, visit

12. TRICARE For Life: Coordinating TFL with OHI
OHI is any non-TRICARE health insurance (including national health insurance overseas) that is not considered a supplement. OHI is provided through an employer, entitlement program (including Medicare), or other source. TRICARE is the last payer to all health benefits and insurance plans, except for Medicaid, TRICARE supplements, the Indian Health Service, and other programs or plans as identified by the Defense Health Agency.
If you have OHI that is not based on your current employment or that of a family member— for example a private Medicare supplement—Medicare pays first and the OHI pays second. If there is a remaining balance, you will need to file a paper claim with WPS. If you have OHI and receive care overseas, you must first file your claim with your OHI. If there is a remaining balance after the OHI processes the claim, you will need to file a claim with the TOP claims processor and include the OHI explanation of benefits.
If you have OHI based on your current employment or that of a family member, the employer-sponsored health plan pays first, Medicare pays second, and TRICARE pays last.

13. TRICARE Program Options: TRICARE Plus
TRICARE Plus is a primary care enrollment program that is offered at select military hospitals and clinics. All beneficiaries eligible for military hospital and clinic care (except those enrolled in TRICARE Prime, a civilian health maintenance organization, or Medicare health maintenance organization) can seek enrollment in TRICARE Plus if enrollment capacity exists.
TRICARE Plus is offered at some military hospitals and clinics and is limited by capacity. Unlike TRICARE Prime, TRICARE Plus is not transferable and availability can change if the military hospital’s or clinic’s capacity decreases or increases.
Non-enrollment in TRICARE Plus does not affect TFL benefits or other existing programs. If you do not have Medicare Part B and receive care outside the military hospital or clinic, you will be responsible for all the charges. The military hospital or clinic is not responsible for any costs when a TRICARE Plus enrollee obtains care outside the military hospital or clinic.

14. TRICARE Program Options: TRICARE Pharmacy Program
TRICARE offers comprehensive prescription drug coverage and several options for filling your prescriptions. The TRICARE Pharmacy Program is available to all TRICARE-eligible beneficiaries registered in DEERS, except those enrolled in USFHP. Dependent parents and parents-in-law can fill prescriptions at military pharmacies and may use other pharmacy options once they become entitled to Medicare Part A and have purchased Medicare Part B.
To fill a prescription, you need a written prescription, a valid uniformed services ID card, and up-to- date information in DEERS. Pharmacies are legally permitted to copy ID cards to verify eligibility.
There are several pharmacy options for filling your prescriptions. This chart displays the following options:
A pharmacy located at a military hospital or clinic is the least expensive option for filling prescriptions. At a military pharmacy, you may receive up to a 90-day supply of most medications at no cost. Non-formulary medications generally are not available at military pharmacies.
TRICARE Pharmacy Home Delivery, or home delivery, is your least expensive option when not using a military pharmacy. There is no cost for ADSMs. For all other beneficiaries, there is no cost for a 90-day supply of generic formulary drugs. Copayments apply for brand-name formulary drugs and non-formulary drugs. A complete street address is required for controlled substance medications and an adult signature is required upon receipt. Controlled substances cannot be shipped to a P.O. Box.
If you need a prescription filled immediately, your best option may be a TRICARE retail network pharmacy. You may fill prescriptions and pay one copayment for up to a 30-day supply.
Note: There are no TRICARE retail network pharmacies in American Samoa.
TRICARE partners with Express Scripts, Inc. to provide home delivery and TRICARE retail network pharmacy services. For more information, visit or call

15. TRICARE Program Options: TRICARE Pharmacy Program (continued)
The most costly option for filling prescriptions 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. Depending on your TRICARE program option, reimbursements are subject to a deductible, out-of- network cost-shares, and TRICARE-required copayments.
The deductible must be met before any reimbursement can be made.
When using any pharmacy option, a generic drug, rather than a brand-name drug, will normally be dispensed. Department of Defense policy on generic drugs states the following:
TRICARE usually fills prescriptions with a generic-equivalent medication when one is available.
Brand-name drugs that have a generic equivalent may be dispensed if the prescribing provider establishes medical necessity by completing and submitting the appropriate TRICARE prior authorization form. Forms are available online at
For more information on which generic and brand-name drugs are covered by TRICARE, visit
Note: Beneficiaries are not required to have Medicare Part D to keep TRICARE prescription drug coverage. For most Medicare-eligible TRICARE beneficiaries, there is no advantage to enrolling in Medicare Part D. The exception is TRICARE beneficiaries with limited income and resources who may qualify for extra help paying for Medicare prescription drug costs.
For more information and costs, visit

16. TRICARE Program Options: TFL Pharmacy Pilot
The TFL Pharmacy Pilot requires TFL beneficiaries living in the United States and U.S. territories who fill select maintenance medications at a retail pharmacy to switch those prescriptions to TRICARE Pharmacy Home Delivery or to a military pharmacy. The pilot is required under the 2013 National Defense Authorization Act.
Maintenance medications are those you use on a regular basis for chronic health conditions (e.g., high cholesterol, blood pressure). These do not include medications needed for a sudden illness or infection. You will be notified if you fill a prescription at a retail pharmacy for a maintenance medication that is impacted by this pilot. If you continue to get the select maintenance medication at a retail pharmacy, you will pay 100 percent of the cost of the medication.
To determine if your medication is included under the pilot, call Most generic medications are not included in the pilot. Visit for more information.
Note: The pilot allows you to opt out after using home delivery to fill at least one of your prescriptions for one full year.

17. TRICARE Program Options: TRICARE Dental Options
The TRICARE Dental Program is available to eligible ADFMs, members of the National Guard and Reserve and/or their eligible family members, and transitional survivors. Benefits include:
Voluntary enrollment and worldwide portable coverage
Single and family plans
Monthly premiums and cost-shares based on sponsor’s pay grade
Comprehensive coverage for most dental services; 100 percent coverage for most preventive and diagnostic services
For more information, visit or call
The TRICARE Retiree Dental Program, or TRDP, is available to retired service members and their eligible family members, including retired National Guard and Reserve members, as well as survivors. Benefits include:
Single, dual, and family plans
Monthly premium rates that vary regionally by ZIP code
For more information, visit or call

18. TRICARE: Your Military Health Plan: TRICARE Benefits/Programs for the National Guard and Reserve during Early Eligibility and Activation
TRICARE benefit during early eligibility and when called or ordered to active service for more than 30 consecutive days. 18

19. TRICARE Eligibility: Coverage Lifecycle
TRICARE has many programs that enable National Guard and Reserve members and their families to have continuous coverage throughout the TRICARE-eligibility lifecycle.
When active duty orders are received, sponsors and family members may become eligible for active duty TRICARE benefits. These benefits continue throughout active duty service. 19 19

20. Medical Coverage: Early Eligibility
Sponsors who are called or ordered to active service for more than 30 consecutive days in support of a contingency operation may be eligible for up to 180 days of early- eligibility active duty benefits. These benefits are based on delayed-effective-date active duty orders; the sponsor’s service personnel office must update the member’s DEERS status to show eligibility.
If the orders are rescinded prior to the report date, then TRICARE coverage ends on the “effective date” the orders are rescinded. You may qualify to purchase TRICARE Reserve Select or you may wish to talk to your employer about getting an employer- based health plan reinstated.
Note: If your orders are terminated at any time during the early eligibility period, your TRICARE coverage will end effective the date of termination. 20 20

21. TRICARE: Your Military Health Plan: TRICARE Benefit/Programs for the National Guard and Reserve during Deactivation
TRICARE benefit during deactivation. 21

22. TRICARE Eligibility: Coverage Lifecycle
Once active duty ends, sponsors and family members may become eligible for transitional benefits.
Transitional benefits include the premium-free Transitional Assistance Management Program, or TAMP, and the premium-based Continued Health Care Benefit Program, or CHCBP. 22 22

23. Medical Coverage: Transitional Assistance Management Program (TAMP)
If called or ordered to active service for more than 30 consecutive days in support of a contingency operation, National Guard and Reserve members and their family members are eligible for the Transitional Assistance Management Program, or TAMP.
Note: TAMP eligibility is determined by the services, so eligibility questions should be directed to each unit’s personnel.
TAMP provides 180 days of transitional health care benefits to help in the transition to civilian life.
The TAMP period begins the day after separating from active duty.
During the TAMP period, service members and their families are covered as active duty family members. There is no enrollment fee, but cost-shares and copayments apply.
When released from active duty, the sponsor’s status in DEERS changes and coverage automatically becomes TRICARE Standard and TRICARE Extra. Where available, reenrollment is necessary for continued TRICARE Prime coverage.
Note: TAMP does not cover line of duty, or LOD, care. When receiving LOD care, eligibility documentation must be provided at the time of service to avoid incurring costs associated with other TRICARE coverage. LOD care is discussed in more detail later in this briefing. 23 23

24. Medical Coverage: Continued Health Care Benefit Program (CHCBP)
If the National Guard or Reserve member does not qualify for TRS at the end of the TAMP period, he or she may qualify for the Continued Health Care Benefit Program, or CHCBP.
CHCBP is a premium-based health care program that provides 18 to 36 months of transitional health care coverage for service members released from active duty, eligible family members, and certain others.
CHCBP is similar to, but not part of, TRICARE. 
The service member can choose to purchase an individual or family plan.
CHCBP allows the freedom to choose providers.
Enroll in CHCBP within 60 days of losing TAMP or other military coverage and make monthly premium payments for continuous coverage.
To enroll:
Complete the Continued Health Care Benefit Program (CHCBP) Application, which is DD Form 2837, available at
Include documentation verifying the loss of eligibility for military health care, such as a Certificate of Release or Discharge from Active Duty.
Include a premium payment for the first 90 days of coverage. 24 24

25. Medical Coverage: TRS Costs
Premiums for TRS are paid monthly. The calendar year, or CY, 2015 TRS premiums are $ for member-only coverage and $ for member-and-family coverage.
Note: All ongoing TRS premium payments must be made by either automatic electronic funds transfers or automatic charges to a credit or debit card. Contact your regional contractor to set up automatic payments. Payments are due no later than the last day of each month and are applied to the following month’s coverage. Failure to pay TRS premiums may result in a suspension of coverage. You may be subject to a 12-month lockout if TRS coverage ends. If your TRS coverage is suspended, contact your regional contractor for information about the possibility of having your coverage reinstated.
The deductible is the amount you pay out-of-pocket per year before TRICARE cost-shares begin.
You are responsible for cost-shares. These are the amounts you pay for TRICARE-covered services, which vary if seeing a network or non-network provider.
Non-network TRICARE providers can choose to accept TRICARE rates, or “participate” in TRICARE, on a claim-by-claim basis. Non-network nonparticipating providers can charge up to 15 percent above the TRICARE-allowable rate.
The catastrophic cap is the maximum amount you pay out-of-pocket for TRICARE-covered services per fiscal year. The $1,000 cap includes deductibles, cost-shares, and prescription copayments, but it does not include monthly TRS premiums or costs incurred by seeking care without prior authorization.
For the most up-to-date TRS cost information, visit 25 25

26. TRICARE Benefits/Programs for National Guard and Reserve Members during Retirement
TRICARE benefit after retirement from the National Guard and Reserve. 26

27. What Is TRICARE? Coverage Lifecycle
Non-activated members of the Selected Reserve and Retired Reserve may qualify to purchase TRICARE Retired Reserve, or TRR, for themselves and their family members.
TRR is a premium-based health care plan that gives beneficiaries the freedom to choose TRICARE- authorized providers and use TRICARE’s pharmacy benefit.
Your coverage options will change if you become eligible for Medicare due to age or disability. 27 27

28. What Is TRICARE? Retired Reserve Coverage Timeline
Upon retirement under age 60, qualified Retired Reserve members may purchase TRR coverage until reaching age 60.
Retired Reserve members ages 60 through 64 are entitled to premium-free TRICARE Standard and TRICARE Extra, or may enroll in TRICARE Prime (if in a Prime Service Area), which requires payment of the annual retiree TRICARE Prime enrollment fee. A Prime Service Area, or PSA, is a geographic area where TRICARE Prime is offered. It is typically an area near a military hospital or clinic. Determine if you live in a PSA by checking your ZIP code at
TRICARE Extra is not available overseas.
Beneficiaries ages 60 through 64 who are entitled to premium-free Medicare Part A and also have Medicare Part B become eligible under TRICARE For Life, or TFL.
At age 65, beneficiaries who are entitled to Medicare Part A and have Medicare Part B will transition to TFL.
Note: If you become Medicare-eligible due to disability, you may transition to TFL as early as age 60. 28 28

29. TRICARE Program Options: Under Age 60: TRR Costs
Premiums for TRR are paid monthly. The calendar year, or CY, 2014 TRR premiums are $ for member-only coverage and $ for member-and-family coverage. CY 2015 TRR premiums are $ for member-only coverage and $ for member-and-family coverage.
Note: Please remember that all ongoing TRR premium payments must be made by either an automatic electronic funds transfer or automatic charge to a credit or debit card. Contact your regional contractor to set up automatic payments. Payments are due no later than the last day of each month and are applied to the following month’s coverage. Do not miss payment due dates. Failure to pay may result in termination of TRR coverage and a 12-month lockout.
The deductible is the amount you pay out-of-pocket per year before TRICARE cost- shares begin.
You are responsible for cost-shares. These are the amounts you pay for TRICARE- covered services, which vary if seeing a network or non-network provider.
The catastrophic cap is the maximum amount you pay out-of-pocket for TRICARE- covered services per fiscal year, or FY. TRICARE’s FY runs from October 1 through September 30. The $3,000 TRR cap includes deductibles, cost-shares, and prescription copayments, but it does not include monthly TRR premiums or costs incurred by seeking care without prior authorization.
For the most up-to-date TRR cost information, visit 29 29

30. TRICARE: Your Military Health Plan: TRICARE Benefits/Programs for National Guard and Reserve Members New to TRICARE/Active Less Than 30 Days
TRICARE benefit while on inactive duty status. 30

31. TRICARE Eligibility: Coverage Lifecycle
Non-activated members of the Selected Reserve may qualify to purchase TRICARE Reserve Select, or TRS, for themselves and their family members.
TRS is a premium-based health care plan that gives beneficiaries the freedom to choose TRICARE-authorized providers and use TRICARE’s pharmacy benefit.
During this time, service members may also have line-of-duty coverage, which is limited to injuries, illnesses, and diseases incurred when drilling or called or ordered to service for 30 days or less. 31 31

32. Other Important Information: TRICARE Dental Program (TDP)
The TRICARE Dental Program, or TDP, is a voluntary, premium-based DoD program. The benefit is administered by MetLife. The TDP offers continuous dental coverage for family members throughout the sponsor’s changing status.
Former spouses and remarried surviving spouses do not qualify to purchase TDP.
If enrolled in the TDP prior to activation, reenrollment is automatic.
If family members were enrolled in the TDP prior to the National Guard or Reserve member’s activation, or if they enrolled more than 30 days after the activation, coverage will continue uninterrupted at the active duty family member premium rate.
Monthly premiums are based on duty status.
Costs are lower when called or ordered to active service for more than 30 consecutive days.
The rates shown on the chart are premiums for 2015 and will continue through January 31, Rates are subject to change annually on February 1st.
Care is provided by participating dentists. To find a dentist, visit the TDP Web site, or receive care from a nonparticipating dentist, which may result in higher costs. 32 32

33. TRICARE Benefit Information: TRICARE and Other Health Insurance
Other health insurance, or OHI, is any non-TRICARE health benefit you receive through an employer or other public or private insurance program, including government programs such as Medicare.
If you have OHI, it is your primary health insurance and TRICARE pays last.
Your provider files a claim with your OHI first and TRICARE pays what is left, up to the TRICARE-allowable charge.
Note: TRICARE is the last payer to all other health benefits and insurance plans except for Medicaid, TRICARE supplements, the Indian Health Service, and other programs and plans as identified by the Defense Health Agency.
If your OHI runs out, or for services covered by TRICARE that are not covered by your OHI, TRICARE becomes the primary payer.
If you have OHI:
Fill out your regional contractor’s TRICARE Other Health Insurance Questionnaire and follow the guidelines for submission. Download the questionnaire from
You must follow your OHI’s prior authorization requirements and rules for filing claims. If your OHI denies a claim for failure to follow its rules, TRICARE may also deny your claim.
Make sure your provider knows you have OHI and TRICARE. Keeping your regional contractor and health care providers informed about your OHI will allow them to better coordinate your benefits.
TRICARE referrals and prior authorizations are generally not required, with some exceptions.
Visit your regional contractor’s Web site or contact them about prior authorization requirements.
You must also report if you no longer have OHI using the above methods. 33 33

34. Other Important Information: The Affordable Care Act
Under federal law, you are required to have health insurance or other health care coverage that meets the definition of “minimum essential coverage.”
Minimum essential coverage is the type of health care coverage that meets the individual responsibility requirement under the Affordable Care Act. The TRICARE program meets the minimum essential coverage requirement.
Most people who do not meet this provision of the law will be required to pay a fee for each month they do not have adequate coverage. The fee will be collected each year with federal tax returns.
If you are eligible for TRICARE, you can explore your TRICARE program options at If you lose TRICARE or are not TRICARE-eligible, you can find other health care coverage options at
For more information, visit or call your TRICARE regional contractor. 34 34

35. 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. 35 35