Tricare

For a complete Tricare reference, visit www.tricare.osd.mil or call (877) TRICARE. Tricare is the health benefit for all seven uniformed services: Army, Navy,Marine Corps, Air Force, Coast Guard, Public Health Service, and National Oceanic and Atmospheric Administration.

Tricare offers a choice of four health care options:

• Tricare Prime
• Tricare Extra
• Tricare Standard
• Tricare For Life

Eligibility
Tricare-eligible persons include active duty and retired service members, their spouses, unmarried children and survivors. To use Tricare, you must be listed in DEERS as being eligible for military health care benefits. To determine your eligibility, call the Defense Enrollment Eligibility Reporting System (DEERS) at (800) 538-9552.

Tricare Prime
Tricare Prime is a voluntary health maintenance organization (HMO)-type option. Active duty service members and their dependents have no enrollment fee. Retirees pay an annual enrollment fee and enroll for one year at a time. You should contact one of the information sources mentioned in the Information section for more details on Tricare Prime, and to find out if this option is right for you. Note: Active duty service members are required to enroll in Tricare Prime.

Tricare at WRNMMC
Choosing to enroll in Tricare Prime at WRNMMC prioritizes certain benefits, including:

• Timely access to care
• First priority treatment
• Tricare Prime coverage away from home
• Regular preventive medical services, such as eye exams, immunizations, hearing tests, nutrition counseling, mammograms, PAP and prostate exams
• A Primary Care Manager (PCM) who coordinates your health care, maintains individual records and makes referrals to specialists
• Privileges at the WRNMMC Wellness Center, offering services, such as stress management, nutritional education and physical fitness
• School and sports physicals (for Prime patients enrolled in WRNMMC’s Pediatric and Adolescent Medicine Clinics)
• Ability to make all your Primary Care appointments online with Tricare Online
• Access to convenient appointment scheduling via the WRNMMC’s Patient Appointment Call Center

Enrolling at WRNMMC:

• Walk-in to enroll at WRNMMC’s Health Benefits Services or TRICARE Service Center.
  • Health Benefits Services - A WRNMMC Health Benefits Advisor (HBA) will provide you with an enrollment packet, instructions, information on all of your options.
    
    
  • TRICARE Service Center (TSC) - A "walk-in" service for enrollment help and other assistance with your TRICARE contract such as benefits, claims, and authorizations.
    TRICARE Service Centers are customer service offices located near or within a Military Treatment Facility (MTF), such as WRNMMC, and in other locations throughout the TRICARE North.
    
    
  • Location - Both Health Benefits Services and the TRICARE Service Center are next to Customer Service Desk in Bldg 9, 1st floor. From entrance to Outpatient Center, Bldg 9, pass escalators. Customer Service, Beneficiary Services, and TRICARE Service Center are on left.
  
  
• Obtain an Enrollment Form at HealthNet Federal Services or call 1-877-TRICARE (1-877-874-2273).

WRNMMC’s Primary Care Clinics
WRNMC’s Primary Care Clinics include:

• Internal Medicine Blue Clinic
• Internal Medicine Gold Clinic
• Pediatric and Adolescent Medicine

Tricare Extra
You do not have to enroll or pay an annual fee to participate in Tricare Extra. You do, however, have to satisfy an annual deductible for outpatient care, just as you do under Tricare Standard. In the Tricare Extra program, you receive discounts on cost sharing when you use a Tricare Extra network provider. You do not have to file your own claims, and may use Tricare Extra on a case-by-case basis just by using the network provider. Tricare Extra is not available overseas. Refer to the Information section to find out how to get details on deductibles and cost sharing through Tricare.

Tricare Standard
Tricare Standard is what was once called the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). Tricare Standard shares most of the costs of care from civilian hospitals and doctors when you don’t get care through a uniformed services hospital or clinic. But there are certain important things you need to know about Tricare Standard before using it, such as the fact that it is not free, it does not cover all health care, it pays for only medically necessary health care and your provider must be certified by the regional contractor as an authorized provider of care.

Pharmacy Benefits
Tricare beneficiaries have three options for filling prescriptions:

• A military treatment facility
• A Tricare retail network pharmacy
• The Tricare Mail Order Pharmacy (TMOP)

Tricare for Life (over 65)
Tricare for Life (TFL) is an enhanced health care benefit for Medicare-eligible uniformed services beneficiaries, their eligible family members and survivors. Some key features of TFL are: you must be enrolled in Medicare Part B, Tricare pays second to Medicare and you will incur no monthly premiums (except for Medicare Part B). For additional information call (888) DOD-LIFE, or visit www.tricare.osd.mil. Tricare Plus is a health care program for selected seniors and other eligible beneficiaries that provide access to Primary Care Managers at participating Military Treatment Facilities (MTFs). Availability of the program is based on the space and resources in individual MTFs, and is at the discretion of the MTF Commander. WRNMMC is proud to be a participating Tricare Plus MTF. The Tricare Plus Program at WRNMMC features the same high access standards as for primary care: Urgent and Acute Care appointments within 24 hours, and routine care appointments within 7 days. Furthermore, Tricare Plus patients are provided specialty care on a space-available basis within the Military Health System. Tricare Senior Pharmacy Benefit provides Medicare-eligible retirees of the uniformed services, their family members and survivors the same pharmacy benefit as retirees who are under age 65. It includes access to prescription drugs not only at military treatment facilities, but also at retail pharmacies and through the Tricare Mail Order Pharmacy program. Contact the Tricare information specialists referred to in the Information section for detailed information on eligibility.

Tricare Online at WRNMMC (TOL)
www.tricareonline.com
An innovative and easy-to-use service that gives you access to your Primary Care Manager’s appointment schedule 24 hours a day from your home or office computer. If you are a Tricare Prime or Tricare Plus beneficiary, you can make all of your routine, primary care appointments at WRNMMC at www.tricareonline.com.

Tricare Information Sources
WRNMMC’s Health Benefit Advisors (HBAs) provide information about Tricare, Tricare Plus, and health care options. Visit an HBA at the Customer Service Center for specific information about enrollment in Tricare Prime at WRNMMC and to receive an enrollment packet with complete instructions.
To enroll in Tricare Prime at WRNMMC, visit the Tricare Service Center located in Bldg. 9 on the 1st floor. You can also obtain an Enrollment Form by calling HealthNet at (877) TRICARE or visiting HealthNet’s Web site at: www.healthnetfederalservices.com.
The Tricare Service Center (TSC) at WRNMMC provides “walk-in service” to all Tricare beneficiaries. The TSC/HBAs provide benefits information, handles claims, answers questions, addresses enrollment inquiries and distributes marketing materials for Tricare beneficiaries.