general knowledge

Plans

100

A great health plan available to ADSM's and their families that requires a PCM. 

What is Triwest Prime?

200

A health plan that allows members to see participating providers without a referral needed. 

What is Tricare Select?

300

A Medicare-wraparound coverage if you are TRICARE-eligible and have Medicare Part A and B, regardless of age or place of residence.

What is Tricare for Life?

400

A health plan only available to active duty service members (including activated National Guard/Reserve members) and command-sponsored family members overseas. This plan requires an assigned PCM. 

What is Tricare Prime overseas?

500

This is a plan for Members of the retired Reserve of a Reserve Component who are qualified for non-regular retirement under 10 U.S.C., Chapter 1223, are under age 60 and, not eligible for, or enrolled in, the Federal Employees Health Benefits (FEHB) program. 

What is Tricare Retired Reserve? 

Former Spouses

100

You are eligible for TRICARE as your own sponsor under your own Social Security Number as long as you meet the following criteria:

• 20 - Your sponsor has at least 20 years of creditable service towards determining retirement pay.
• 20 - You were married to the same sponsor/service member for at least 20 years
• 20 - All 20 years of marriage overlap the 20 years of creditable (Active or Reserve) service which counted towards your sponsor's retirement.

What is the "20-20-20" rule?

200

• 20 - Your sponsor has at least 20 years of creditable service towards determining retirement pay.
• 20 - You were married to the same sponsor/service member for at least 20 years
• 15 - 15 of those years overlap the 20 years of creditable (Active or Reserve) service which counted towards your sponsor's retirement.

What is the 20-20-15 Rule?

300

Re-marry, even if the remarriage ends in death or divorce (unless you gain eligibility under your new spouse). Purchase and are covered by an employer-sponsored health plan. Were the former spouse of a North Atlantic Treaty Organization or Partners for Peace nation member

What can cause a former spouse to lose eligibility? 

400

A Marriage Certificate, Divorce Decree, and DD Form 214 or Statement of Service from the applicable Service Personnel Component.

What documents do you need to establish your eligibility as an un-remarried former spouse?

500

Before April 1, 1985
April 1, 1985 – September 28, 1988
On or after September 29, 1988

What are the coverage eligibilty dates for Ex-spouses under the 20-20-15 rule

Special Programs

100

This covers applied behavior analysis (ABA) services. Under the ACD, ABA services are authorized to target the core symptoms of ASD.  

What is Autism Care Demonstration?

200

This benefit reimburses reasonable travel expenses Amounts you pay when traveling to and from your appointment.  This includes mileage, meals, tolls, parking, lodging, local transportation, and tickets for public transportation for a qualified trip by a retired TRICARE For Life (TFL) or TRICARE Select enrollee with a verified combat-related disability or disabilities.

What is Combat-related disability travel benefit? 

300

This special program health plan gives you : 

•  temporary health coverage for 18 to 36 months when you lose eligibility for TRICARE. 
• Acts as a bridge between military health benefits and your new civilian health plan.
• Provides the same coverage as TRICARE Select, including prescriptions.
• Gives you minimum essential coverage Basic health care coverage that meets the Affordable Care Act requirement.

What is the Continued Health Care Benefit Program?

400

This is a primary care program offered at some military hospitals and clinics.

• Each hospital or clinic leader decides if this is available.
• You must enroll to participate.
• Your enrollment is only for the hospital or clinic where you enrolled.
• Contact your local military hospital or clinic to see if they offer the program.

What is Tricare Plus?

500

This provides assistive technology and services to:

• Federal employees with disabilities
• Wounded, ill and injured Service members
• Federal managers who are ready to hire and accommodate 
• Federal employees with disabling conditions including:
  • Workers' Compensation beneficiaries
  • Term and Temporary Employees
  • Workforce Recruitment Program (WRP)
  • Detail appointments

Computer/electronic Accommodations Program

Tools

100

This tool helps you determine eligibility and available plans. 

What is the "find a plan" tool?

200

A tool that helps you quickly see the differences between plans. 

What is the "compare plans" tool?

300

A tool that can be used to view the different co-pays, co-insurance, premiums, etc.

What is the "Compare costs" tool?

400

This tool can help you find a participating provider, Urgent care center, MTF, convenient care Clinic, or Telemedicine provider. 

What is the "Provider Directory" ? 

500

This tool can be used to find an MTF nearest you. 

What is the Find a Military Hospital or Clinic Tool?

Qualifying Life Events

100

This is the amount of time you have to make an eligible enrollment change.

What is 90 days?

200

This is where you update your information to report the QLE. 

What is DEERS?

300

This is the time period you can make enrolments/changes outside of QLE's. 

What is open season/open enrollment?

400

Name 3 Qualifying Life events. 

What are retiring, separation from duty, birth/adoption, moving, getting married, divorce, Medicare eligibility, going to college, children become adults, losing or gaining OHI, Death in family, injured on active duty, activating, de-activating. ?

500

• Update DEERS with the QLE.
• Make the enrollment changes within 90 days following the QLE.
• Pay any enrollment fees or premiums due during that period

What must you do to enroll or change your plan after a QLE?