TRICARE OVERVIEW
The health care program for uniformed service members, retirees, and their families.
TRICARE
Active duty, Retired and Guard/Reserve service members.
Sponsors
Active-duty beneficiaries must enroll in this plan.
TRICARE PRIME
Individual entitled to receive care through the TRICARE Program.
Beneficiary
"I wanna dance with somebody"
Whitney Houston
Preventive care, emergency care, urgent care, primary care...
Types of care covered under TRICARE
Spouses, Children, Survivors, dependent parents or parents-in-law.
Family
Sponsor's home and work addresses are more than 50 miles from a military clinic.
TICARE PRIME Remote
Individual responsible for providing and coordinating a range of health care services for a beneficiary.
Primary Care Manager (PCM)
"We are the Champions"
Queen
Customer Service model to guide interactions and effectively honor our commitment to superior customer service.
CLASS
The maximum amount a beneficiary can pay out of pocket each calendar year.
Catastrophic Cap
Plan that qualified adult children can purchase after eligibility for regular TRICARE coverage ends.
TRICARE Young Adult
Process of signing up for a TriWest-managed TRICARE health plan.
Enrollment
"Paparazzi"
Lady Gaga
"________________" is not only our motto, but also a deep-rooted desire to go above and beyond.
Whatever It Takes!
Military hospital or clinic, civilian network of providers or TRICARE authorized non-network providers.
Where beneficiaries can get care
Self-managed, preferred provider organization plan.
TRICARE Select
Often required when the PCM sends a beneficiary to another provider for specialty care.
Referral
"Someday"
Mariah Carey
Founding and and awarded Department of Defense (DOD) TRICARE Contract.
1996
Beneficiaries pay these fees when they see a TRICARE authorized provider other than their PCM for non-emergency services without a referral.
Point of Service (POS)
Coverage is only for those with Medicare and who are TRICARE eligible.
TRICARE For Life
Request for payment submitted to TRICARE for covered services.
Claim
"Despacito"
Luis Fonsi