• TRICARE Retiree Dental Program Enrollment
• TRICARE Retiree Dental Program Providers
• TRICARE Retiree Dental Program Eligibility
• TRDP Benefits offered to Reserve and Guard

TRICARE Retiree Dental Enrollment

• A 12-month commitment is required upon enrollment.
• A grace period of 30 days from the coverage effective date is available during which termination of enrollment may be allowed without any further obligation, providing that no benefits have been used.
• After the initial 12-month commitment, enrollment continues on a month-to-month basis.
• Enroll three ways: online at www.trdp.org, by toll-free telephone at 1 (888) 838-8737 or by mail.

 

TRICARE Retiree Dental Providers

• Enrollees may seek treatment from any licensed dentist or specialist within the TRDP coverage area.
• To minimize out-of-pocket expenses, enrollees may seek treatment from 67,000 participating provider locations.

TRICARE Retiree Dental Eligibility
You are eligible to enroll in the TRDP if you are:

A member of the Uniformed Services who is entitled to Uniformed Services retired pay, including those age 65 and over.

A member of the Retired Reserve/Guard, including a "gray-area" reservist who is entitled to retired pay but will not begin receiving it until age 60.

A current spouse of an enrolled member.

A child of an enrolled member, up to age 21 (to age 23 if a full-time student, or older if disabled before losing eligibility).

An unremarried surviving spouse or eligible child of a deceased member who died while in retired status or while on active duty.

A Medal of Honor recipient and eligible immediate family member, or an unremarried surviving spouse/eligible immediate family member of a deceased recipient.

A current spouse and/or eligible child of certain nonenrolled members with documented proof the nonenrolled member is:

 

Benefits Offered to National Guard and Reserve Members:
National Guard and Reserve personnel who elect to enroll in the TRDP within 120 days after retirement are now eligible to skip the 12-month waiting period normally required for certain TRDP benefits. Effective February 1, 2005, TMA has authorized a waiver from requiring retired National Guard and Reserves who meet the criteria to enroll in the TRDP for 12 months prior to gaining the maximum allowed benefits for cast crowns, cast restorations, bridges, dentures and orthodontics for adults and children.

Additionally, this new waiver will be applied retroactively to February 1, 2004, for any Guard and Reserve enrollees who can document their enrollment in the TRDP within 120-days after their retirement effective date. Delta will process any claim adjustments resulting from this retroactive waiver upon notification from the enrollee and submission of the appropriate documentation.

All new enrollees seeking to obtain the waiver should submit a copy of their retirement orders with their TRDP application.

Eligible retirees and their family members can find information about the program by visiting the TRDP Web site and toll-free number listed below.

For more information about the TRDP, call toll-free at 1-888-838-8737, or visit Delta Dental online at: www.trdp.org.

• Appeals
• Chiropractic Care Program
• Defense Enrollment Eligibility Reporting System (DEERS)
• Dual-Eligibility
• Eligibility
• FEHBP Demonstration Project
• Health Insurance Portability and Accountability Act (HIPAA)
• How TRICARE Changes When a Military Sponsor Retires or Dies
• Maternity Care
• Next Generation of TRICARE Contracts
• Pharmacy Program
• Point-of-Service Option
• Portability
• Privacy Practices
• Regional Managed Care Support Contractors
• Reserve Component
• Transitional Health Care Benefits
• Travel Reimbursement
• TRICARE Basics
• TRICARE Dental Program
• TRICARE Dental Program Overseas
• TRICARE For Life
• TRICARE Online
• TRICARE Overseas Program
• TRICARE Plus
• TRICARE Prime Remote
• TRICARE Reserve Family Demonstration Project
• TRICARE Retiree Dental Program
• TRICARE Standard
• Uniformed Services Family Health Plan
• Women, Infants, and Children (WIC) Overseas Program

 

LONG TERM CARE Web Site:
The U.S. Office of Personnel Management has announced the launch of a new and improved Website for the Federal Long Term Care Insurance Program at www.LTCFEDS.com. Long Term Care Partners, LLC, administers the long term care program and maintains the site. The Federal Long Term Care Insurance Program is the largest group long term care insurance program in the nation. It provides federal employees and annuitants, active and retired members of the uniformed services, and their qualified relatives the opportunity to apply for coverage at group rates. "The new Website is a great tool for federal employees and annuitants, providing better access and enhanced education and decision-making capabilities," said Robert F. Danbeck, associate director of the U.S. Office of Personnel Management's Human Resources Products and Services Division. "The site is interactive, allowing eligible persons to make informed decisions regarding long term care insurance."

 

State-by-State Guide to Disability Resources
Visitors to the DisabilityInfo.gov website can locate disability programs and information for their state. To browse through state information, select one of the nine subject tabs at the top of any DisabilityInfo.gov page. Then click on the State and Local Resources map on the right-hand side bar to find information on that subject in your state. You can also subscribe to receive e-mail updates on information and resources in your state. For more information, visit the DisabilityInfo.gov website at (http://www.disabilityinfo.gov).

 

Skilled Nursing Facilities:
Under TRICARE, a skilled nursing facility is a facility with the staff and equipment to provide skilled nursing, skilled rehabilitation or other medically necessary healthcare services, including prescription medications. Skilled nursing care isn’t typically provided in a nursing home or a patient's home.

Skilled Nursing Facility Admission Criteria
For TRICARE to cover your skilled nursing facility admission you must meet the following criteria:
* You must be treated in a hospital for at least three consecutive days, not including the day of discharge;
* You must be admitted within 30 days of your hospital discharge (with some exceptions) to a skilled nursing facility;
* Your doctor’s treatment plan must demonstrate your need for medically-necessary rehabilitation and skilled services; and
* The facility must be Medicare-certified and a participating provider.

Skilled Nursing Coverage
Under skilled nursing care, TRICARE typically covers the following:

• Medically-necessary skilled nursing care;
• Rehabilitative (physical, occupational and speech) therapies;
• Room and board;
• Prescribed drugs;
• Laboratory work;
• Supplies;
• Appliances; and
• Medical-equipment.

You are responsible for TRICARE beneficiary cost shares. The amount you pay varies, depending on your eligibility status and TRICARE option. For more information, please see the chart at www.tricare.osd.mil/tricarecost.cfm.

If you are Medicare and TRICARE eligible:

• For days 1 to 20, Medicare pays 100 percent;
• For days 21 to 100, Medicare covers all costs, except for the required Medicare copayment. TRICARE covers the copayment; and
• After day 100, TRICARE is the primary payer and you pay TRICARE beneficiary cost shares.
Medicare and TRICARE have the same benefits, skilled nursing facility decision process and payment calculation method, except TRICARE doesn’t limit the benefit to 100 days (after obtaining a Medicare claim denial).

Durable Medical Equipment
TRICARE covers medically necessary equipment costing more than $100, such as wheelchairs, hospital beds and respirators. You may buy or rent the equipment (whichever costs less). Send your doctor's prescription with your claim, specifying the type of equipment, why you need it and for how long. TRICARE won’t cover general use equipment, such as air cleaners or whirlpool baths. Before getting durable medical equipment, check with your region’s toll-free call center about rules and coverage limitations.

 

Hospice
Hospice care is available for terminally ill patients expected to live six months or less if the illness runs its normal course. A Medicare-approved program must provide the hospice care, which may include the following:

• Physician services;
• Nursing care;
• Counseling;
• Inpatient respite care;
• Medical supplies;
• Medications;
• Home health aide services; and
• Short-term acute patient care.

TRICARE Standard pays the full cost of covered hospice care services, except for small cost-share amounts the hospice may collect for drugs and inpatient respite care. See also: TRICARE for Life and Medicare Fact Sheet

 

VA Chiropractic Care:
Good news to those veterans who are suffering from back pain caused by neuromusculoskeletal conditions. The VA will begin providing Chiropractic Care at 26 selected Department of Veterans Affairs (VA) facilities beginning this fall. They VA plan to hire or contract chiropractic Doctors to provide the care. In consultation with VA primary care providers, chiropractors will offer patient evaluations and chiropractic care for neuromusculoskeletal conditions. Care will be provided in the following locations: Sacramento & Los Angeles CA, West Haven & Newington CT, Togus ME, Tampa & Miami FL, Augusta GA, Danville IL, Kansas City KS, Iron Mountain MI, Fort Harrison MT, Albuquerque NM, Buffalo & the Bronx NY, Jackson MS, Columbus OH Butler PA, Mountain Home TN, San Antonio, Temple, & Dallas TX, Columbia SC, Sioux Falls SD, Seattle WA, and Martinsburg WV. Eligible veterans in areas remote to these locations will be able to receive chiropractic care through VA's outpatient program after being referred by their primary care provider, and receiving authorization by the department. [Source: Military.com 28 Aug 06]

 

TRICARE: Allowable Charges Easy to Find
FALLS CHURCH, Va. –The new Web site shows the TRICARE Maximum Allowable Charge tables, listing the most frequently used procedures, more than 300 of them, and the amount TRICARE is legally allowed to pay for them. These charges are tied to Medicare allowable charges, effectively making them a federal standard for health care costs. TRICARE figures the allowable charge from all professional (non-institutional) providers' bills nationwide, with adjustments for specific localities, over the previous year. A claims processor can tell a provider the allowable charge amount for specific services or procedures and now, anyone can see the charges on the new Web site. Anyone can use the rate table’s itemized format to determine the appropriate charge for professional services, based on the Healthcare Common Procedure Coding System (HCPCS.) The charges in this table don’t reflect discounts regional contractors may negotiate with TRICARE network providers, so they may differ from the amounts shown on TRICARE beneficiaries’ explanation of benefits. The TRICARE allowable charges are listed on line at www.tricare.osd.mil/allowablecharges.

 

TRICARE for Life to Limit Explanations of Benefits
MOAA recently learned of a cost-saving measure instituted by Wisconsin Physicians Services (WPS), the claims administrator for all TRICARE for Life (TFL) claims, and approved by the TRICARE Management Activity (TMA) to stop the mailing of a printed Explanation of Benefits (EOB) when a beneficiary’s balance due is zero. Most beneficiaries will receive no advance notice of this change, which is effective April 1, 2007.

 

TRICARE Implements Enhanced Coverages
TRICARE will implement coverage for anesthesia services and associated costs for dental treatment for beneficiaries with developmental, mental or physical disabilities, and children age 5 or under beginning July 1, 2007. Additionally, TRICARE encourages beneficiaries who received these services between Oct. 17, 2006 and July 1, 2007 to contact their TRICARE regional contractor for help with reimbursement. The change in statute does not provide coverage for the actual dental care services, which are available through the TRICARE Dental Program and the TRICARE Retiree Dental Program.

 

TRICARE Dental Program
The TRICARE Dental Program (TDP) is a voluntary dental care plan for eligible active duty family members, National Guard and Reserve members and their families. Eligibility is based on the sponsor's information in the Defense Enrollment Eligibility Reporting System (DEERS). If you are an active duty service member or a National Guard or Reserve member with active duty orders for more than 30 consecutive days, you are not eligible for the TDP. You must receive dental care through the active duty military dental care system. For more information about dental benefits for National Guard and Reserve members and their families, visit www.tricare.osd.mil/reserve/dental.cfm. For more information on the TDP, visit www.TRICAREdentalprogram.com or call United Concordia's 24-hour line at 1-800-866-8499.

TRICARE Dental Care Overseas
Currently, host nation dentists often require military families to make full payment up front, and then wait for reimbursement from United Concordia, the administrator of the TRICARE Dental Program (TDP). Now, TRICARE has modified their dental contract in an effort to eliminate the problem by seeking out host nation dentists who will not expect the total payment for treatment in advance. In light of this change, TRICARE encourages beneficiaries to remain enrolled in the TDP when they move overseas. In the near future, beneficiaries will be able to see the list of TRICARE Preferred Dentists on the (http://www.tricaredentalprogram.com/) United Concordia website

 

TRICARE officials urge preparation for hurricane season
FALLS CHURCH, Va.(AFRNS) -- With meteorologist predicting another active Atlantic hurricane season, Tricare officials are urging beneficiaries to prepare now before a hurricane causes evacuations or limits access to health care.

The Atlantic storm season is under way, and hurricanes and typhoons at home and abroad may affect military families. But preparing for a disaster ahead of time may alleviate some stress they may face during the storm, and ease the burden on family and loved ones. A few simple steps will help military families prepare for storm season or any disaster.

“Americans must be prepared” to care for themselves and their loved ones during and immediately following a disaster for at least three days until other resources are available, according to R. David Paulison, Federal Emergency Management Agency administrator.

There are several simple things military families can do to prepare for the hurricane season. As a family, make a plan. The plan should outline how to contact each other, how to reunite and what to do in different situations, if a disaster were to happen. Keep basic items like water, food, a battery-powered radio, flashlights and first-aid items in an emergency kit.

Because medical help may not be immediately available during a natural disaster, be sure to pack all of your health-related items in a waterproof emergency kit. These items include:

-- Copies of each family member’s uniformed services ID card (or sponsor’s name and Social Security number, family members’ names, addresses, phone numbers, etc.).

-- Copies of each family member’s Medicare card or other health insurance card, if applicable.

-- Copies of medical records for each family member.

-- List of each family member’s primary care manager, other doctors names and phone numbers.

-- Emergency contact names and phone numbers.

-- List of other important phone numbers, including your regional contractor, Medicare, and Express Scripts (the Tricare pharmacy contractor).

-- List of each family member’s prescription medications and their doses, in case they need to be replaced.

-- List of each family member’s allergies.

-- A properly-stored 30-day supply of all prescription medications for each family member.

-- For those who require insulin, a 30-day supply as well as proper storage to keep it cool.

-- Nonprescription drugs, such as pain relievers, anti-diarrhea medication, antacid, laxatives, bug spray, itch control, etc.

-- List of medical devices’ style/model and serial numbers, such as pacemakers.

-- Extra wheelchair batteries or other special equipment.

-- Extra eyeglasses and hearing-aid batteries.

For more information and valuable tips, please visit http://www.tricare.mil/DisasterRelief/index.cfm, Tricare’s disaster relief Web page.

To learn more about TRICARE, visit www.military.com/benefits/tricare.

 

Drug Information:
Drug Digest is a noncommercial, evidence-based, consumer health and drug information site dedicated to empowering consumers to make informed choices about drugs and treatment options. The entire site is available free of charge and can be accessed at http://www.drugdigest.org/. Your personal Medication and Emergency Contact Card can be obtained at this web site by clicking on this web link http://www.drugdigest.org/DD/SeniorCorner/PrintableMedCard/1,10374,IT,00.html? If clicking doesn't work, simply cut and paste this link into your Web browser.

Generic Drugs:
The FDA requires pharmaceutical companies prove that the generic drug contains the identical amount of the active ingredient and works the same way as the brand-name drug. The pharmaceutical company also must manufacture the generic drug under the same strict quality guidelines as a brand-name drug. Plus, the FDA scientists, chemists and microbiologists reviewing generic medicines must have the same qualifications as those reviewing the brand drugs. Sometimes the generic manufacturer may not be allowed to use the same color or shape because of patents protecting the brand drug. These are only cosmetic differences that in no way impact the safety or effectiveness of the generic version. Buying generic is completely safe and will save you money at the pharmacy counter. Generic drugs cost much less than the brand-name version. When you buy generic drugs, your copay is only $3-that's one-third of the $9 copay for brand-name drugs. I would like to encourage you to ask for the more affordable generic drugs when filling prescriptions at your local pharmacy.
The Defense Department's long-practiced mandatory generic drug policy requires pharmacists to fill your prescriptions with a generic drug, if one is available. Tricare will fill prescriptions for brand-name drugs that have a generic equivalent if your prescribing physician establishes medical necessity for using the brand-name drug. If you have a prescription for a drug that has no generic equivalent, your pharmacist will give you the brand-name drug at the brand-name copay. Tricare is committed to meeting your health care needs-and you can help us help you. By using generics, you will enjoy a safe and less expensive alternative to brand-name drugs. Buying generics saves you money today and helps Defense Department's save money, ensuring the future of the Tricare benefit.

By David N. Tornberg, MD, MPH
Deputy Assistant Secretary of Defense
for Clinical and Program Policy