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Thursday, September 09, 2010
Army Reserve Family Programs
TRICARE

When the Reserve Component sponsor is on orders for more than 30 consecutive days, his/her family's medical needs are covered under several TRICARE options. 


Eligibility   

The most important thing you can do is make sure all your information in the Defense Enrollment Eligibility Reporting System (DEERS) is accurate. Since DEERS is the system used to determine eligibility for military health care, family members could be denied care if DEERS information is incorrect or incomplete.

Eligibility

TRICARE Options
TRICARE Standard: No enrollment necessary
TRICARE Extra: No enrollment necessary
TRICARE Prime: Must enroll, not available everywhere
TRICARE Prime Remote: Must live at least 50 miles from Military Treatment Facility (MTF) to enroll
TRICARE Dental Plan: Must enroll within 30 days


TRICARE Regions  

TRICARE Regions

TRICARE North - Health Net Federal Services, Inc. 1-877-874-2273: 8a-7p (EST)
TRICARE North Regional Office: 1-866-307-9749
Claims Status
Health Net Federal Services, Inc., c/o PGBA, LLC/TRICARE, PO Box 870140, Surfside Beach, SC 29587-9740
TRICARE South - Humana Military Healthcare Services, Inc. 1-800-444-5445, 8a-7p (EST)
TRICARE South Regional Office:1-800-544-2397
Claims Status
TRICARE South Region, Claims Department, P.O. Box 7031, Camden, SC 29020-7031
1-800-403-3950
TRICARE West - TriWest Healthcare Alliance, Inc. 1-888-874-9378, 8a-6p (PST)
TRICARE West Regional Office, 1-888-874-9378
Claims Status
West Region Claims, P.O. Box 77028, Madison, WI 53707-7028
1-888-TRIWEST (1-888-874-9378)


Early TRICARE  
Some members of the National Guard and Reserve (collectively known as the Reserve Component, or RC), who are issued delayed-effective-date active duty orders for more than 30 days in support of a contingency operation, are eligible for “early” TRICARE medical and dental benefits beginning on the later of either: (a) the date their orders were issued or (b) 90 days before they report to active duty.

TRICARE Eligibility for RC Members and Family Members To be eligible for this early TRICARE benefit, RC members and family members must be registered and TRICARE eligible in the Defense Enrollment Eligibility Reporting System (DEERS). The member’s Service personnel office is responsible for determining the member’s eligibility for the early TRICARE benefit. The Services will notify and advise eligible RC members of their TRICARE medical and dental benefits when their delayed-effective-date active duty orders are issued.

RC members may verify their eligibility for TRICARE through the secure Guard and Reserve Web Portal Web site at www.dmdc.osd.mil/appj/esgr/index.jsp (if the employer input page appears, click the “BACK” button located on the bottom of the “employer input page”). For assistance with an eligibility problem, members should contact their Service Point of Contact listed on the TRICARE Web site at www.tricare.osd.mil/reserve/reservepoc.cfm.

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Choosing a Primary Care Manager (PCM)  
Choosing a Primary Care Manager (PCM)
  • Choose a PCM at the time of enrollment
  • Obtain provider info via regional contractor’s web site
  • Customer service line, or
  • www.tricare.osd.mil/ProviderDirectory
  • If PCM is not chosen at time of enrollment, one is assigned
  • Change of PCM may be submitted at any time if more than one provider is in your area
  • PCM will obtain necessary referral for specialty care

  • TRICARE Pharmacy  

    TRICARE Pharmacy Program

    Military Treatment Facility (MTF)
    -Perscriptions filled at no charge
    -Carries DoD Basic Core Formulary Rx
    Retail Pharmacy Network
    -$3-generic Rx
    -$9-brand name Rx
    -$22 non-formulary Rx
    www.tricare.osd.mil/pharmacy or 866-363-8779
    Mail Order Pharmacy
    -Mail Rx and co-pay, refill by mail, call 866-636-8667 or online
    -Free shipping, handling, home delivery to ADSMs
    -Up to 90-day supply
    Non-network Pharmacies *most costly Rx option
    -TRICARE Standard deductibles and cost-shares apply
    -May have to pay total amount for Rx and file claim for reimbursement


    Back Military ID Cards and DEERS
    Next Dental (UCCI)
    Return to MOB and Deployment Brief Table of Contents