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Tricare Medical Benefits for Military

Tricare 300x271 Tricare Medical Benefits for MilitaryHow to Update DEERS Online

Click here to update your DEERS online. (Please note you must have a MyPay login to do this from your personal computer). Click on DoD and/or VA Beneficiaries, then select Continue. Click OK. Login using your myPay user name and password. After the system has let you in, you may update your information.

How to change your PCM online for Military Dependents

Click here to update your PCM for Tricare online. (Please note you must have a MyPay login to do this from your personal computer). Click on ‘Log On’ listed in red at the top of the page. Click on the DFAS/MyPay link. After you log in, a list of patients listed under Tricare will show up. Click on the blue people in the box listed on the far right hand side to change your PCM. You may also update your addresses by clicking on the pencil icon.

Please note when you are searching for a new PCM, you may choose ‘Civilian Care’ or ‘Military Treatment Facilities.’ If you are searching for a provider, you must choose the city, specialty and gender before results are shown. I have also found better results by typing in the city/state rather than searching by zip code.

Over 30 minutes drive time allows you to utilize a civilian primary care manager for free without any co-pays of fees. For those who live less than 30 minutes from a Military Treatment Facility, you cannot use Civilian Care. There are exceptions—if you are wanting to use a pediatrician and there is no pediatrician at the closest facility, but the main hospital has a pediatrician and is more than 30 minutes away … you can use civilian care. It is wise to call Tricare and talk to a specialist to have them verify your doctor and make notes on your file before you make an appointment with your new provider.

An important note: your new civilian care manager must be less than 30 minutes drive time as well. All times are calculated with the Bing mapping system. You must have a drive time waiver access (DTWA) on the Tricare Prime Enrollment site if your civilian provider of choice is more than 30 minutes away.

Tricare for those married to Active Duty Military

Here is a great overview or read below.

Exceptional Family Member Online Information

Tricare PRIME

  1. Free for all military dependents. They will pay 100% of all medical bills. You must see your authorized Primary Care Manager (PCM) on base or office out in town (may be a civilian provider in some cases), everything will be paid for. If you get a referral to a private care provider outside of the PCM or hospital, you will get everything paid for as well.
  2. You can go to ANY emergency room for a bona fide emergency and they will cover 100% of those costs.
  3. Prime also includes free pharmaceuticals at military installations and designated pharmacies.

Tricare PRIME POS Option

  1. Allows you to receive non-emergency care from private providers without a referral. Those visits may be subject to a ($300 individual, $600 family) E5 and above or ($50 individual, $100 family deductible) E4 and below.
  2. 50% cost shares for inpatient and outpatient claims and excess charges up 15% over the allowed amount may also be implemented. The 50% cost-share continues to be applied even after the Enrollment Year catastrophic cap has been met. When you use this option, all of the Tricare STANDARD rules automatically apply, except for the NAS (Nonavailability statement).

Tricare Prime REMOTE

  1. This is for those who don’t have a military base within proximity of your home (50 miles or an hour commute) if you move away during a deployment or get stationed at a remote place like Bridgeport, CA.
  2. You will get a Primary Care Manager (PCM) assigned to you at a public hospital. In some cases, you can apply for travel reimbursement.

Tricare STANDARD and Extra

  1. You may choose to go out in town, but you will end up paying 20%.

Life Events

If you are having a baby, going through a deployment, or have any other major life issue, click here for great information.

I want to have a baby outside of a military hospital

Can be done with Tricare Prime if you call Tricare and find a Tricare authorized OB and hospital. This is the only way to do this with no out of pocket costs. You can choose to get your own provider, but may have to choose Tricare Standard in that instance. Best bet is to call Tricare and discuss your situation with them.

 

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