New policies improve healthcare benefits - Round The Reserve

Thanks to a couple of policy changes, families of mobilized guardsmen and reservists are eligible for improved health-care insurance under the Tricare program.

In one change, family members of people mobilized for more than 30 consecutive days may enroll in Tricare Prime, the military's best form of health insurance.

"Previously, sponsors had to be eligible in the Defense Enrollment Eligibility Reporting System and activated for 179 days or more before family members were eligible to enroll in Tricare Prime," said Dr. William Winkenwerder Jr., assistant secretary of defense for health affairs. "The Department of Defense recognizes the contributions and sacrifices made by these families each and every day. Our commitment is to continue making improvements to the Tricare benefit to enhance access and quality of care these families receive."

Under Tricare Prime, family members are eligible for preventive services, and they have to pay no deductibles, enrollment fees or cost-shares.

Prior to the policy change, family members of guardsmen and reservists who were activated for less than 179 days were automatically covered under either Tricare Standard or Tricare Extra without having to send enrollment forms to Tricare.

The second policy change allows family members who reside with their sponsors in a Tricare Prime Remote location when the sponsors are activated to enroll in the Tricare Prime Remote for Active Duty Family Members program. Prior to this change, family members could enroll in the program but lost their eligibility for coverage as soon as their activated sponsors deployed outside the immediate area.

To be eligible to enroll in this program, sponsors and their family members must reside at a location that is at least 50 miles or more, or approximately a one-hour drive, from the nearest military treatment facility. Sponsors and family members also must be identified as eligible in DEERS.

"It's important that we take care of the families of our reserve component members," said Thomas F. Hall, assistant secretary of defense for reserve affairs. "We want to ensure that our mobilized national guard and reserve members aren't worried about who's caring for their families while they're gone and to return them to families whose health-care needs have been met by the military health system."

Winkenwerder and Hall said the change in qualifying days for Tricare Prime took effect March 10. The effective date of the new Tricare Prime Remote policy was March 11 and was not retroactive. Tricare officials said they are working with the military services, manage care support contractors and military treatment facilities to work out details and develop guidance on implementing these new changes.

Guard and reserve family members who choose not to enroll in either the Tricare Prime or Remote program may still use the Tricare Standard and Extra benefits, with applicable cost-shares and deductibles.

Guard and reserve sponsors need to verify that DEERS information for themselves and their family members is accurate and up to date. They can contact DEERS at the Defense Manpower Data Center support office toll free at (800) 538-9552. Sponsors and family members can also update their addresses in DEERS on the Tricare Web site (http://www.tricare.osd.mil) trader "DEERS." (AFRC News Service)

COPYRIGHT 2003 Air Force Reserves
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