by Bianca Strzalkowski
Military life is transient in nature creating a necessity for accessible, portable healthcare for those families traveling for leisure or executing permanent-change-of-station (PCS) orders.
Like many Americans, military families take advantage of holidays, like spring break, to travel to extended family or squeeze in quality time. In fact, 42 percent of Americans expect to take a vacation in 2017, according to a recent AAA survey, with roughly one-third stating they are more likely to take a vacation this year compared to 2016. If you are amongst that group, there are proactive steps to take when traveling with TRICARE to avoid unnecessary costs or obstacles to medical treatment.
Like many Americans, military families take advantage of holidays, like spring break, to travel to extended family or squeeze in quality time. In fact, 42 percent of Americans expect to take a vacation in 2017, according to a recent AAA survey, with roughly one-third stating they are more likely to take a vacation this year compared to 2016. If you are amongst that group, there are proactive steps to take when traveling with TRICARE to avoid unnecessary costs or obstacles to medical treatment.
Routine Care Ahead Of Planned Trips
Defense Health Agency spokesman Kevin Dwyer advises TRICARE Prime beneficiaries to satisfy any routine care before traveling because it will usually not be authorized during travel.
Always Bring Important Documents/ Contact Information
It is important to pack important documents for your trip that may be required if you end up needing to access care while away from home: shot records, phone numbers for your Primary Care Manager (PCM) and Nurse Advice Line, and your military identification card. If you have a dependent 10 years or older, they too must carry their card at all times. “You always need to show your military ID card at the doctor’s
office to show proof of TRICARE coverage. TRICARE regulations allow providers to copy your military ID card to facilitate submitting TRICARE claims,” Dwyer said.
Care During Travel
Unfortunately, there may be a scenario where medical care is required while traveling. If it is an emergency situation (threatens life, limb or eyesight), Dwyer states beneficiaries can go to an emergency room that is in or out-of-network. But, it is important to contact a PCM or regional contractor within 24 hours of being seen, “especially if you’re admitted so the continued care can be authorized,” he added.
For non-emergent medical needs, there are several options:
1. Contact your PCM for a referral;
2. Call the Nurse Advice Line at 1-800-TRICARE, Option 1, which is available 24 hours a day, seven
days a week; or,
3. Self-refer to an urgent care facility
Urgent Care Pilot Program
Last year, TRICARE announced the UrgentCare Pilot Program, which will run through May 2019. It allows enrollees to self-refer to an urgent care facility – a TRICARE network or TRICARE authorized non-network centers – without an authorization for up to two visits per year. However, “if you’re enrolled at military hospital or clinic and receive pre-authorization from the Nurse Advice Line for urgent care, or your PCM submits a referral for urgent care, it won’t count against your two visits. If you’re enrolled to a civilian PCM and your PCM submits a referral for urgent care, it won’t count against your two visits,” according to the TRICARE website. Urgent care is different than emergency care and should be accessed for non-life threatening illnesses, such as a sprain or fever. If you are unsure, refer to the Nurse Advice Line. Further, urgent care visits are typically less expensive than emergency room visits ($12 copay vs. $30 copay) but TRICARE covers both.
Military Moves With Tricare
For a good number of families, travel may be for a more permanent situation, such as orders to a new duty station. TRICARE should make the cut of your moving checklist because as Murphy’s Law goes, if something can happen it will happen and medical is no exception. As you are researching where you are relocating to, be proactive in understanding your options for care. Dwyer says common mistakes of military families are:
- Obtaining care without the required referral or prior authorization. Without these, beneficiaries may be charged for the care received, above the standard copayment.
- Beneficiaries should seek care from TRICARE network or participating non-network providers. Nonnetwork providers may not file claims on your behalf. By law, TRICARE cannot cost share on a claim if the provider is not TRICARE authorized.
TRICARE beneficiaries should wait until after they complete their move
– even if it is within the same region
– to update their contact information in the Defense Enrollment Eligibility Reporting System.
To update an address, you can:
- Log into MilConnect at https://www.dmdc.osd.mil/milconnect/
- Call 1-800-538-9552
- Fax updates to 1-831-655-8317
- Mail updates to: Defense Manpower Data Center Support Office Attn: COA 400 Gigling Road Seaside, CA 93955-6771
Important Regional Numbers For Tricare North:
Health Net Federal Services
1-877-874-2273
South:
Humana Military
1-800-444-5445
West:
United Healthcare
1-877-988-9378
For more information on understanding your coverage, visit http://www.tricare.mil/
