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TRICARE
®
For Life Handbook
TR
ICA
RE F
or
Life
Wis
consi
n P
hys
icia
ns
Serv
ice
ww
w.T
RIC
AR
E4u.c
om
1-8
66-7
73-0
404
TR
ICA
RE N
ort
h R
egi
on
Heal
th N
et
Federa
l Se
rvic
es,
LLC
ww
w.h
nfs
.com
1-877-
TR
ICA
RE (
1-877-
874
-2273)
TR
ICA
RE S
outh
Regi
on
Hum
ana
Mili
tary
, a
div
isio
n o
f
Hum
ana
Gove
rnm
ent
Busi
ness
Hum
ana-
Mili
tary
.com
1-800-4
44-5
445
TR
ICA
RE W
est
Regi
on
Unit
edH
eal
thca
re M
ilita
ry &
Vete
rans
ww
w.u
hcm
ilita
ryw
est
.com
1-877-
988-W
EST
(1-
877-
988-9
378)
ww
w.t
rica
re.m
il
HA6551BET11123
TRICARE Expectations for Beneficiaries
Acc
ord
ing
to t
he D
epar
tment
of D
efe
nse
(D
oD
), a
s a
TR
ICA
RE b
enefici
ary,
you
should
expect
to h
ave
the
follo
win
g ab
ilities
and s
upport
:
You s
hould
expect
to r
ece
ive a
ccura
te, eas
y-to
-unders
tand info
rmat
ion fro
m w
ritt
en
mat
eri
als,
pre
senta
tions,
and T
RIC
AR
E
repre
senta
tive
s to
help
you m
ake
info
rmed d
eci
sions
about
TR
ICA
RE
pro
gram
s, m
edic
al p
rofe
ssio
nal
s,
and fac
ilities.
You
should
expect
a c
hoic
e o
f heal
th c
are
pro
viders
that
is
suffi
cient
to e
nsu
re
acce
ss t
o a
ppro
pri
ate h
igh-q
ual
ity
heal
th c
are.
You s
hould
expect
to
acc
ess
medic
ally
nece
ssar
y an
d
appro
pri
ate e
merg
ency
heal
th c
are
serv
ices
as is
reas
onab
ly a
vaila
ble
when
and w
here
the n
eed a
rise
s.
Y
ou s
hould
expect
to r
ece
ive a
nd r
evie
w in
form
atio
n
about
the d
iagn
osi
s, t
reat
ment,
and
pro
gress
of yo
ur
condit
ions,
and t
o fully
par
tici
pat
e in a
ll deci
sions
rela
ted t
o
your
heal
th c
are, or
to b
e r
epre
sente
d
by
fam
ily m
em
bers
or
oth
er
duly
ap
poin
ted r
epre
senta
tive
s.
You s
hould
expect
to r
ece
ive
consi
dera
te, re
spect
ful ca
re fro
m a
ll m
em
bers
of th
e h
eal
th c
are s
yste
m
wit
hout
dis
crim
inat
ion b
ased o
n r
ace,
colo
r, n
atio
nal
ori
gin, or
any
oth
er
bas
is r
eco
gniz
ed in a
pplic
able
law
or
regu
lations.
You s
hould
expect
to
com
munic
ate w
ith h
eal
th c
are
pro
viders
in c
onfidence
and t
o h
ave
the c
onfidenti
alit
y of yo
ur
heal
th c
are
info
rmat
ion p
rote
cted t
o t
he e
xte
nt
perm
itte
d b
y la
w. You a
lso s
hould
expect
to h
ave t
he a
bili
ty t
o r
evi
ew
, co
py,
and r
equest
am
endm
ents
to
your
medic
al r
eco
rds.
Y
ou s
hould
expect
a fai
r an
d e
ffici
ent
pro
cess
for
reso
lvin
g diffe
rence
s w
ith h
eal
th p
lans,
heal
th c
are p
rovi
ders
, an
d inst
itutions
that
serv
e y
ou.
Addit
ional
ly, D
oD
has
the follo
win
g expect
atio
ns
of
you a
s a
TR
ICA
RE
benefici
ary:
Y
ou s
hould
m
axim
ize h
eal
thy
hab
its
such
as
exerc
isin
g, n
ot
smokin
g, a
nd m
ainta
inin
g a
heal
thy
die
t.
You s
hould
be invo
lved in h
eal
th c
are
deci
sions,
whic
h m
ean
s w
ork
ing
wit
h
pro
vider
s to
pro
vide
rele
vant in
form
atio
n,
clear
ly c
om
munic
ate w
ants
and n
eeds,
an
d d
eve
lop a
nd c
arry
out
agre
ed-u
pon
treat
ment
pla
ns.
You s
hould
be k
now
ledge
able
about
TR
ICA
RE c
ove
rage
and p
rogr
am o
ptions.
S
how
resp
ect
for
oth
er
pat
ients
and
heal
th c
are w
ork
ers
.
Mak
e a
good-f
aith
effort
to m
eet
finan
cial
oblig
atio
ns.
Use
the d
ispute
d c
laim
s pro
cess
when
there
is
a dis
agre
em
ent.
“TRICARE” is a registered trademark of the TRICARE Management Activity. All rights reserved.
Nove
mber
201
2
Important Information
Medic
are:
1-800-M
ED
ICA
RE (
1-800-6
33-4
227)
Soci
al S
ecu
rity
Adm
inis
trat
ion:
1-800-7
72-1
213
TR
ICA
RE W
eb S
ite:
ww
w.tri
care
.mil
TRICARE For Life Contractor
Wis
consi
n P
hys
icia
ns
Serv
ice:
1-866-7
73-0
404
TR
ICA
RE F
or
Life
Web S
ite:
ww
w.T
RIC
AR
E4u.c
om
TRICARE North Region Contractor
Heal
th N
et
Federa
l Se
rvic
es,
LLC
: 1-
877-
TR
ICA
RE (
1-877-
874
-2273)
Heal
th N
et
Web S
ite:
ww
w.h
nfs
.com
TRICARE South Region Contractor
Hum
ana
Mili
tary
, a
div
isio
n o
f
Hum
ana
Gove
rnm
ent
Busi
ness
: 1-
800-4
44-5
445
Hum
ana
Mili
tary
Web S
ite:
Hum
ana-
Mili
tary
.com
TRICARE West Region Contractor
Unit
edH
eal
thca
re M
ilita
ry &
Vete
rans:
1-
877-
988-W
EST
(1-
877-
988-9
378)
Unit
edH
eal
thca
re W
eb S
ite:
ww
w.u
hcm
ilita
ryw
est
.com
An I
mp
ort
ant
No
te A
bo
ut
TR
ICA
RE
Pro
gra
m C
ha
nges
At
the t
ime o
f pri
nting,
this
info
rmat
ion is
curr
ent.
It
is im
port
ant
to r
em
em
ber
that
T
RIC
AR
E p
olic
ies
and b
enefits
are
gove
rned b
y public
law
and federa
l regu
lations.
Chan
ges
to T
RIC
AR
E p
rogr
ams
are c
ontinual
ly m
ade a
s public
law
and
/or
federa
l re
gula
tions
are
amended. For
the m
ost
rece
nt
info
rmat
ion, co
nta
ct y
our
regi
onal
contr
acto
r or
loca
l T
RIC
AR
E S
erv
ice C
ente
r. M
ore
info
rmat
ion r
ega
rdin
g T
RIC
AR
E, in
cludin
g th
e H
eal
th
Insu
rance
Port
abili
ty a
nd A
ccounta
bili
ty A
ct (
HIP
AA
) N
otice
of Pri
vacy
Pra
ctic
es,
can
be
found o
nlin
e a
t w
ww
.tri
care
.mil.
Imp
ort
an
t C
on
tact
In
form
ati
on
Use
th
is p
age
as
a g
uid
e fo
r th
e m
ost
im
port
an
t re
sourc
es a
vail
able
to y
ou
.
TR
ICA
RE’s
We
b S
ite: w
ww
.tri
care
.mil
TR
ICA
RE
’s o
ffici
al
Web
sit
e is
you
r fi
rst
stop f
or
the
most
up
to
dat
e in
form
atio
n a
bout
you
r
ben
efit. G
o to w
ww
.tri
care
.mil
for
info
rmat
ion a
bout el
igib
ilit
y a
nd T
RIC
AR
Ec
over
ed s
ervic
es;
answ
ers
to f
requen
tly a
sked
ques
tions;
in
form
atio
n o
n y
ou
r T
RIC
AR
E p
harm
acy b
enefi
t; t
o
dow
nlo
ad c
laim
s fo
rms
and i
nst
ruct
ions;
to l
oca
te a
TR
ICA
RE
Ser
vic
e C
ente
r or
mil
itary
trea
tmen
t fa
cili
ty; to
find a
TR
ICA
RE
Deb
t C
oll
ecti
on A
ssis
tance
Offi
cer;
and to a
nsw
er q
ues
tions
about su
rviv
or
cover
age,
loss
of
elig
ibil
ity,
and p
rog
ram
opti
on in
form
atio
n, am
ong o
ther
th
ings.
Subsc
rib
e to
TR
ICA
RE
For
Lif
e (T
FL
) pro
gra
m u
pd
ates
at
ww
w.t
ric
are
.mil
/su
bsc
rip
tion
s.
Ge
ne
ral
Co
nta
ct I
nfo
rmati
on
Gri
eva
nce
sC
laim
s
Phone:
18
66
773
04
04
Web
: w
ww
.TR
ICA
RE
4u
.com
Wri
tten
Corr
esp
onden
ce:
WP
S/T
RIC
AR
E F
or
Lif
e
P.O
. B
ox 7
889
Mad
ison, W
I 53
70
77
880
TR
ICA
RE
Over
seas
Pro
gra
m*
P.O
. B
ox 7
992
Mad
ison, W
I 53
70
77
992
Em
ail
: re
porti
t@w
psi
c.c
om
WP
S/T
FL
(st
ate
sid
e)
P.O
. B
ox 8
974
M
adis
on, W
I 5370
88
974
TR
ICA
RE
Over
seas
Gri
evance
s P.
O. B
ox 7
992
Mad
ison, W
I 5370
77
992
WP
S/T
RIC
AR
E F
or
Lif
e (U
.S.)
P.
O. B
ox 7
89
0
Mad
ison, W
I 5370
77
89
0
TR
ICA
RE
Over
seas
(E
ura
siaA
fric
a)
P.O
. B
ox 8
976
Mad
ison, W
I 537077
992 U
SA
TR
ICA
RE
Over
seas
(L
ati
n A
mer
ica a
nd C
anada
) P.
O. B
ox 7
985
Mad
ison, W
I 537077
985 U
SA
TR
ICA
RE
Over
seas
(P
aci
fic)
P.
O. B
ox 7
985
Mad
ison, W
I 537077
985 U
SA
* U
se t
his
ad
dre
ss f
or
ove
rsea
s a
ppea
ls a
nd g
rieva
nce
s a
s w
ell
as
gen
era
l in
qu
irie
s.
Defe
nse E
nro
llm
en
t Eli
gib
ilit
y R
ep
ort
ing
Syste
m (
DE
ER
S)
DE
ER
S i
s a
dat
abas
e of
un
iform
ed s
ervic
e m
emb
ers
(spo
nso
rs),
fam
ily m
emb
ers,
and o
ther
s
worl
dw
ide
who a
re e
nti
tled
under
law
to m
ilit
ary
ben
efits
, in
clud
ing T
RIC
AR
E. S
ponso
rs a
re
requ
ired
to k
eep D
EE
RS
updat
ed, in
clud
ing t
hei
r re
siden
tial
and m
ail
ing a
dd
ress
for
them
selv
es
and e
lig
ible
dep
enden
ts.
You
have
sev
era
l o
pti
on
s fo
r u
pd
ati
ng
an
d v
erif
yin
g D
EE
RS
in
form
ati
on
:
In P
ers
on
Ph
on
e o
r Fa
x
Vis
it a
lo
cal
iden
tifi
cati
on c
ard
iss
uin
g f
acil
ity.
Fin
d a
fa
cili
ty n
ear
you a
t w
ww
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dc.o
sd.m
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sl. C
all
to v
erif
y
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tion a
nd b
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nes
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rs.
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TD
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t: h
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ect.
dm
dc.
mil
Ben
efici
ary
Web
En
roll
men
t: w
ww
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dc.
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.mil
/ap
pj/
bw
e/
Def
ense
Manp
ow
er D
ata
Cen
ter
Supp
ort
Offi
ce
40
0 G
igli
ng R
oad
S
easi
de,
CA
93955
6771
34
TR
ICA
RE
Extr
a, 4
, 7
TR
ICA
RE
Manag
emen
t A
ctiv
ity,
9, 19
TR
ICA
RE
Over
seas
Pro
gra
m (
TO
P),
10,
13
–14
, 17
, 21
TR
ICA
RE
Pharm
acy H
om
e D
eliv
ery,
17–20
TR
ICA
RE
Plu
s, 1
1–12
TR
ICA
RE
Pri
me,
4, 7,
11–12
TR
ICA
RE
Reg
ional
Offi
ce, 23, 28
TR
ICA
RE
Ret
iree
Den
tal P
rogra
m (
TR
DP
),
13, 15
–16
TR
ICA
RE
Ser
vic
e C
ente
r (T
SC
), 2
2, 2
4
TR
ICA
RE
Sta
nd
ard
, 4, 7,
10
–11
TR
ICA
RE
supple
men
t, 9
TR
ICA
RE
You
ng A
du
lt, 26
TR
ICA
RE
all
ow
able
charg
e, 8
, 29
TR
ICA
RE
auth
ori
zed p
rovid
er, 12
, 30
U
Un
iform
ed s
ervic
es iden
tifi
cati
on (
ID)
card
,
7, 1
7–18
, 2
4–25
Un
ited
Hea
lthca
re M
ilit
ary
& V
eter
ans
(Un
ited
Hea
lthca
re),
14
U.S
. te
rrit
ori
es, 9
–10
, 16
, 18
, 20, 26
Urg
ent
care
, 13
–14
V
Vet
erans
Aff
air
s, 1
2, 2
4
W
Wis
consi
n P
hysi
cians
Ser
vic
e (W
PS
), 7
–9,
11, 14
–15, 22
, 28, 30
33
Hosp
ice
care
, 4, 14
Hosp
ital,
4, 12
, 16
Hu
mana
Mil
itary
, 14
I Iden
tifi
cati
on (
ID)
card
, 7,
17–18
, 2
4–25
Ind
ian H
ealt
h S
ervic
e, 9
L
Lim
itat
ions,
15, 19
Longt
erm
care
, 16
M
Marr
iage,
25
Med
icaid
, 4, 9
Med
ical
equ
ipm
ent,
5
Med
icare
Part
A, 1,
4–7
, 11
, 27
Med
icare
Part
B, 1,
4–7
, 10
–11
, 27
Med
icare
Part
D, 17
Med
icare
cer
tifi
ed p
rovid
er, 11
, 26
Med
icare
part
icip
atin
g p
rovid
er, 1,
4–17
,
22
–23, 27–28, 30
Med
icat
ion, 17
–20
Mem
ber
Choic
e C
ente
r, 1
8
Met
Lif
e, 1
5
Mil
itary
tre
atm
ent fa
cili
ty (
MT
F),
1, 11
–13,
15, 17
–18
, 20, 22
–23, 28
Movin
g, 26
N
Nat
ional
Guard
and R
eser
ve,
4, 15
–16
Net
work
pharm
acy,
17–21
Net
work
pro
vid
er, 29
Nonf
orm
ula
ry d
rugs,
17,
19
Nonn
etw
ork
pharm
acy,
17–18
, 20
Nonn
etw
ork
pro
vid
er, 29
Nonpart
icip
atin
g p
rovid
er, 1,
12
O
Occ
upat
ional
ther
apy,
16
Oth
er h
ealt
h i
nsu
rance
(O
HI)
, 1,
8–11
, 16
,
18, 22
Out
of
po
cket
cost
s, 7
–9,
11–12
, 15, 18
Outp
atie
nt
care
, 5
P
Part
icip
atin
g p
rovid
er, 29
Pay
men
t, 5
–8, 11
–12
, 14
, 21
–22
, 27–28
Pharm
acy,
1, 17
–21
Physi
cal
ther
apy,
16
Pre
miu
m, 4
–7,
10
–11
, 27
Pre
scri
pti
on, 17
–21
Pre
ven
tive
care
, 5
Pri
me
Ser
vic
e A
rea
(PS
A),
4, 7
Pri
or
auth
ori
zati
on, 11
, 14
, 16
, 19
, 28
Pro
gra
m o
pti
ons,
7, 26
Q
Quanti
ty l
imit
s, 1
9
R
Ref
erra
l, 1
1
Rei
mbu
rsem
ent,
17–18
, 21
, 23
Ren
al
dis
ease
, 4
Ret
ail
net
work
pharm
acy,
18
–21
Ret
ired
, 4
–6, 11
–13, 15
–16
, 2
4–25
S
Sh
ips,
9–10
Sk
ille
d n
urs
ing c
are
, 16
Sk
ille
d n
urs
ing f
acil
ity (
SN
F),
4, 16
So
cial
Sec
uri
ty A
dm
inis
trat
ion (
SS
A),
4–7
So
cial
Sec
uri
ty n
um
ber
(S
SN
), 5
, 7,
22
,
25, 27,
29
–30
Spac
eav
ail
able
care
, 11
–12
Spec
ialt
y M
edic
atio
n C
are
Man
agem
ent,
20
Spec
ialt
y m
edic
atio
n, 20
Sp
eech
ther
apy,
16
Spouse
, 4
–7,
11,
22
, 25
–27
Su
rviv
or,
4, 16
, 26
T
Th
irdp
art
y l
iabil
ity,
23
Tra
nsp
lants
, 14
Tra
vel
, 10
, 13, 17
SECTION 9
INDEX
TR
ICA
RE R
eg
ion
al
Co
ntr
acto
rs
Reg
ional co
ntr
acto
rs p
rovid
e hea
lth c
are
ser
vic
es a
nd s
upport
in the
TR
ICA
RE
reg
ions
and c
an
hel
p T
FL
ben
efici
arie
s w
ith p
rior
auth
ori
zati
ons,
but do n
ot pro
vid
e re
ferr
als
for
TF
L b
enefi
ciar
ies.
Wis
consi
n P
hysi
cians
Ser
vic
e ad
min
iste
rs t
he
TF
L p
rog
ram
and s
hou
ld b
e you
r pri
mary
conta
ct f
or
TR
ICA
RE
rel
ated
cust
om
er s
ervic
e nee
ds
in t
he
Un
ited
Sta
tes
or
U.S
. te
rrit
ori
es
(Am
eric
an S
am
oa
, G
ua
m, th
e N
ort
her
n M
ari
an
a I
sla
nd
s, P
uer
to R
ico, a
nd t
he
U.S
. Vir
gin
Isla
nd
s). G
o t
o w
ww
.med
ica
re.g
ov
and c
lick
on “
Fac
ilit
ies
& D
oct
ors
” fo
r hel
p fi
nd
ing
pro
vid
ers.
Over
seas
, co
nta
ct y
ou
r T
RIC
AR
E O
ver
seas
Pro
gra
m (
TO
P)
Reg
ional
Call
Cen
ter.
Reg
ion
al
Con
tra
cto
rs (
Sta
tesi
de)
TR
ICA
RE
No
rth
Re
gio
nT
RIC
AR
E S
ou
th R
eg
ion
TR
ICA
RE
We
st R
eg
ion
Hea
lth
Net
Fed
era
l S
erv
ices
, L
LC
1
877
TR
ICA
RE
(1
877
874
2273)
w
ww
.hn
fs.c
om
Hu
ma
na M
ilit
ary
, a d
ivis
ion
of
Hu
ma
na G
over
nm
ent
Bu
sin
ess
180
04
44
54
45
H
um
ana
Mil
itary
.com
Un
ited
Hea
lth
care
M
ilit
ary
& V
eter
an
s 1
877
988
WE
ST
(1
877
988
9378)
w
ww
.uhcm
ilit
ary
wes
t.co
m
Reg
ion
al
Con
tra
cto
r (O
ver
sea
s)
TR
ICA
RE
Eu
rasi
a-A
fric
aT
RIC
AR
E L
ati
n A
me
rica
a
nd
Ca
na
da
TR
ICA
RE
Pa
cifi
c
TR
ICA
RE
Over
sea
s P
rog
ram
(T
OP
) R
egio
na
l C
all
Cen
ter
+
44
20
8762
838
4 (
ove
rsea
s)
18776
78
12
07 (
sta
tesi
de)
tr
icare
lon@
inte
rnat
ionals
os.
com
TO
P R
egio
na
l C
all
Cen
ter
+1
215
942
8393 (
ove
rsea
s)
18774
518
659 (
sta
tesi
de)
tr
icare
ph
l@in
tern
atio
nals
os.
com
TO
P R
egio
na
l C
all
Cen
ters
Sin
gapore
: +
656
3392
676
(ove
rsea
s)
18776
78
12
08 (
sta
tesi
de)
si
n.t
rica
re@
inte
rnat
ionals
os.
com
Syd
ney:
+61
29
273
271
0 (
ove
rsea
s)
18776
78
12
09 (
sta
tesi
de)
sy
dtr
icare
@in
tern
atio
nals
os.
com
Oth
er C
on
tact
In
form
ati
on
Fo
r M
ore
In
form
ati
on
Re
sou
rce
Nu
mb
ers
We
b S
ite
s
Med
icare
18
00
633
4227
ww
w.m
edic
are
.gov
So
cial
Sec
uri
ty A
dm
inis
trat
ion
18
00
772
1213
ww
w.s
sa.g
ov
TR
ICA
RE
Pharm
acy P
rog
ram
18
773
63
13
03
ww
w.t
ric
are
.mil
/ph
arm
acy
w
ww
.ex
pre
sss
crip
ts.c
om
/TR
ICA
RE
Pre
scri
pti
on D
rug F
orm
ula
ry S
earc
h18
773
63
13
03
ww
w.p
ec.h
a.o
sd.m
il/
form
ula
ry_
sea
rch
.ph
p
TR
ICA
RE
Den
tal
Pro
gra
m18
55
63
88
371
(st
ate
sid
e)
18
55
63
88
372
(ove
rsea
s)
18
55
63
88
373
(T
DD
/TT
Y)
htt
ps:
//m
yb
enefi
ts.m
etli
fe.c
om
/tric
are
TR
ICA
RE
Ret
iree
Den
tal P
rogra
m18
88
83
88
737
ww
w.t
rdp
.org
Offi
ce o
f P
erso
nnel
Manag
emen
t18
88
7676
73
8
18
00
582
3337
ww
w.o
pm
.gov/f
orm
s w
ww
.op
m.g
ov/i
nsu
re/l
tc
Fin
d a
Deb
t C
oll
ecti
on A
ssis
tance
O
ffice
r or
a B
enefi
ciary
Counse
ling
and A
ssis
tance
Co
ord
inat
or
See
Web
sit
ew
ww
.tric
are
.mil
/bcacd
cao
Fin
d a
mil
itary
tre
atm
ent
faci
lity
See
Web
sit
ew
ww
.tric
are
.mil
/mtf
Toll
fre
e over
seas
conta
ct
info
rmat
ion
See
ch
art
ab
ove
ww
w.t
ric
are
over
sea
s.co
m
1
Wel
com
e to
TR
ICA
RE
Fo
r L
ife
TR
ICA
RE
For
Lif
e (T
FL
) is
the
Med
icare
wra
paro
und c
over
age
for
TR
ICA
RE
ben
efici
ari
es w
ho h
ave
Med
icare
Part
A a
nd M
edic
are
Part
B,
regard
less
of
age
or
pla
ce o
f re
siden
ce.
TF
L p
rovid
es c
om
pre
hen
sive
hea
lth c
are
cover
age.
You h
ave
the
free
dom
to s
eek
care
fro
m a
ny M
edic
are
part
icip
atin
g o
r
nonpart
icip
atin
g p
rov
ider
, or
mil
itary
trea
tmen
t fa
cili
ty o
n a
spac
eav
ail
able
bas
is. M
edic
are
part
icip
atin
g p
rovid
ers
file
you
r cl
aim
s w
ith M
edic
are
. A
fter
pay
ing i
ts p
ort
ion, M
edic
are
auto
mat
icall
y
forw
ard
s th
e cl
aim
to T
RIC
AR
E f
or
pro
cess
ing (
unle
ss y
ou h
ave
oth
er h
ealt
h
insu
ran
ce [
OH
I]).
TR
ICA
RE
pay
s aft
er
Med
icare
and O
HI
for
cover
ed h
ealt
h
care
ser
vic
es.
Th
is h
andb
ook
wil
l hel
p y
ou
make
the
most
of
you
r T
FL
cover
age.
You w
ill
find
info
rmat
ion a
bout
elig
ibil
ity r
equ
irem
ents
,
get
ting
care
, and
cla
ims.
Th
is h
andb
ook
als
o p
rovid
es d
etail
s ab
out
you
r pharm
acy
and d
enta
l co
ver
age
opti
ons.
32
Ind
ex
A
Acc
iden
t, 2
3
Act
ive
duty
fam
ily m
emb
er (
AD
FM
),
4–5, 12
Act
ive
duty
ser
vic
e m
emb
er (
AD
SM
),
4–5, 12
, 15, 17
, 2
4
Act
ive
duty
sponso
r, 1
1, 1
6
Acu
pu
nct
ure
, 15
Age
lim
itat
ions,
19,
26
All
ow
able
charg
e, 8
, 12
, 29
App
eal,
8, 21
–23, 28
–29
Appoin
tmen
t, 1
1–12
, 14
, 29
Auth
ori
zati
on, 11
, 14
, 16
, 19
, 22
, 28
–29
B
Beh
avio
ral
hea
lth c
are
, 14
Ben
efici
ary
Cou
nse
ling a
nd A
ssis
tance
Coord
inat
or
(BC
AC
), 2
3, 28
Bil
l, 5
–6, 8, 12
, 22
–23, 27
Bra
ndn
am
e d
rug, 19
C
Cen
ters
for
Med
icare
& M
edic
aid
Ser
vic
es, 4
Cer
tifi
cate
of
cred
itab
le c
over
age,
26
–27
Charg
e, 8
–9,
12
, 22
, 29
Ch
ild
ren, 26
–27,
30
Cla
im, 1,
7–10
, 12
–14
, 17
–18
, 20
–23, 28
Com
mon A
cces
s C
ard
(C
AC
), 1
7, 2
4–25
Conti
nued
Hea
lth C
are
Ben
efit
Pro
gra
m
(CH
CB
P),
26
Copay
men
t, 8
, 17
–19
Cost
share
, 8
–10
, 12
, 18
Cust
od
ial
care
, 16
D
Deb
t C
oll
ecti
on A
ssis
tance
Offi
cer
(DC
AO
), 2
3
Ded
uct
ible
, 8
–10
, 12
, 18
Def
ense
En
roll
men
t E
lig
ibil
ity R
eport
ing
Syst
em (
DE
ER
S),
7, 2
4–27
Def
ense
Manpow
er D
ata
Cen
ter
Support
Offi
ce, 27
Del
ta D
enta
l® o
f C
ali
forn
ia
(Del
ta D
enta
l), 16
Den
tal
care
, 13
–14
Dep
enden
t ch
ild
, 27,
30
Dis
abil
ity,
4–5, 14
, 26
–27
Div
orc
e, 5
, 7,
25
–27
Du
rable
med
ical
equ
ipm
ent,
5
E
Eli
gib
ilit
y, 1
, 4
–7, 11
, 13, 15
–16
, 22
,
24
–27,
29
–30
Em
ergen
cy, 13
–14
Ends
tage
renal
dis
ease
(E
SR
D),
4–5
En
roll
men
t, 4
–7, 11
–13, 17
, 2
4, 26
–27
Expla
nat
ion o
f b
enefi
ts (
EO
B),
22
–23,
28
–29
Expre
ss S
crip
ts, In
c. (
Expre
ss S
crip
ts),
17–21
Eye
exam
inat
ions,
15
F
Fed
eral
Em
plo
yee
s H
ealt
h B
enefi
ts
(FE
HB
), 1
1
Form
er s
pouse
, 4, 11
, 22
, 25, 27
G
Gen
eric
dru
g, 17
, 19
Gen
eric
equ
ivale
nt,
19
Gri
evance
, 30
Guard
ian, 30
H
Hea
lth N
et F
eder
al
Ser
vic
es, L
LC
(Hea
lth N
et),
14
Hea
ring a
ids,
15
Hom
e hea
lth c
are
, 4
–5
31
Lis
t o
f Fi
gu
res
Fig
ure
1.1
T
RIC
AR
E F
or
Lif
e O
ut
of
Po
cket
Cost
s ......................................................
9
Fig
ure
2.1
M
TF
Appoin
tmen
t P
riori
ties
.......................................................................1
2
Fig
ure
4.1
T
RIC
AR
E P
harm
acy H
om
e D
eliv
ery R
egis
trat
ion M
etho
ds
.....................1
8
Fig
ure
6.1
E
lig
ibil
ity R
equ
irem
ents
for
Form
er S
pouse
s .............................................2
5
Fig
ure
7.1
T
RIC
AR
E F
or
Lif
e A
pp
eals
Req
uir
emen
ts ..
..............................................
29
SECTION 7
FOR INFORMATION AND ASSISTANCE
SECTION 8
LIST OF FIGURES
2
Tab
le o
f C
on
ten
ts
1.
Ho
w T
RIC
AR
E F
or
Lif
e W
ork
s ...
....
....
....
....
....
......
....
....
....
....
....
....
....
...4
Eli
gib
ilit
y ..
....................................................................................................................
4
Under
stand
ing M
edic
are
..............................................................................................4
Fre
quen
tly A
sked
Ques
tions:
Med
icare
........................................................................6
How
TR
ICA
RE
For
Lif
e W
ork
s w
ith M
edic
are
...........................................................7
Fre
quen
tly A
sked
Ques
tions:
How
TR
ICA
RE
For
Lif
e W
ork
s ..................................
10
2.
Gett
ing
Care
....
....
....
....
....
....
....
....
....
....
....
....
....
....
....
....
....
....
....
....
....
.12
Fin
din
g a
Pro
vid
er ..
....................................................................................................
12
Em
ergen
cy C
are
.........................................................................................................1
3
Urg
ent
Care
................................................................................................................1
3
Beh
avio
ral
Hea
lth C
are
..............................................................................................1
4
Pri
or
Auth
ori
zati
on f
or
Care
.......................................................................................1
4
3.
TR
ICA
RE F
or
Lif
e C
overa
ge ..
....
....
....
....
....
....
....
....
....
....
....
....
....
....
....
15
TR
ICA
RE
Med
ical
Cover
age .....................................................................................1
5
Den
tal
Cover
age
.........................................................................................................1
5
Fre
quen
tly A
sked
Ques
tions:
TR
ICA
RE
For
Lif
e C
over
age
......................................
16
4.
Ph
arm
acy ..
....
....
....
....
....
....
....
....
....
....
....
....
....
....
....
....
....
....
....
....
....
....
17
Pre
scri
pti
on D
rug C
over
age
.......................................................................................1
7
Fil
ling P
resc
ripti
ons
...................................................................................................1
7
Pharm
acy P
oli
cy ..
.......................................................................................................1
9
Pharm
acy C
laim
s .......................................................................................................2
0
5.
Cla
ims ..
....
....
....
....
....
....
....
....
....
....
....
....
....
....
....
....
....
....
....
....
....
....
....
.22
Hea
lth C
are
Cla
ims
....................................................................................................
22
App
eali
ng a
Cla
im o
r A
uth
ori
zati
on D
enia
l ...............................................................
22
Th
irdP
art
y L
iabil
ity ..
................................................................................................
23
Expla
nat
ion o
f B
enefi
ts ..
.............................................................................................2
3
Deb
t C
oll
ecti
on A
ssis
tance
Offi
cers
...........................................................................2
3
3
6.
Lif
e C
han
ges: U
pd
ate
Yo
ur
DE
ER
S R
eco
rd ..
................................
...2
4
Usi
ng m
ilC
on
nec
t to
Up
dat
e In
form
atio
n i
n D
EE
RS
.................................................2
4
Get
ting M
arr
ied o
r D
ivorc
ed .
....................................................................................
25
Ch
ild
ren
......................................................................................................................
26
Movin
g .......................................................................................................................
26
Su
rviv
or
Cover
age
......................................................................................................
26
Loss
of
Eli
gib
ilit
y ..
.....................................................................................................2
6
Susp
ensi
on o
f S
oci
al
Sec
uri
ty D
isab
ilit
y I
nsu
rance
...................................................2
7
7.
Fo
r In
form
ati
on
an
d A
ssi
sta
nce .................
..................................
..28
Ben
efici
ary
Cou
nse
ling a
nd A
ssis
tance
Coord
inat
ors
................................................
28
You
r R
ight
to A
pp
eal
a D
ecis
ion
................................................................................
28
Fil
ing a
Gri
evance
......................................................................................................
30
8.
Lis
t o
f Fig
ure
s .............
..................................
................................
...31
9.
Ind
ex ..
....
....
..................
..................................
................................
...32
See
the
insi
de
bac
k c
over
of
this
handbook f
or
“T
RIC
AR
E E
xp
ecta
tions
for
Ben
efici
ari
es.”
30
Filin
g a
Grie
vance
A g
riev
ance
is
a w
ritt
en c
om
pla
int
or
conce
rn a
bout
a nona
pp
eala
ble
iss
ue
regard
ing a
per
ceiv
ed f
ail
ure
by a
ny
mem
ber
of
the
TF
L h
ealt
h c
are
del
iver
y
team
, in
clud
ing T
RIC
AR
Ea
uth
ori
zed
pro
vid
ers
or
mil
itary
pro
vid
ers,
to p
rovid
e
appro
pri
ate
and t
imel
y h
ealt
h c
are
ser
vic
es,
acce
ss, or
quali
ty, or
to d
eliv
er t
he
pro
per
level
of
care
or
serv
ice.
The
TF
L g
riev
ance
pro
cess
pro
vid
es t
he
opport
un
ity t
o r
eport
, in
wri
ting, any
conce
rn o
r co
mpla
int
regard
ing h
ealt
h
care
quali
ty o
r se
rvic
e. A
ny T
FL
civ
ilia
n
or
mil
itary
pro
vid
er;
TF
L b
enefi
ciary
;
sponso
r; o
r pare
nt,
guard
ian, or
oth
er
repre
senta
tive
of
an e
lig
ible
dep
enden
t
chil
d m
ay fi
le a
gri
evance
. W
PS
is
resp
onsi
ble
for
the
inves
tigat
ion a
nd
reso
luti
on o
f all
gri
evance
s.
Gri
evance
s are
gen
erall
y r
esolv
ed w
ith
in
60 d
ays
of
rece
ipt.
Foll
ow
ing r
esolu
tion,
the
part
y t
hat
subm
itte
d t
he
gri
evance
is
noti
fied
of
the
revie
w c
om
ple
tion.
Gri
evance
s m
ay i
ncl
ude
such
iss
ues
as:
• T
he
quali
ty o
f hea
lth c
are
or
serv
ices
(e.g
., a
cces
sibil
ity,
appro
pri
ate
nes
s,
leve
l, c
on
tin
uit
y, t
imel
ines
s of
care
)
• T
he
dem
eanor
or
beh
avio
r of
pro
vid
ers
and t
hei
r st
aff
mem
ber
s
• T
he
per
form
ance
of
any p
art
of
the
hea
lth
care
del
iver
y s
yst
em
• P
ract
ices
rel
ated
to p
atie
nt
safe
ty
When
fili
ng a
gri
evance
, in
clude
the
foll
ow
ing i
nfo
rmat
ion:
• B
enefi
ciary
’s n
am
e, a
dd
ress
, and
tele
phone
nu
mb
er
• S
ponso
r’s
SS
N o
r D
BN
• B
enefi
ciary
’s d
ate
of
bir
th
• B
enefi
ciary
’s s
ignat
ure
A d
escr
ipti
on o
f th
e is
sue
or
conce
rn m
ust
incl
ude
the
foll
ow
ing:
• D
ate
and t
ime
of
the
even
t
• N
am
e(s)
of
the
pro
vid
er(s
) and
/or
per
son(s
) in
volv
ed
• A
dd
ress
of
the
even
t
• N
atu
re o
f th
e co
nce
rn o
r co
mpla
int
• D
etail
s des
crib
ing t
he
even
t or
issu
e
• A
ny a
ppro
pri
ate
support
ing d
ocu
men
ts
Conta
ct M
edic
are
to fi
le M
edic
are
rel
ated
gri
evance
s.
29
App
eals
shou
ld c
onta
in t
he
foll
ow
ing:
• B
enefi
ciary
’s n
am
e, a
dd
ress
, and
tele
phone
nu
mb
er
• S
ponso
r’s
So
cial
Sec
uri
ty n
um
ber
(S
SN
)
or
Dep
art
men
t of
Def
ense
Ben
efits
Nu
mb
er (
DB
N)
• B
enefi
ciary
’s d
ate
of
bir
th
• B
enefi
ciar
y’s
or
appea
ling p
arty
’s s
ignat
ure
A d
escr
ipti
on o
f th
e is
sue
or
conce
rn
must
incl
ude:
• T
he
spec
ific
issu
e in
dis
pute
• A
copy o
f th
e pre
vio
us
den
ial
det
erm
inat
ion n
oti
ce
• A
ny a
ppro
pri
ate
support
ing
do
cum
ents
TR
ICA
RE
Fo
r L
ife
Ap
pea
ls R
equ
irem
ents
Fig
ure
7.1
1A
n a
ppro
pri
ate
app
eali
ng
part
y m
ust
subm
it t
he
app
eal.
Pro
per
app
eali
ng
part
ies
incl
ude:
• Y
ou,
the
ben
efici
ary
• N
onn
etw
ork
part
icip
atin
g p
rov
ider
s
If a
part
y o
ther
than
those
lis
ted
above
subm
its
the
app
eal,
you
wil
l gen
erall
y b
e re
qu
ired
to c
om
ple
te a
nd
sig
n a
n A
pp
oin
tmen
t o
f R
epre
sen
tati
ve f
orm
, w
hic
h i
s av
ail
able
on
you
r
reg
ional
contr
acto
r’s
Web
sit
e. A
pp
eals
subm
itte
d w
ithout
this
form
wil
l not
be
pro
cess
ed,
exce
pt
in t
he
foll
ow
ing
cas
es:
• A
cust
od
ial
pare
nt
subm
its
an
app
eal
on
beh
alf
of
a m
inor
ben
efici
ary
• A
n a
ttorn
ey fi
les
an
app
eal
wit
hout
spec
ific
app
oin
tmen
t by
the
pro
per
app
eali
ng
part
y
Note
: N
etw
ork
pro
vid
ers
are
not
appro
pri
ate
app
eali
ng
part
ies,
but
may
be
app
oin
ted
as
repre
senta
tives
, in
wri
ting,
by
you.
2T
he
app
eal
must
be
subm
itte
d i
n w
riti
ng.
3T
he
issu
e in
dis
pute
must
be
an
app
eala
ble
iss
ue.
The
foll
ow
ing
are
not
app
eala
ble
iss
ues
:
• A
llow
able
charg
es
• E
lig
ibil
ity
• D
enia
l of
serv
ices
fro
m a
n u
nau
thori
zed
pro
vid
er
• D
enia
l of
trea
tmen
t pla
n w
hen
an
alt
ernat
ive
trea
tmen
t pla
n i
s se
lect
ed
4A
n a
pp
eal
must
be
file
d w
ith
in 9
0 d
ays
of
the
dat
e on
the
expla
nat
ion
of
ben
efits
or
den
ial
noti
fica
tion
let
ter.
5T
her
e m
ust
be
an a
mount
in d
ispute
to fi
le a
n a
ppea
l. I
n c
ases
invo
lvin
g a
n a
ppea
l of
a
den
ial
of
an
auth
ori
zati
on
in
advance
of
rece
ivin
g t
he
actu
al
serv
ices
, th
e am
ou
nt
in
dis
pute
is
dee
med
to
be
the
esti
mat
ed T
RIC
AR
Ea
llow
able
charg
e fo
r th
e se
rvic
es
reques
ted.
Ther
e is
no
min
imu
m a
mou
nt
to r
eques
t a
reco
nsi
der
atio
n.
SECTION 7
FOR INFORMATION AND ASSISTANCE
4
Ho
w T
RIC
AR
E F
or
Lif
e W
ork
s
Eligib
ilit
y
TR
ICA
RE
For
Lif
e (T
FL
) is
avail
able
to
TR
ICA
RE
ben
efici
ari
es, re
gard
less
of
age
and p
lace
of
resi
den
ce, i
f yo
u h
ave
Med
icare
Par
t A
and M
edic
are
Par
t B
. You a
re e
ligib
le
for
TF
L o
n t
he
firs
t d
ate
that
you h
ave
both
Med
icare
Part
A a
nd M
edic
are
Part
B.
TR
ICA
RE E
lig
ibil
ity R
eq
uir
em
en
ts
When
you a
re e
nti
tled
to p
rem
ium
fre
e
Med
icare
Part
A:
• M
edic
are
Part
B c
over
age
is r
equ
ired
to
rem
ain
TR
ICA
RE
eli
gib
le i
f you a
re a
:
• R
etir
ed s
ervic
e m
emb
er (
incl
udin
g
reti
red N
ati
on
al
Gu
ard
an
d R
eser
ve
mem
ber
s dra
win
g r
etir
emen
t p
ay)
• F
am
ily m
emb
er o
f a
reti
red
serv
ice
mem
ber
• M
edal
of
Honor
reci
pie
nt
or
elig
ible
fam
ily m
emb
er
• S
urv
ivor
of
a dec
ease
d s
ponso
r
• Q
uali
fyin
g f
orm
er s
pouse
• M
edic
are
Part
B c
over
age
is n
ot
requ
ired
to r
emain
TR
ICA
RE
eli
gib
le i
f:
• Y
ou a
re a
n a
ctiv
e duty
ser
vic
e m
emb
er
(AD
SM
) or
acti
ve
duty
fam
ily m
emb
er
(AD
FM
) (A
DS
Ms
an
d A
DF
Ms
rem
ain
elig
ible
for
TR
ICA
RE
Pri
me a
nd
TR
ICA
RE
Sta
nd
ard
an
d T
RIC
AR
E
Extr
a o
pti
on
s w
hil
e th
e sp
on
sor
is o
n
act
ive
duty
. H
ow
ever
, w
hen
the
sponso
r
reti
res,
you m
ust
have
Med
icare
Part
B
to r
ema
in T
RIC
AR
Ee
ligib
le. See
“M
edic
are
Part
B [
Med
ical
Insu
rance
]”
on t
he
foll
ow
ing p
age
for
info
rma
tio
n
abou
t th
e M
edic
are
Part
B s
pec
ial
enro
llm
ent
per
iod f
or
AD
SM
s a
nd
AD
FM
s.)
Note
: R
egard
less
of
age,
AD
FM
s w
ho h
ave
Med
icare
Part
A m
ay e
nro
ll i
n T
RIC
AR
E
Pri
me
if t
hey
liv
e in
a T
RIC
AR
E P
rim
e
Ser
vic
e A
rea
(PS
A).
The
TR
ICA
RE
Pri
me
enro
llm
ent
fee
is w
aiv
ed f
or
reti
ree
fam
ily
mem
ber
s w
ith M
edic
are
Part
B c
over
age.
Understa
ndin
g M
edic
are
TF
L i
s m
anag
ed
by
the
Dep
art
men
t
of
Def
ense
. M
ed
icare
is
manag
ed
by
the
Cen
ters
for
Med
icare
& M
edic
aid
Ser
vic
es (
CM
S).
The
two a
gen
cies
work
toget
her
to c
oord
inat
e b
enefi
ts.
Med
icare
is
a fe
der
al
enti
tlem
ent
hea
lth
insu
rance
pro
gra
m f
or
peo
ple
:
• A
ge
65 o
r old
er
• U
nder
age
65 w
ith c
erta
in d
isab
ilit
ies
• A
ny a
ge
wit
h e
nds
tage
renal
dis
ease
(E
SR
D)
Med
icare
Part
A (
Ho
sp
ital In
su
ran
ce)
Med
icare
Part
A c
over
s in
pat
ient
hosp
ital
care
, hosp
ice
care
, in
pat
ient sk
ille
d n
urs
ing
faci
lity
care
, and s
om
e hom
e hea
lth c
are
.
The
So
cial
Sec
uri
ty A
dm
inis
trat
ion (
SS
A)
det
erm
ines
you
r en
titl
emen
t to
Med
icare
Part
A b
ased
on y
ou
r w
ork
his
tory
or
you
r
spouse
’s w
ork
his
tory
. Y
ou a
re e
lig
ible
for
pre
miu
mf
ree
Med
icare
Part
A a
t ag
e 65
if y
ou o
r you
r sp
ouse
has
40 q
uart
ers
or
10 y
ears
of
So
cial
Sec
uri
tyc
over
ed
emplo
ym
ent.
5
If, w
hen
you t
urn
65, yo
u a
re n
ot el
igib
le f
or
pre
miu
mf
ree
Med
icare
Part
A u
nder
you
r
ow
n S
oci
al
Sec
uri
ty n
um
ber
(S
SN
), y
ou
must
file
for
ben
efits
under
you
r sp
ouse
’s
(this
incl
udes
div
orc
ed o
r dec
ease
d s
pouse
s)
SS
N, i
f he
or
she
is 6
2 o
r old
er. I
f yo
ur
spouse
is n
ot yet
62
, you s
hou
ld e
nro
ll in M
edic
are
Part
B a
t ag
e 65 to a
void
pay
ing a
su
rcharg
e
for
late
en
roll
men
t, a
nd y
ou s
hou
ld fi
le f
or
Part
A b
enefi
ts u
nder
you
r sp
ouse
’s r
ecord
when
he
or
she
turn
s 62.
Med
icare
Part
B (
Med
ical
Insu
ran
ce)
Med
icare
Part
B c
over
s pro
vid
er s
ervic
es,
outp
atie
nt
care
, pre
ven
tive
care
, hom
e
hea
lth c
are
, and d
ura
ble
med
ical
equip
men
t.
Med
icare
Part
B h
as a
month
ly p
rem
ium
,
wh
ich m
ay c
hange
an
nuall
y a
nd v
ari
es
bas
ed o
n i
nco
me.
If
you s
ign u
p a
fter
you
r
init
ial
enro
llm
ent
per
iod f
or
Med
icare
Part
B, you m
ay h
ave
to p
ay a
month
ly
pre
miu
m s
urc
harg
e fo
r as
long a
s you
hav
e M
edic
are
Part
B. T
he
surc
harg
e is
10 p
erce
nt
for
each
12m
onth
per
iod t
hat
you w
ere
elig
ible
for
Med
icare
Part
B b
ut
did
not
enro
ll.
Med
icare
all
ows
AD
SM
s an
d A
DF
Ms
who
are
enti
tled
to M
edic
are
bas
ed o
n a
ge
or
dis
abil
ity (d
oes
not a
pply
to th
ose
with E
SR
D)
to d
elay
Part
B e
nro
llm
ent
and s
ign u
p
du
ring a
sp
ecia
l en
roll
men
t p
erio
d, w
hic
h
waiv
es t
he
late
en
roll
men
t su
rcharg
e. T
he
spec
ial
enro
llm
ent
per
iod f
or
AD
SM
s and
AD
FM
s is
avail
able
any t
ime
the
sponso
r
is o
n a
ctiv
e duty
or
wit
hin
eig
ht
month
s
foll
ow
ing e
ither
(1)
the
sponso
r’s
reti
rem
ent
or
(2)
the
end o
f T
RIC
AR
E c
over
age,
wh
ichev
er c
om
es fi
rst.
To a
void
a b
reak i
n
cove
rage,
AD
SM
s an
d A
DF
Ms
must
sig
n u
p
for
Med
icare
Part
B b
efore
sponso
rs r
etir
e.
Note
: If
you h
ave
ES
RD
, si
gn u
p f
or
Med
icare
Part
A a
nd P
art
B a
s so
on
as y
ou a
re e
lig
ible
to a
void
a b
reak i
n
TR
ICA
RE
cover
age
and t
he
Med
icare
Part
B lat
een
roll
men
t pre
miu
m s
urc
harg
e.
Med
icare
En
titl
em
en
t B
ased
on
a D
isa
bil
ity
If y
ou r
ecei
ve
dis
abil
ity b
enefi
ts f
rom
the
SS
A, you a
re e
nti
tled
to M
edic
are
in t
he
25th
month
of
rece
ivin
g d
isab
ilit
y p
aym
ents
.
The
CM
S w
ill noti
fy y
ou o
f you
r M
edic
are
enti
tlem
ent
dat
e.
If y
ou r
etu
rn t
o w
ork
and y
ou
r S
oci
al
Sec
uri
ty d
isab
ilit
y p
aym
ents
are
susp
ended
,
you
r M
edic
are
enti
tlem
ent
conti
nues
for
up t
o e
ight
yea
rs a
nd s
ix m
onth
s. W
hen
you
r d
isab
ilit
y p
aym
ents
are
susp
ended
,
you w
ill
rece
ive
a bil
l ev
ery t
hre
e m
onth
s
for
you
r M
ed
icare
Part
B p
rem
ium
s.
You m
ust
conti
nue
to p
ay y
ou
r M
edic
are
Part
B p
rem
ium
s to
rem
ain
eli
gib
le f
or
TR
ICA
RE
cover
age.
SECTION 1
HOW TRICARE FOR LIFE WORKS
28
Fo
r In
form
ati
on
an
d A
ssis
tan
ce
Benefi
cia
ry C
ounseling a
nd
Assis
tance C
oordin
ato
rs
TR
ICA
RE
Ben
efici
ary
Cou
nse
ling a
nd
Ass
ista
nce
Coord
inat
ors
(B
CA
Cs)
can
hel
p y
ou w
ith T
RIC
AR
E F
or
Lif
e (T
FL
)
ques
tions
and c
once
rns,
and they
can
advis
e
you a
bout
obta
inin
g h
ealt
h c
are
. B
CA
Cs
are
lo
cate
d a
t m
ilit
ary
tre
atm
ent
faci
liti
es
and T
RIC
AR
E R
egio
nal
Offi
ces.
To lo
cate
a B
CA
C, vis
it t
he
on
line
dir
ecto
ry a
t
ww
w.t
ric
are
.mil
/bca
cdca
o.
Your
Rig
ht
to A
ppeal a D
ecis
ion
If y
ou b
elie
ve
a se
rvic
e or
claim
was
den
ied i
mpro
per
ly, in
whole
or
in p
art
,
you (
or
an
oth
er a
ppro
pri
ate
part
y) m
ay
file
an a
pp
eal.
An a
pp
eal
must
involv
e
an a
pp
eala
ble
iss
ue.
For
exam
ple
, you
hav
e th
e ri
ght
to a
ppea
l M
edic
are
or
TF
L
dec
isio
ns
regard
ing c
laim
s pay
men
ts.
Med
icare
and T
FL
hav
e se
para
te c
laim
s
pro
cess
es. F
or
most
ser
vic
es, M
edic
are
is
you
r pri
mary
pay
er. If
you w
ant
to a
pp
eal
a M
edic
are
dec
isio
n, you m
ust
conta
ct
Med
icare
. C
onta
ct W
isco
nsi
n P
hysi
cians
Ser
vic
e (W
PS
) to
app
eal
TF
L d
ecis
ions.
Med
icare
Den
ials
Any s
ervic
es o
r su
ppli
es d
enie
d p
aym
ent by
Med
icare
and a
pp
eala
ble
under
Med
icare
are
not
consi
der
ed f
or
cover
age
by T
FL
.
How
ever
, if
a M
edic
are
app
eal
resu
lts
in
som
e pay
men
t by M
edic
are
, T
RIC
AR
E
consi
der
s co
ver
age
as t
he
seco
nd p
ayer
.
For
more
in
form
atio
n o
n M
edic
are
appea
ls,
read
the
bac
k o
f you
r M
edic
are
Su
mm
ary
noti
ce o
r co
nta
ct M
edic
are
.
TR
ICA
RE F
or
Lif
e A
pp
eals
R
eq
uir
em
en
ts
You m
ay a
ppea
l a
TF
L d
enia
l of
a re
ques
ted
auth
ori
zati
on o
f se
rvic
es e
ven
if
no c
are
was
pro
vid
ed a
nd n
o c
laim
was
subm
itte
d. T
her
e
are
som
e th
ings
you m
ay n
ot
app
eal.
For
exam
ple
, w
hen
TF
L i
s th
e pri
mary
pay
er,
you m
ay n
ot
app
eal
the
den
ial
of
care
fro
m
a pro
vid
er w
ho is
not T
RIC
AR
Ea
uth
ori
zed.
When
ser
vic
es a
re d
enie
d b
ased
on m
edic
al
nec
essi
ty o
r a
ben
efit
dec
isio
n, you a
re
auto
mat
icall
y n
oti
fied
in w
riti
ng. T
he
noti
fica
tion i
ncl
udes
an e
xpla
nat
ion o
f w
hat
was
den
ied o
r w
hy a
pay
men
t w
as r
educe
d
and t
he
reas
on
ing b
ehin
d t
he
dec
isio
n.
Fil
ing
TR
ICA
RE F
or
Lif
e A
pp
eals
TF
L a
pp
eals
must
be
file
d w
ith W
PS
wit
hin
90 d
ays
from
the
dat
e th
at a
pp
ears
on t
he
expla
nat
ion o
f b
enefi
ts o
r den
ial
noti
fica
tion l
ette
r. I
f you a
re n
ot
sati
sfied
wit
h a
dec
isio
n r
ender
ed o
n a
n a
pp
eal,
ther
e m
ay b
e fu
rther
lev
els
of
app
eal
avail
able
to y
ou. Y
ou
r T
FL
app
eal
must
mee
t th
e re
qu
irem
ents
lis
ted i
n F
igu
re 7
.1
on
the
foll
ow
ing
pag
e. F
or
speci
fic
info
rmat
ion a
bout
fili
ng a
TF
L a
pp
eal,
conta
ct W
PS
.
Pri
or
auth
ori
zati
on d
enia
l ap
pea
ls m
ay b
e
eith
er e
xped
ited
or
none
xped
ited
, dep
endin
g
on t
he
urg
ency
of
the
situ
atio
n. Y
ou o
r an
appoin
ted r
epre
senta
tive
must
file
for
an
exp
edit
ed r
evie
w o
f a
pri
or
auth
ori
zati
on
den
ial w
ith
in t
hre
e ca
lend
ar
day
s of
rece
ipt
of
the
init
ial den
ial.
A n
one
xped
ited
den
ial
revie
w m
ust
be
file
d n
o l
ater
than 9
0 d
ays
aft
er r
ecei
pt
of
the
init
ial
den
ial.
27
Cer
tifi
cate
s m
ay b
e is
sued
in t
he
foll
ow
ing
circ
um
stance
s:
• U
pon t
he
sponso
r’s
separa
tion f
rom
act
ive
duty
, a
cert
ifica
te i
s is
sued
to t
he
sponso
r
list
ing a
ll e
lig
ible
fam
ily m
emb
ers.
• U
pon the
loss
of
elig
ibil
ity for
a dep
enden
t
chil
d (
age
21, or
age
23 i
f en
roll
ed i
n a
full
tim
e co
urs
e of
stu
dy
at
an a
ppro
ved
inst
itu
tio
n o
f h
igh
er l
earn
ing, a
nd i
f th
e
spo
nso
r pro
vid
es o
ver
50 p
erce
nt
of
the
fin
an
cia
l su
pport
), a
cer
tifi
cate
is
issu
ed
to t
he
dep
enden
t ch
ild.
• U
pon l
oss
of
cover
age
aft
er d
ivorc
e, a
cert
ifica
te i
s is
sued
to t
he
form
er s
pouse
once
in
form
atio
n i
s up
dat
ed i
n D
EE
RS
.
Cer
tifi
cate
s au
tom
atic
all
y r
eflec
t th
e m
ost
rece
nt
per
iod o
f co
nti
nuous
cover
age
under
TR
ICA
RE
. C
erti
fica
tes
issu
ed u
pon a
ben
efici
ary
req
ues
t re
flec
t ea
ch p
erio
d o
f
conti
nuous
TR
ICA
RE
cover
age
that
ended
wit
hin
the
24 m
onth
s pri
or
to t
he
dat
e of
loss
of
elig
ibil
ity.
Eac
h c
erti
fica
te iden
tifi
es
the
nam
e of
the
sponso
r or
fam
ily m
ember
it i
s is
sued
for,
the
dat
es T
RIC
AR
E
cover
age
beg
an a
nd e
nded
, and t
he
cert
ifica
te i
ssue
dat
e.
Sen
d w
ritt
en r
eques
ts f
or
cert
ifica
tes
of
cred
itab
le c
over
age
to:
Def
ense
Manpow
er D
ata
Cen
ter
Support
Offi
ce
AT
TN
: C
erti
fica
te o
f
Cre
dit
able
Cover
age
40
0 G
igli
ng R
oad
Sea
side,
CA
93955
6771
The
reques
t m
ust
incl
ude:
• S
ponso
r’s
nam
e and S
SN
or
DB
N
• N
am
e of
per
son t
he
cert
ifica
te i
s
reques
ted f
or
• R
easo
n f
or
the
reques
t
• N
am
e of
per
son a
nd a
dd
ress
the
cert
ifica
te s
hou
ld b
e se
nt
to
• R
eques
ter’
s si
gnat
ure
Cer
tifi
cate
s ca
nnot
be
reques
ted b
y p
hone.
If t
her
e is
an u
rgen
t nee
d f
or
a ce
rtifi
cate
of
cred
itab
le c
over
age,
fax y
ou
r re
ques
t
to 1
8316
55
8317
and
/or
reques
t th
at t
he
cert
ifica
te b
e fa
xed
to a
part
icu
lar
nu
mb
er.
Suspensio
n o
f Socia
l Securit
y
Dis
abilit
y Insura
nce
Med
icare
cover
age
may
conti
nue
up t
o
eig
ht
yea
rs a
nd s
ix m
onth
s fo
llow
ing
susp
ensi
on o
f S
oci
al
Sec
uri
ty D
isab
ilit
y
Insu
rance
pay
men
ts. W
hen
So
cial S
ecu
rity
Dis
abil
ity I
nsu
rance
pay
men
ts a
re s
usp
ended
bec
ause
you h
ave
retu
rned
to w
ork
, you
wil
l re
ceiv
e quart
erly
bil
ls f
or
the
Med
icare
Part
B p
rem
ium
. A
s lo
ng a
s you r
emain
enti
tled
to p
rem
ium
fre
e M
edic
are
Part
A,
you m
ust
pay
the
Part
B p
rem
ium
to
main
tain
you
r T
RIC
AR
E c
over
age.
SECTION 6
LIFE CHANGES: UPDATE YOUR DEERS RECORD
6
Med
icare
En
titl
em
en
t B
ased
on
Ag
e
The
Med
icare
enti
tlem
ent
age
is 6
5. If
you
alr
eady r
ecei
ve
ben
efits
fro
m t
he
SS
A o
r
the
Rail
road
Ret
irem
ent
Board
, you w
ill
auto
mat
ical
ly r
ecei
ve
Part
A a
nd b
e en
roll
ed
in P
art
B a
t ag
e 65.
If y
ou a
re a
ge
65 o
r old
er a
nd d
o n
ot re
ceiv
e
So
cial
Sec
uri
ty o
r R
ail
road
Ret
irem
ent
Board
ben
efits
, you m
ust
apply
for
Med
icare
ben
efits
. Y
ou
r M
edic
are
in
itia
l en
roll
men
t
per
iod i
s a
seven
month
per
iod.
• If
you
r bir
thd
ay f
all
s on t
he
firs
t of
the
month
, you
r in
itia
l en
roll
men
t p
erio
d
beg
ins
fou
r m
onth
s bef
ore
the
month
you
turn
65. E
nro
ll n
o l
ater
than t
wo m
onth
s
bef
ore
the
month
you t
urn
65 t
o a
void
a
bre
ak i
n T
RIC
AR
E c
over
age.
You a
re
elig
ible
for
Med
icare
cover
age
on t
he
firs
t
day
of
the
month
bef
ore
you t
urn
65.
• If
you
r bir
thd
ay f
all
s on a
ny d
ay o
ther
than t
he
firs
t of
the
month
, you
r in
itia
l
enro
llm
ent
per
iod b
egin
s th
ree
month
s
bef
ore
the
month
you t
urn
65.
En
roll
no
late
r th
an o
ne
month
bef
ore
you
r bir
th
month
to a
void
a b
reak i
n T
RIC
AR
E
cover
age.
You a
re e
lig
ible
for
Med
icare
on t
he
firs
t d
ay o
f th
e m
onth
you t
urn
65.
En
roll
in
Med
ica
re P
art
B w
hen
firs
t
elig
ible
to a
void
a b
rea
k i
n T
RIC
AR
E
cover
age.
If
you s
ign u
p a
fter
you
r in
itia
l
enro
llm
ent
per
iod
, you m
ay h
ave
to p
ay a
pre
miu
m s
urc
harg
e fo
r as
long a
s you h
ave
Part
B. T
he
Med
icare
Part
B s
urc
harg
e is
10 p
erce
nt fo
r ea
ch 1
2m
onth
per
iod that
you
wer
e el
igib
le to e
nro
ll i
n P
art
B b
ut d
id n
ot.
You
r P
art
B p
rem
ium
s are
auto
mat
icall
y
taken
out
of
you
r S
oci
al
Secu
rity
or
Rail
road
Ret
irem
ent
Board
chec
ks.
If
you
are
not
rece
ivin
g t
hes
e ty
pes
of
pay
men
ts,
Med
icare
bil
ls y
ou e
ver
y t
hre
e m
onth
s fo
r
Part
B p
rem
ium
s.
Frequentl
y A
sked Q
uesti
ons:
Medic
are
I w
ill
be
65 s
oon
an
d w
ill
bec
om
e en
titl
ed
to M
edic
are
. I
work
fu
ll t
ime
an
d h
ave
emp
loyer
gro
up
hea
lth
pla
n c
over
age,
an
d I
don
’t p
lan
on
ret
irin
g f
or
a f
ew
more
yea
rs. M
edic
are
says
I ca
n d
elay
my P
art
B e
nro
llm
ent
if I
have
emp
loyer
gro
up
hea
lth
pla
n c
over
age.
How
does
this
aff
ect
my T
RIC
AR
E b
enefi
t?
Med
icare
all
ow
s in
div
iduals
wit
h g
roup
hea
lth p
lan c
over
age
bas
ed o
n c
urr
ent
emplo
ym
ent
to d
elay
Part
B e
nro
llm
ent
and
sig
n u
p d
uri
ng a
sp
ecia
l en
roll
men
t p
erio
d,
wh
ich w
aiv
es t
he
late
en
roll
men
t pre
miu
m
surc
harg
e. I
f you o
r you
r sp
ouse
sti
ll w
ork
s
and h
as g
roup h
ealt
h p
lan c
over
age
thro
ugh
curr
ent
emplo
ym
ent,
you m
ay s
ign u
p
for
Med
icare
Part
B d
uri
ng t
he
spec
ial
enro
llm
ent
per
iod
, w
hic
h i
s av
ail
able
wit
hin
the
eig
ht
month
s fo
llow
ing e
ither
(1)
reti
rem
ent
or
(2)
the
end o
f th
e g
roup
hea
lth p
lan c
over
age,
wh
ichev
er c
om
es fi
rst.
If y
ou a
re e
nti
tled
to p
rem
ium
fre
e M
edic
are
Part
A, y
ou m
ust
als
o h
ave
Part
B to r
emain
TR
ICA
RE
eli
gib
le, ev
en i
f you h
ave
gro
up
hea
lth p
lan c
over
age
bas
ed o
n c
urr
ent
emplo
ym
ent.
Sig
n u
p f
or
Part
B b
efore
you
reti
re o
r lo
se g
roup h
ealt
h p
lan c
over
age
to
ensu
re y
ou
r T
RIC
AR
E c
over
age
under
TF
L
wil
l beg
in im
med
iate
ly foll
ow
ing the
end o
f
you
r g
roup h
ealt
h p
lan c
over
age.
You
r T
FL
cover
age
beg
ins
on t
he
firs
t d
ay y
ou h
ave
both
Med
icare
Part
A a
nd P
art
B c
over
age.
7
If I
am
not
enti
tled
to p
rem
ium
fre
e
Med
ica
re P
art
A w
hen
I t
urn
65, ca
n
I st
ill
use
TF
L?
Bec
ause
you a
re n
ot
enti
tled
to p
rem
ium
free
Med
icare
Part
A, you d
o n
ot
nee
d
Med
icare
Part
B t
o k
eep y
ou
r T
RIC
AR
E
ben
efit.
You d
o n
ot
transi
tion t
o T
FL
. Y
ou
may
conti
nue
enro
llm
ent
in T
RIC
AR
E
Pri
me
if y
ou liv
e in
a P
SA
, or
use
TR
ICA
RE
Sta
nd
ard
and T
RIC
AR
E E
xtr
a. F
or
info
rmat
ion a
bout
TR
ICA
RE
pro
gra
m
opti
ons,
vis
it t
he
TR
ICA
RE
Web
sit
e at
ww
w.t
ric
are
.mil
.
If y
ou a
re n
ot
elig
ible
for
pre
miu
mf
ree
Med
icare
Part
A u
nder
you
r ow
n S
SN
when
you t
urn
65, you m
ust
file
for
ben
efits
under
you
r sp
ouse
’s (
this
in
clu
des
div
orc
ed
or
dec
ease
d s
pou
ses)
SS
N i
f he
or
she
is
62 o
r old
er. If
you
r sp
ouse
is
not
yet
62
,
you m
ust
file
for
ben
efits
under
his
or
her
SS
N w
hen
he
or
she
turn
s 62.
If y
ou w
ill
be
elig
ible
under
you
r sp
ouse
’s
SS
N i
n t
he
futu
re, you s
hou
ld s
ign u
p
for
Med
icare
Part
B d
uri
ng y
ou
r in
itia
l
enro
llm
ent
per
iod t
o a
void
pay
ing a
Part
B
pre
miu
m s
urc
harg
e fo
r la
te e
nro
llm
ent.
Even
if
you a
re n
ot
enti
tled
to p
rem
ium
free
Med
icare
Part
A, you a
re e
lig
ible
for
Part
B a
t ag
e 65.
See
“M
edic
are
Enti
tlem
ent
Bas
ed o
n A
ge”
earl
ier
in t
his
sec
tion f
or
more
in
form
atio
n.
If y
ou s
ign u
p f
or
Med
icare
and a
re n
ot
elig
ible
for
pre
miu
mf
ree
Part
A u
nder
you
r or
you
r sp
ouse
’s (
this
in
clu
des
div
orc
ed o
r d
ecea
sed s
pou
ses)
SS
N, you
rece
ive
a “N
oti
ce o
f A
ward
” or
“Noti
ce
of
Dis
appro
ved
Cla
im”
from
SS
A. T
o
kee
p y
ou
r T
RIC
AR
E c
over
age,
take
the
“Noti
ce(s
) of
Aw
ard
” or
“Noti
ce(s
) of
Dis
appro
ved
Cla
im”
to a
un
iform
ed
serv
ices
iden
tifi
cati
on (
ID)
card
iss
uin
g
faci
lity
to h
ave
you
r D
efen
se E
nro
llm
ent
Eli
gib
ilit
y R
eport
ing S
yst
em (
DE
ER
S)
reco
rd u
pd
ated
and r
ecei
ve
a new
ID
card
.
Th
is a
llow
s you t
o k
eep y
ou
r el
igib
ilit
y f
or
TR
ICA
RE
Pri
me
or
TR
ICA
RE
Sta
nd
ard
and T
RIC
AR
E E
xtr
a aft
er y
ou t
urn
65.
To c
on
firm
that
you
r T
RIC
AR
E c
over
age
wil
l co
nti
nue
wit
hout
a bre
ak
, co
nta
ct
Wis
consi
n P
hysi
cians
Ser
vic
e (W
PS
)
aft
er y
ou u
pd
ate
you
r D
EE
RS
rec
ord
.
Note
: A
Rep
ort
of
Co
nfi
den
tia
l S
oci
al
Sec
uri
ty B
enefi
t In
form
ati
on (
SS
A2
458)
from
the
SS
A i
s not
acce
pte
d a
s pro
of
of
none
nti
tlem
ent
to p
rem
ium
fre
e P
art
A
to k
eep T
RIC
AR
E e
lig
ibil
ity.
How
TR
ICA
RE F
or L
ife W
ork
s
wit
h M
edic
are
Med
icare
and T
FL
work
toget
her
to
min
imiz
e you
r out
of
po
cket
exp
ense
s.
How
ever
, th
ere
are
inst
ance
s w
hen
som
e
hea
lth c
are
cost
s m
ay n
ot
be
cover
ed b
y
Med
icare
and
/or
TF
L.
Healt
h C
are
Serv
ices C
overe
d b
y
Med
icare
an
d T
RIC
AR
E
When
you s
ee a
part
icip
atin
g o
r
nonpart
icip
atin
g M
edic
are
pro
vid
er, you
hav
e no o
ut
of
po
cket
cost
s fo
r se
rvic
es
cover
ed b
y b
oth
Med
icare
and T
FL
. M
ost
hea
lth c
are
ser
vic
es f
all
into
th
is c
ateg
ory
.
Aft
er M
edic
are
pay
s it
s port
ion o
f th
e cl
aim
,
TF
L p
ays
the
rem
ain
ing a
mou
nt
and y
ou
pay
noth
ing.
As
the
pri
mary
pay
er, M
edic
are
appro
ves
hea
lth c
are
serv
ices
for
pay
men
t. I
f M
edic
are
SECTION 1
HOW TRICARE FOR LIFE WORKS
26
Children
You
r dep
enden
t’s
cover
age
do
es n
ot
change
bec
ause
you a
re e
nti
tled
to T
FL
.
Any c
hil
dre
n w
ho r
etain
eli
gib
ilit
y u
nder
the
sponso
r re
main
TR
ICA
RE
eli
gib
le
unti
l re
ach
ing a
ge
21 (
or
age
23 i
f en
roll
ed
in a
full
tim
e co
urs
e of st
udy
at an a
ppro
ved
inst
itu
tio
n o
f h
igh
er l
earn
ing, a
nd i
f th
e
spo
nso
r pro
vid
es o
ver
50 p
erce
nt
of
the
fin
an
cia
l su
pport
), a
s lo
ng a
s h
is o
r
her
DE
ER
S i
nfo
rmat
ion i
s cu
rren
t. T
o
exte
nd c
over
age
bey
ond y
ou
r ch
ild’s
21s
t
bir
thd
ay, co
nta
ct D
EE
RS
to v
erif
y w
hat
do
cum
enta
tion i
s nee
ded
.
At
age
21 (
or
23),
adu
lt c
hil
dre
n m
ay
be
elig
ible
for
the
TR
ICA
RE
You
ng
Adu
lt (
TY
A)
pro
gra
m, and l
ater
for
the
Conti
nued
Hea
lth C
are
Ben
efit
Pro
gra
m
(CH
CB
P).
For
more
in
form
atio
n o
n
TY
A, vis
it w
ww
.tric
are
.mil
/tya. F
or
more
in
form
atio
n o
n C
HC
BP,
vis
it
ww
w.t
ric
are
.mil
/ch
cbp
.
Note
: C
hil
dre
n w
ith d
isab
ilit
ies
may
rem
ain
TR
ICA
RE
eli
gib
le b
eyond t
he
norm
al
age
lim
its.
Conta
ct t
he
DE
ER
S S
upport
Offi
ce
for
elig
ibil
ity c
rite
ria.
Movin
g
Whet
her
you a
re m
ovin
g a
cross
the
stre
et
or
over
seas
, m
ovin
g w
ith T
FL
is
easy
.
Just
up
dat
e you
r p
erso
nal
info
rmat
ion i
n
DE
ER
S, fi
nd a
pro
vid
er w
ho i
s M
edic
are
cert
ified
(in
th
e U
nit
ed S
tate
s a
nd U
.S.
terr
itori
es [
Am
eric
an S
am
oa,
Guam
,
the
Nort
her
n M
ari
ana
Isla
nds,
Puer
to
Ric
o, and t
he
U.S
. V
irg
in I
slands]
) and
TR
ICA
RE
auth
ori
zed
, and c
onti
nue
to r
ecei
ve
care
when
you n
eed i
t. S
ee
“Fin
din
g a
Pro
vid
er”
in t
he
Get
ting C
are
sect
ion o
f th
is h
andbook.
Surviv
or C
overa
ge
If y
ou
r T
FL
sponso
r d
ies,
you r
emain
TR
ICA
RE
eli
gib
le a
nd w
ill
conti
nue
to
rece
ive
TF
L b
enefi
ts a
s lo
ng a
s yo
ur
DE
ER
S
info
rmat
ion is
up t
o d
ate
and y
ou a
re e
ither
of
the
foll
ow
ing:
• A
su
rviv
ing s
pouse
and d
o n
ot
rem
arr
y
(If
you r
emarr
y, T
RIC
AR
E e
ligib
ilit
y
can
not
be
rega
ined
la
ter,
eve
n i
f yo
u
div
orc
e or
your
new
spou
se d
ies.
)
• A
n u
nm
arr
ied c
hil
d u
nder
age
21 (
or
age
23 i
f en
roll
ed i
n a
full
tim
e co
urs
e of
stu
dy
at a
n a
ppro
ved in
stit
uti
on o
f h
igh
er
learn
ing, a
nd if th
e sp
onso
r pro
vided
ove
r
50 p
erce
nt
of
the
fin
an
cia
l su
pport
)
Note
: C
hil
dre
n w
ith d
isab
ilit
ies
may
rem
ain
TR
ICA
RE
eli
gib
le b
eyond n
orm
al
age
lim
its.
Conta
ct t
he
DE
ER
S S
upport
Offi
ce
for
elig
ibil
ity c
rite
ria.
Upon t
he
dea
th o
f you
r sp
onso
r, y
ou w
ill
rece
ive
a le
tter
fro
m D
EE
RS
tel
ling y
ou
about
you
r pro
gra
m o
pti
ons
and h
ow
you
r
ben
efits
wil
l ev
entu
all
y c
hange.
If
you h
ave
any q
ues
tions,
vis
it w
ww
.tri
care
.mil
/dee
rs.
Loss o
f Eligib
ilit
y
Upon l
oss
of
TR
ICA
RE
eli
gib
ilit
y, e
ach
fam
ily m
emb
er a
uto
mat
icall
y r
ecei
ves
a
cert
ifica
te o
f cr
edit
able
cover
age.
The
cert
ifica
te o
f cr
edit
able
cover
age
is a
do
cum
ent
that
ser
ves
as
evid
ence
of
pri
or
hea
lth c
are
cover
age
under
TR
ICA
RE
so
that
you c
an
not
be
excl
uded
fro
m a
new
hea
lth p
lan f
or
pre
exis
ting c
ond
itio
ns.
25
Gett
ing M
arrie
d o
r D
ivorced
Marr
iag
e
It i
s ex
trem
ely i
mport
ant
for
sponso
rs t
o
reg
iste
r new
spouse
s in
DE
ER
S t
o e
nsu
re
they
are
eli
gib
le f
or
TR
ICA
RE
pro
gra
ms,
incl
ud
ing T
FL
. T
o r
egis
ter
a new
spouse
in D
EE
RS
, th
e sp
onso
r nee
ds
to p
rovid
e a
copy o
f th
e m
arri
age
cert
ifica
te to
the
nea
rest
un
iform
ed s
ervic
es I
D c
ard
iss
uin
g f
acil
ity.
The
new
spouse
is
als
o r
equ
ired
to s
how
two f
orm
s of
ID (
e.g
., a
ny
com
bin
ati
on
of
So
cia
l Sec
uri
ty c
ard
, dri
ver’
s li
cen
se,
bir
th c
erti
fica
te, cu
rren
t m
ilit
ary
ID
card
,
or
CA
C).
Once
you
r sp
ouse
is
reg
iste
red
in D
EE
RS
, he
or
she
rece
ives
a u
nif
orm
ed
serv
ices
ID
card
and i
s el
igib
le f
or
TF
L.
You
r sp
ouse
must
show
his
or
her
ID
card
to a
cces
s ca
re.
Div
orc
e
Sponso
rs m
ust
up
dat
e D
EE
RS
in t
he
even
t
of
a d
ivorc
e. T
he
sponso
r nee
ds
to p
rovid
e
a co
py o
f th
e d
ivorc
e dec
ree,
dis
solu
tion,
or
an
nu
lmen
t.
Fo
rmer
Sp
ou
se C
overa
ge
Cer
tain
form
er s
pouse
s are
eli
gib
le t
o
conti
nue
TF
L c
over
age
as l
ong a
s th
ey:
• D
o n
ot
rem
arr
y (
If a
form
er s
pou
se
rem
arr
ies,
th
e lo
ss o
f ben
efits
rem
ain
s
appli
cable
eve
n i
f th
e re
marr
iage
end
s
in d
eath
or
div
orc
e.)
• A
re n
ot
cover
ed b
y e
mplo
yer
sponso
red
hea
lth p
lans
• A
re n
ot
als
o f
orm
er s
pouse
s of
Nort
h
Atl
anti
c T
reat
y O
rgan
izat
ion o
r P
art
ner
s
for
Pea
ce n
atio
n m
emb
ers
• M
eet
the
requ
irem
ents
of
one
of
the
two
situ
atio
ns
des
crib
ed i
n F
igu
re 6
.1
Form
er s
pouse
s w
ho a
re T
FL
eli
gib
le m
ust
change
thei
r p
erso
nal
info
rmat
ion i
n
DE
ER
S s
o t
hei
r nam
e and S
oci
al
Sec
uri
ty
nu
mb
er (
SS
N)
or
DoD
Ben
efits
Nu
mb
er
(DB
N)
are
lis
ted f
or
the
pri
mary
conta
ct
info
rmat
ion. T
he
form
er s
pouse
’s T
RIC
AR
E
elig
ibil
ity i
s sh
ow
n i
n D
EE
RS
under
his
or
her
SS
N o
r D
BN
, not
the
sponso
r’s.
Eli
gib
ilit
y R
equ
irem
ents
fo
r F
orm
er S
pou
ses
Fig
ure
6.1
1•
The
form
er s
pouse
must
hav
e bee
n m
arr
ied to the
sam
e m
ilit
ary
mem
ber
or
form
er m
ember
for
at lea
st 2
0 y
ears
, an
d a
t le
ast
20 o
f th
ose
yea
rs m
ust
hav
e bee
n c
redit
able
in d
eter
min
ing
the
mem
ber
’s e
lig
ibil
ity
for
reti
rem
ent
pay
.
• T
he
form
er s
pouse
is
elig
ible
for
TR
ICA
RE
cover
age
aft
er t
he
dat
e of
the
div
orc
e,
dis
solu
tion,
or
an
nu
lmen
t.1
• E
lig
ibil
ity
conti
nues
as
long
as
the
pre
ced
ing
req
uir
emen
ts c
onti
nue
to b
e m
et a
nd
the
form
er s
pouse
do
es n
ot
rem
arr
y.
2•
The
form
er s
pouse
must
hav
e b
een
marr
ied
to
the
sam
e m
ilit
ary
mem
ber
or
form
er
mem
ber
for
at l
east
20
yea
rs,
and
at
leas
t 15
—but
less
than
20
—of
those
marr
ied
yea
rs
must
hav
e b
een
cre
dit
able
in
det
erm
inin
g t
he
mem
ber
’s e
lig
ibil
ity
for
reti
rem
ent
pay
.
• T
he
form
er s
pouse
is
elig
ible
for
TR
ICA
RE
cover
age
for
on
ly o
ne
yea
r fr
om
the
dat
e of
the
div
orc
e.
1. F
or
div
orc
e d
ecre
es, d
isso
luti
on
s, o
r a
nn
ulm
en
ts o
n o
r b
efore
Sep
tem
ber
29, 19
88
, co
nta
ct D
EE
RS f
or
elig
ibil
ity
veri
fica
tio
n.
SECTION 6
LIFE CHANGES: UPDATE YOUR DEERS RECORD
8
do
es n
ot
pay
bec
ause
it
det
erm
ines
that
the
care
is n
ot m
edic
ally
nec
essa
ry, T
FL
als
o d
oes
not p
ay. Y
ou m
ay a
ppea
l Med
icar
e’s
dec
isio
n,
and i
f M
edic
are
rec
onsi
der
s and p
rovid
es
cover
age,
TF
L a
lso r
econsi
der
s co
ver
age.
If a
hea
lth c
are
ser
vic
e is
cover
ed b
y b
oth
Med
icare
and T
FL
, but
Med
icare
do
es n
ot
pay
bec
ause
you h
ave
use
d u
p y
our
Med
icar
e
ben
efit,
TF
L b
ecom
es t
he
pri
mary
pay
er. In
this
cas
e, y
ou a
re r
esponsi
ble
for
you
r T
FL
ded
uct
ible
and c
ost
share
s.
If a
hea
lth c
are
ser
vic
e is
norm
all
y c
over
ed
by b
oth
Med
icare
and T
FL
, but you r
ecei
ve
the
serv
ice
from
a p
rovid
er w
ho h
as o
pte
d
out
of
Med
icare
, th
e pro
vid
er c
an
not
bil
l
Med
icare
and
, ther
efore
, Med
icare
wil
l pay
noth
ing. W
hen
you s
ee a
n o
pt
out pro
vid
er,
TF
L w
ill
pro
cess
the
claim
as
the
seco
nd
pay
er, u
nle
ss y
ou h
ave
oth
er h
ealt
h insu
rance
(OH
I). T
FL
pay
s th
e am
ou
nt
it w
ou
ld h
ave
paid
if
Med
icare
had
pro
cess
ed t
he
claim
(norm
all
y 2
0 p
erce
nt
of
the
TR
ICA
RE
all
ow
able
ch
arg
e) a
nd y
ou a
re r
esponsi
ble
for
the
rem
ain
der
of
the
bil
led c
harg
es.
Opt
out pro
vid
ers
esta
bli
sh p
rivat
e co
ntr
acts
wit
h p
atie
nts
. Under
a p
rivat
e co
ntr
act,
ther
e
are
no lim
its
on w
hat
the
pro
vid
er c
an c
har
ge
for
hea
lth c
are
ser
vic
es.
Healt
h C
are
Serv
ices C
overe
d b
y
Med
icare
bu
t N
ot
by T
RIC
AR
E
When
you r
ecei
ve
care
that
is
cover
ed
by M
edic
are
on
ly (
e.g., c
hir
opra
ctic
care
),
Med
icar
e pro
cess
es the
clai
m a
s th
e pri
mar
y
pay
er. T
FL
makes
no p
aym
ent,
reg
ard
less
of
any a
ctio
n M
edic
are
takes
. Y
ou a
re
resp
onsi
ble
for
the
Med
icare
ded
uct
ible
and c
opay
men
ts.
Healt
h C
are
Serv
ices C
overe
d b
y
TR
ICA
RE b
ut
No
t b
y M
ed
icare
When
you r
ecei
ve
care
that
is
cover
ed
on
ly b
y T
FL
(e.g
., T
RIC
AR
Ec
ove
red
serv
ices
rec
eive
d o
vers
eas)
, T
RIC
AR
E
pro
cess
es t
he
claim
as
the
pri
mary
pay
er.
You a
re r
esponsi
ble
for
the
appli
cable
TF
L
ded
uct
ible
, co
sts
hare
s, a
nd r
emain
ing
bil
led c
harg
es.
TF
L c
laim
s ar
e norm
ally
file
d w
ith M
edic
are
firs
t; h
ow
ever
, w
hen
a h
ealt
h c
are
ser
vic
e is
not co
ver
ed b
y M
edic
are
, you
r pro
vid
er m
ay
file
the
claim
dir
ectl
y w
ith W
PS
, u
nle
ss
you h
ave
OH
I. S
ee t
he
Cla
ims
sect
ion o
f
this
handbook f
or
add
itio
nal
info
rmat
ion.
Healt
h C
are
Serv
ices N
ot
Co
vere
d
by M
ed
icare
or
TR
ICA
RE
When
you r
ecei
ve
care
that
is
not
cover
ed
by M
edic
are
or
TF
L (e.
g., c
osm
etic
surg
ery)
,
nei
ther
makes
a p
aym
ent
on t
he
claim
. Y
ou
are
res
ponsi
ble
for
the
enti
re b
ill.
For
more
in
form
atio
n o
n c
over
ed
serv
ices
, vis
it w
ww
.med
ica
re.g
ov
or
ww
w.t
rica
re.m
il o
r co
nta
ct W
PS
.
See
Fig
ure
1.1
on t
he
foll
owin
g p
age
for
TF
L o
ut
of
pock
et c
ost
s.
9
Co
ord
inati
ng
TR
ICA
RE F
or
Lif
e w
ith
O
ther
Healt
h I
nsu
ran
ce
How
Med
icare
coord
inat
es w
ith O
HI
dep
ends
on w
het
her
or
not
the
OH
I is
bas
ed o
n c
urr
ent
emplo
ym
ent.
In e
ither
case
, T
FL
is
the
last
pay
er.
OH
I N
ot
Base
d o
n C
urr
en
t Em
plo
ym
en
t
If y
ou h
ave
OH
I th
at i
s not
bas
ed o
n y
ou
r
or
a fa
mil
y m
emb
er’s
cu
rren
t em
plo
ym
ent,
Med
icare
pay
s fi
rst,
the
OH
I pay
s se
cond
,
and T
FL
pay
s la
st.
OH
I B
ase
d o
n C
urr
en
t Em
plo
ym
en
t
Gen
erall
y, i
f you h
ave
an e
mplo
yer
sponso
red h
ealt
h p
lan b
ased
on c
urr
ent
emplo
ym
ent,
that
hea
lth p
lan p
ays
firs
t,
Med
icare
pay
s se
cond
, and T
FL
pay
s la
st.
If t
her
e are
few
er t
han
20 e
mplo
yee
s in
the
emplo
yer
sponso
red p
lan, M
edic
are
pay
s
firs
t, t
he
emplo
yer
pla
n p
ays
seco
nd
, and
TF
L p
ays
last
.
When
you
r O
HI
pro
cess
es t
he
claim
aft
er
Med
icare
, you n
eed t
o s
ubm
it a
cla
im t
o
WP
S f
or
any r
emain
ing b
ala
nce
. S
ee
the
Cla
ims
sect
ion o
f th
is h
andbook f
or
add
itio
nal
info
rmat
ion.
Note
: T
RIC
AR
E p
ays
aft
er m
ost
insu
rance
pla
ns
wit
h t
he
exce
pti
on o
f M
edic
aid
,
TR
ICA
RE
supple
men
ts, th
e In
dia
n H
ealt
h
Ser
vic
e, a
nd o
ther
pro
gra
ms
and p
lans
as
iden
tifi
ed b
y t
he
TR
ICA
RE
Manag
emen
t
Act
ivit
y.
Ho
w T
RIC
AR
E F
or
Lif
e W
ork
s O
vers
eas
Med
icare
pro
vid
es c
over
age
in t
he
Un
ited
Sta
tes
and U
.S. te
rrit
ori
es, w
hic
h a
re:
• A
mer
ican S
am
oa
• G
uam
• N
ort
her
n M
ari
ana
Isla
nds
• P
uer
to R
ico
• U
.S. V
irg
in I
slands
Med
icare
als
o c
over
s hea
lth c
are
ser
vic
es
rece
ived
on b
oard
sh
ips
in U
.S. te
rrit
ori
al
wat
ers.
In t
hes
e lo
cati
ons,
TF
L w
ork
s
exac
tly a
s it
do
es i
n t
he
Un
ited
Sta
tes.
Un
less
you h
ave
OH
I, T
FL
is
the
seco
nd
pay
er a
fter
Med
icare
for
most
hea
lth c
are
serv
ices
. Y
ou
r pro
vid
er fi
les
the
claim
wit
h M
edic
are
firs
t. M
edic
are
pay
s it
s
port
ion a
nd a
uto
mat
icall
y f
orw
ard
s th
e
claim
to W
PS
for
pro
cess
ing.
TR
ICA
RE
Fo
r L
ife
Ou
tof
Po
cket
Cost
s
Fig
ure
1.1
Typ
e o
f Serv
ice
Me
dic
are
Pays
TR
ICA
RE
Pays
Yo
u P
ay
Cover
ed b
y T
RIC
AR
E
an
d M
edic
are
Med
icare
auth
ori
zed
am
ou
nt
Rem
ain
ing
am
ou
nt
Noth
ing
Cover
ed b
y M
edic
are
on
lyM
edic
are
auth
ori
zed
am
ou
nt
Noth
ing
Med
icare
ded
uct
ible
and
cost
share
Cover
ed b
y T
RIC
AR
E
on
lyN
oth
ing
TR
ICA
RE
all
ow
able
am
ou
nt
TR
ICA
RE
ded
uct
ible
and
cost
share
Not
Cover
ed b
y
TR
ICA
RE
or
Med
ica
re
Noth
ing
Noth
ing
Bil
led c
harg
es (w
hic
h
ma
y ex
ceed
th
e
Med
icare
am
ou
nt
or
ba
lan
ceb
illi
ng
ca
p)
SECTION 1
HOW TRICARE FOR LIFE WORKS
24
Lif
e C
han
ges:
Up
date
Yo
ur
DEER
S R
eco
rd
TR
ICA
RE
For
Lif
e (T
FL
) co
nti
nues
to
pro
vid
e hea
lth c
are
cove
rage
for yo
u a
nd y
our
fam
ily a
s you
r li
fe c
hanges
. H
ow
ever
, you
nee
d t
o t
ake
spec
ific
acti
ons
to m
ake
sure
you r
emai
n T
RIC
AR
Ee
ligib
le. I
t is
ess
enti
al
that
you k
eep i
nfo
rmat
ion i
n t
he
Def
ense
En
roll
men
t E
lig
ibil
ity R
eport
ing S
yst
em
(DE
ER
S)
curr
ent
for
you a
nd y
ou
r fa
mil
y.
DE
ER
S i
s a
com
pute
rize
d d
atab
ase
of
un
iform
ed s
ervic
e m
emb
ers
(act
ive
du
ty
an
d r
etir
ed),
thei
r fa
mil
y m
emb
ers,
and
oth
ers
who a
re e
ligib
le f
or
mil
itary
ben
efits
,
incl
ud
ing T
RIC
AR
E. P
rop
er a
nd c
urr
ent
DE
ER
S r
egis
trat
ion i
s key
to r
ecei
vin
g
tim
ely,
eff
ecti
ve
TF
L b
enefi
ts.
Main
tain
ing y
ou
r T
RIC
AR
E e
lig
ibil
ity
is y
ou
r re
sponsi
bil
ity.
It
is e
ssen
tial
to
ver
ify y
ou
r in
form
atio
n i
n D
EE
RS
any
tim
e you h
ave
a li
fec
hang
ing e
ven
t.
You h
ave
sever
al
opti
ons
for
up
dat
ing
and v
erif
yin
g D
EE
RS
in
form
atio
n. S
ee
“Im
port
ant
Conta
ct I
nfo
rmat
ion”
at t
he
beg
inn
ing o
f th
is h
andbook.
Note
: O
nly
sponso
rs (
or
those
appoin
ted
pow
er o
f a
ttorn
ey)
can a
dd o
r del
ete
a
fam
ily m
ember
. F
am
ily m
ember
s ag
e 18
and o
lder
may
up
dat
e th
eir
ow
n c
onta
ct
info
rmat
ion
.
Usin
g m
ilConnect
to U
pdate
In
form
ati
on in D
EER
S
Act
ive
duty
ser
vic
e m
emb
ers,
ret
iree
s,
and e
lig
ible
fam
ily m
emb
ers
can u
se t
he
mil
Con
nec
t W
eb s
ite
to a
cces
s hea
lth
care
eli
gib
ilit
y a
nd p
erso
nnel
in
form
atio
n,
un
iform
ed s
ervic
es i
den
tifi
cati
on (
ID)
card
s and i
nfo
rmat
ion o
n o
ther
ben
efits
,
incl
ud
ing S
ervic
emem
ber
s’ G
roup
Lif
e In
sura
nce
.
You c
an l
og o
n t
o m
ilC
on
nec
t’s
secu
re
site
usi
ng a
Com
mon A
cces
s C
ard
(C
AC
),
Def
ense
Fin
ance
and A
ccou
nti
ng S
ervic
es
use
r nam
e and p
assw
ord
or
Dep
art
men
t
of
Def
ense
(D
oD
) S
elf
Ser
vic
e L
ogon
(DS
Logon)
. Y
ou m
ay v
isit
a T
RIC
AR
E
Ser
vic
e C
ente
r or
a V
eter
ans
Aff
air
s
Reg
ional
Offi
ce t
o c
om
ple
te a
n i
np
erso
n
pro
ofi
ng p
roce
ss t
o r
eques
t a
DS
Logon, or
you m
ay g
o o
nli
ne
for
a re
mote
pro
ofi
ng
pro
cess
. F
or
more
in
form
atio
n, vis
it
ww
w.d
md
c.osd
.mil
/id
enti
tym
an
agem
ent.
If y
ou n
eed a
new
ID
card
, you c
an v
isit
a u
nif
orm
ed s
ervic
es I
D c
ard
iss
uin
g
faci
lity
and r
eques
t a
DS
Logon a
t th
e
sam
e ti
me.
23
Thir
d-P
arty
Lia
bilit
y
If T
RIC
AR
E i
s th
e pri
mary
pay
er, th
e
Fed
eral M
edic
al C
are
Rec
over
y A
ct a
llow
s
TR
ICA
RE
to b
e re
imbu
rsed
for
trea
tmen
t
cost
s if
you a
re inju
red in a
n a
ccid
ent ca
use
d
by s
om
eone
else
. T
he
Sta
tem
ent of P
erso
nal
Inju
ry—
Poss
ible
Th
ird
Part
y L
iabil
ity
form
(D
D F
orm
2527)
is s
ent
to y
ou i
f a
claim
app
ears
to h
ave
thir
dp
art
y l
iabil
ity
involv
emen
t. W
ith
in 3
5 c
ale
nd
ar
day
s,
you m
ust
com
ple
te a
nd s
ign t
his
form
and f
oll
ow
the
dir
ecti
ons
for
retu
rnin
g i
t
to t
he
appro
pri
ate
claim
s pro
cess
or.
Vis
it
ww
w.t
ric
are
.mil
/cla
ims
to d
ow
nlo
ad
DD
Form
2527.
Expla
nati
on o
f B
enefi
ts
A T
RIC
AR
E E
OB
is
not
a bil
l. I
t is
an
item
ized
sta
tem
ent
that
show
s th
e ac
tion
TR
ICA
RE
has
taken
on y
ou
r cl
aim
s. A
n
EO
B i
s fo
r you
r in
form
atio
n a
nd fi
les.
Aft
er r
evie
win
g t
he
EO
B, you h
ave
the
rig
ht
to a
pp
eal
cert
ain
dec
isio
ns
regard
ing
you
r cl
aim
s and m
ust
do s
o i
n w
riti
ng
wit
hin
90 d
ays
of
the
dat
e of
the
EO
B
noti
ce. Y
ou s
hou
ld k
eep E
OB
s w
ith y
ou
r
hea
lth insu
rance
rec
ord
s fo
r fu
ture
ref
eren
ce.
For
more
in
form
atio
n a
bout
app
eals
, vis
it
ww
w.T
RIC
AR
E4u
.com
or
see
the
For
Info
rma
tio
n a
nd A
ssis
tan
ce s
ecti
on o
f
this
handbook.
Debt
Collecti
on
Assis
tance O
fficers
TR
ICA
RE
Deb
t C
oll
ecti
on A
ssis
tance
Offi
cers
(D
CA
Os)
are
loca
ted a
t M
TF
s an
d
TR
ICA
RE
Reg
ional
Offi
ces
to h
elp r
esolv
e
you
r T
RIC
AR
E h
ealt
h c
are
coll
ecti
on
rela
ted i
ssues
. C
onta
ct a
DC
AO
if
you
rece
ived
a n
egat
ive
cred
it r
atin
g o
r w
ere
conta
cted
by a
coll
ecti
on a
gen
cy d
ue
to
an i
ssue
rela
ted t
o y
ou
r T
FL
cla
im.
When
you
vis
it a
TR
ICA
RE
DC
AO
for
assi
stance
, you m
ust
take
or
subm
it
docu
men
tati
on a
ssoci
ated
wit
h a
coll
ecti
on
acti
on o
r ad
ver
se c
red
it r
atin
g, in
clud
ing
deb
t co
llec
tion l
ette
rs, E
OB
s, a
nd m
edic
al
and
/or
den
tal bil
ls f
rom
pro
vid
ers.
The
more
info
rmat
ion y
ou p
rovid
e, the
fast
er the
cause
of
the
pro
ble
m c
an b
e det
erm
ined
. T
he
DC
AO
res
earc
hes
you
r cl
aim
, pro
vid
es y
ou
wit
h a
wri
tten
res
olu
tion o
f you
r co
llec
tion
pro
ble
m, and in
form
s th
e co
llec
tion a
gen
cy
that
act
ion is
bei
ng tak
en to r
esolv
e th
e is
sue.
DC
AO
s ca
nnot
pro
vid
e le
gal
advic
e or
repair
you
r cr
edit
rat
ing, but
they
can
hel
p b
y p
rovid
ing d
ocu
men
tati
on f
or
the
coll
ecti
on o
r cr
editr
eport
ing a
gen
cy t
o
expla
in t
he
circ
um
stan
ces
rela
ting t
o t
he
deb
t. V
isit
the
DC
AO
dir
ecto
ry o
nli
ne
at w
ww
.tric
are
.mil
/bca
cdca
o t
o fi
nd a
TR
ICA
RE
DC
AO
nea
r you.
TR
ICA
RE
DC
AO
s ca
n o
nly
ass
ist yo
u w
ith
TF
Lr
elat
ed i
ssues
. C
onta
ct M
edic
are
for
assi
stance
wit
h M
edic
are
rel
ated
iss
ues
.
SECTION 5
CLAIMS
10
Med
icare
does
not
pro
vid
e co
ver
age
outs
ide
of
the
Un
ited
Sta
tes,
U.S
. te
rrit
ori
es, and
ship
s in
ter
rito
rial
wat
ers.
Ther
efore
, T
FL
is
you
r pri
mary
pay
er f
or
hea
lth c
are
rec
eived
in a
ll o
ther
over
seas
lo
cati
ons,
un
less
you
hav
e O
HI.
TF
L p
rovid
es t
he
sam
e co
ver
age
as T
RIC
AR
E S
tand
ard
and h
as t
he
sam
e
cost
share
s an
d d
educt
ible
s fo
r ben
efici
ari
es
who l
ive
or
trav
el o
ver
seas
. W
hen
see
kin
g
care
fro
m a
host
nat
ion p
rovid
er, re
gio
n
or
cou
ntr
ys
pec
ific
requ
irem
ents
may
als
o
apply
. You s
hould
be
pre
par
ed to
pay
up f
ront
for
serv
ices
and s
ubm
it a
cla
im t
o t
he
TR
ICA
RE
Over
seas
Pro
gra
m (
TO
P)
claim
s pro
cess
or.
Cla
ims
for
care
rec
eived
over
seas
are
subm
itte
d d
irec
tly t
o t
he
TO
P c
laim
spro
cess
ing a
dd
ress
for
the
reg
ion w
her
e you r
ecei
ved
care
. S
ee t
he
Cla
ims
sect
ion o
f th
is h
andbook f
or
more
info
rmat
ion.
Frequentl
y A
sked Q
uesti
ons:
How
TR
ICA
RE F
or L
ife W
ork
s
Does
TF
L p
ay f
or
the
Med
ica
re P
art
B
pre
miu
m a
nd
ded
uct
ible
?
The
Part
B m
onth
ly p
rem
ium
is
you
r
resp
onsi
bil
ity.
TF
L c
over
s th
e M
edic
are
Part
B d
educt
ible
as
long a
s th
e hea
lth
care
ser
vic
e is
cover
ed b
y b
oth
Med
icare
and T
RIC
AR
E.
Usi
ng T
FL
see
ms
so e
asy
. Sh
ou
ld I
can
cel
my M
edic
are
su
pp
lem
ent,
Med
ica
re
Ad
va
nta
ge
Pla
n, or
OH
I?
You s
hou
ld c
are
full
y e
valu
ate
you
r hea
lth
insu
rance
nee
ds
to d
eter
min
e if
you
shou
ld c
onti
nue
any O
HI
pla
ns,
Med
icare
supple
men
ts, and M
edic
are
Advanta
ge
Pla
ns.
You m
ay c
onta
ct y
ou
r lo
cal
Sta
te
11
Hea
lth I
nsu
rance
Ass
ista
nce
Pro
gra
m
for
free
hea
lth i
nsu
rance
cou
nse
ling
and a
ssis
tance
.
Note
: If
you d
rop y
ou
r O
HI
cover
age,
you
must
noti
fy W
PS
.
I a
m a
TF
L b
enefi
cia
ry a
nd
a r
etir
ed
fed
era
l em
plo
yee
. C
an
I s
usp
end
my
Fed
era
l E
mp
loyee
s H
ea
lth
Ben
efi
ts
(FE
HB
) p
rogra
m c
over
age
to u
se T
FL
?
Yes
. Y
ou m
ay s
usp
end y
ou
r F
EH
B
cover
age
and p
rem
ium
pay
men
ts a
t any
tim
e. V
isit
ww
w.o
pm
.gov/f
orm
s to
get
a
Hea
lth B
enefi
ts E
lect
ion F
orm
(S
F 2
80
9).
Eli
gib
le u
nre
marr
ied f
orm
er s
pouse
s ca
n
get
the
form
fro
m t
he
emplo
yin
g o
ffice
s
or
reti
rem
ent
syst
em m
ain
tain
ing t
hei
r
enro
llm
ents
.
Is a
ref
erra
l or
TR
ICA
RE
prio
r
au
thoriz
ati
on
req
uir
ed f
or
hea
lth
care
ser
vic
es?
A r
efer
ral or
TR
ICA
RE
pri
or
auth
ori
zati
on
is n
ot
requ
ired
under
TF
L w
hen
Med
icare
is t
he
pri
mary
pay
er. H
ow
ever
, w
hen
TF
L
bec
om
es t
he
pri
mary
pay
er, T
RIC
AR
E
auth
ori
zati
on r
equ
irem
ents
apply
as
they
would
for
a T
RIC
AR
E S
tandar
d b
enefi
ciar
y.
I w
as
enro
lled
in
TR
ICA
RE
Prim
e at
a m
ilit
ary t
reatm
ent
faci
lity
(M
TF
).
I re
ceiv
ed a
let
ter
from
th
e M
TF
tell
ing m
e I
wa
s n
o l
on
ger
eli
gib
le f
or
enro
llm
ent
in T
RIC
AR
E P
rim
e. W
hat
does
that
mea
n?
Once
you b
ecom
e en
titl
ed t
o p
rem
ium
fre
e
Med
icare
Part
A b
ecau
se y
ou a
re a
ge
65,
you a
re e
lig
ible
for
TF
L w
hen
you a
lso
hav
e M
edic
are
Part
B. Y
ou a
re n
o l
onger
elig
ible
for
enro
llm
ent
in T
RIC
AR
E P
rim
e,
un
less
you h
ave
an a
ctiv
e duty
sponso
r.
You m
ay c
onti
nue
to s
eek c
are
at
an M
TF
on a
spac
eav
ail
able
bas
is, but
wil
l li
kel
y
nee
d t
o s
eek c
are
fro
m c
ivil
ian M
edic
are
pro
vid
ers.
When
you v
isit
civ
ilia
n M
edic
are
pro
vid
ers,
you h
ave
no o
ut
of
po
cket
cost
s
for
serv
ices
cover
ed b
y b
oth
Med
icare
and
TR
ICA
RE
. Conta
ct M
edic
are
for
assi
stan
ce
wit
h fi
nd
ing M
edic
are
cer
tifi
ed p
rovid
ers.
You m
ay b
e ab
le t
o s
ign u
p f
or
TR
ICA
RE
Plu
s. T
RIC
AR
E P
lus
is a
pro
gra
m t
hat
allo
ws
ben
efici
ari
es w
ho n
orm
ally
are
on
ly
able
to g
et M
TF
care
on a
spac
eav
ail
able
bas
is t
o e
nro
ll a
nd r
ecei
ve
pri
mary
care
appoin
tmen
ts a
t th
e M
TF
wit
hin
the
sam
e pri
mary
care
acc
ess
stand
ard
s as
ben
efici
ari
es e
nro
lled
in a
TR
ICA
RE
Pri
me
opti
on. B
enefi
ciari
es s
hould
conta
ct
thei
r lo
cal
MT
Fs
to d
eter
min
e if
they
may
part
icip
ate
in T
RIC
AR
E P
lus.
En
roll
men
t in
TR
ICA
RE
Plu
s at
one
MT
F
do
es n
ot
auto
mat
icall
y e
xte
nd T
RIC
AR
E
Plu
s en
roll
men
t to
anoth
er M
TF. T
he
MT
F
is n
ot
resp
onsi
ble
for
any c
ost
s w
hen
a
TR
ICA
RE
Plu
s en
roll
ee i
s re
ferr
ed o
uts
ide
the
MT
F f
or
add
itio
nal
civil
ian c
are
.
SECTION 1
HOW TRICARE FOR LIFE WORKS
22
Cla
ims
Healt
h C
are C
laim
s
In m
ost
cas
es, yo
ur
pro
vid
er fi
les
your
hea
lth
care
cla
ims
wit
h M
edic
are
firs
t. M
edic
are
pay
s it
s port
ion a
nd
, u
nle
ss y
ou h
ave
oth
er
hea
lth i
nsu
rance
(O
HI)
, fo
rward
s th
e cl
aim
to T
RIC
AR
E F
or
Lif
e (T
FL
) fo
r pro
cess
ing.
How
ever
, w
hen
TF
L i
s th
e pri
mary
pay
er
(e.g
., i
f M
edic
are
does
not
cove
r th
e h
ealt
h
care
ser
vice
), y
ou
r pro
vid
er m
ay b
e re
quir
ed
to fi
le y
ou
r cl
aim
dir
ectl
y w
ith W
isco
nsi
n
Physi
cian
s S
ervic
e (W
PS
)/T
FL
. If
you h
ave
OH
I, y
ou m
ust
file
the
claim
wit
h y
ou
r O
HI
bef
ore
fili
ng w
ith T
FL
.
You a
re r
esponsi
ble
for
mak
ing s
ure
you
r cl
aim
s are
file
d w
ith
in o
ne
yea
r of
eith
er t
he
dat
e of
serv
ice
or
the
dat
e of
an i
npat
ient
dis
charg
e. T
o fi
le a
cla
im
wit
h T
FL
, fi
ll o
ut
a T
RIC
AR
E D
oD
/
CH
AM
PU
S M
edic
al
Cla
im—
Pa
tien
t’s
Req
ues
t fo
r M
edic
al
Pa
ymen
t fo
rm
(DD
Form
26
42)
. Y
ou c
an d
ow
nlo
ad
form
s and i
nst
ruct
ions
from
TR
ICA
RE
at w
ww
.tric
are
.mil
/cla
ims
or
the
WP
S
Web
sit
e at
ww
w.T
RIC
AR
E4u
.com
.
You c
an a
lso o
bta
in f
orm
s an
d i
nst
ruct
ions
at a
TR
ICA
RE
Ser
vic
e C
ente
r (T
SC
) or
a m
ilit
ary
tre
atm
ent
faci
lity
(M
TF
). F
ill
out
the
form
com
ple
tely
and s
ign i
t. V
isit
ww
w.t
ric
are
.mil
/con
tact
us
to l
oca
te a
TS
C o
r M
TF.
When
fili
ng a
cla
im w
ith T
FL
, in
clude
you
r M
edic
are
Su
mm
ary
Noti
ce a
nd O
HI
expla
nat
ion o
f ben
efits
(E
OB
), i
f ap
pli
cable
.
Att
ach a
rea
dab
le c
opy o
f th
e pro
vid
er’s
bil
l to
the
claim
form
, m
ak
ing s
ure
it
conta
ins
the
foll
ow
ing:
• P
atie
nt’s
nam
e
• S
ponso
r’s
So
cial
Sec
uri
ty n
um
ber
(S
SN
)
or
Dep
art
men
t of
Def
ense
Ben
efits
Nu
mb
er (
DB
N)
(Eli
gib
le f
orm
er s
pou
ses
shou
ld u
se t
hei
r ow
n S
SN
s or
DB
Ns,
not
thei
r sp
on
sors
’.)
• P
rovid
er’s
nam
e an
d a
dd
ress
(If
more
than
on
e pro
vid
er’s
na
me
is o
n t
he
bil
l, c
ircl
e
the
na
me
of
the
per
son w
ho p
rovi
ded
th
e
serv
ice
for
wh
ich t
he
cla
im i
s fi
led
.)
• D
ate
and p
lace
of
each
ser
vic
e
• D
escr
ipti
on o
f ea
ch s
ervic
e or
supply
fu
rnis
hed
• C
harg
e fo
r ea
ch s
ervic
e
• D
iag
nosi
s (I
f th
e dia
gn
osi
s is
not
on
the
bil
l, b
e su
re t
o c
om
ple
te b
lock
8a
on t
he
form
.)
Un
like
oth
er T
RIC
AR
E b
enefi
ciari
es, T
FL
ben
efici
arie
s sh
ould
file
cla
ims
in the
regio
ns
wher
e th
ey r
ecei
ved
care
. S
end c
laim
s to
the
appro
pri
ate
ing a
dd
ress
pro
vid
ed
in “
Import
ant
Conta
ct I
nfo
rmat
ion”
at t
he
beg
inn
ing o
f th
is h
andbook.
Appealing a
Cla
im o
r
Auth
oriz
ati
on D
enia
l
You m
ay a
pp
eal
auth
ori
zati
on d
enia
ls o
f
reques
ted s
ervic
es o
r dec
isio
ns
regard
ing
claim
s pay
men
ts. M
edic
are
and T
FL
hav
e
separa
te a
pp
eals
pro
cess
es. M
edic
are
rela
ted a
pp
eals
shou
ld b
e su
bm
itte
d t
o
Med
icare
. Y
ou s
hou
ld o
nly
subm
it a
pp
eals
to W
PS
if
TF
L i
s th
e pri
mary
pay
er.
21
(Am
eric
an S
am
oa
,* G
ua
m, th
e N
ort
her
n
Mari
an
a I
sla
nd
s, P
uer
to R
ico, a
nd t
he
U.S
. V
irgin
Isl
an
ds)
, you m
ust
pay
the
full
pri
ce o
f you
r pre
scri
pti
on u
p f
ront
and fi
le
a cl
aim
for
reim
bu
rsem
ent.
If y
ou l
ive
in t
he
Ph
ilip
pin
es, you a
re
requ
ired
to v
isit
a c
erti
fied
pharm
acy.
A
cert
ified
pharm
acy h
as b
een v
erifi
ed t
o
mee
t re
qu
ired
TO
P c
ontr
act
stand
ard
s
and i
s all
ow
ed t
o i
nvoic
e T
RIC
AR
E f
or
TR
ICA
RE
ben
efici
ary
cla
ims.
* C
urr
en
tly,
th
ere
are
no T
RIC
AR
E r
eta
il
net
work
ph
arm
aci
es i
n A
mer
ica
n S
am
oa
.
To fi
le a
cla
im:
1.
Dow
nlo
ad T
RIC
AR
E D
oD
/CH
AM
PU
S
Med
ica
l C
laim
Pa
tien
t’s
Req
ues
t fo
r
Med
ical P
aym
ent fo
rm (
DD
Form
26
42)
at w
ww
.tric
are
.mil
/cla
ims.
2.
Com
ple
te t
he
form
and a
ttac
h t
he
requ
ired
pap
erw
ork
as
des
crib
ed o
n
the
form
.
3.
the
form
and p
aper
work
to:
Expre
ss S
crip
ts, In
c.
TR
ICA
RE
Cla
ims
P.O
. B
ox 5
2132
Pho
enix
, A
Z 8
5082
Pre
scri
pti
on c
laim
s re
qu
ire
the
foll
ow
ing
info
rmat
ion f
or
each
dru
g:
• P
atie
nt’s
nam
e
• P
resc
ripti
on n
am
e, s
tren
gth
, d
ate
fill
ed,
day
s’ s
upply
, quan
tity
dis
pen
sed, a
nd p
rice
• N
atio
nal
Dru
g C
ode,
if
avail
able
• P
resc
ripti
on n
um
ber
• N
am
e and a
dd
ress
of
the
pharm
acy
• N
am
e and a
dd
ress
of
the
pre
scri
bin
g
physi
cian
Conta
ct E
xpre
ss S
crip
ts a
t 18
773
63
13
03
wit
h q
ues
tions
about fi
ling p
har
mac
y c
laim
s.
Ph
arm
acy C
laim
s A
pp
eals
If y
ou d
isag
ree
wit
h t
he
det
erm
inat
ion
on y
ou
r pharm
acy c
laim
(i.
e., i
f yo
ur
cla
im i
s d
enie
d),
you o
r you
r ap
poin
ted
repre
senta
tive
has
the
rig
ht
to r
eques
t a
reco
nsi
der
atio
n. T
he
reques
t (o
r a
ppea
l)
for
reco
nsi
der
atio
n m
ust
be
in w
riti
ng,
sig
ned
, and p
ost
mark
ed o
r re
ceiv
ed b
y
Expre
ss S
crip
ts w
ith
in 9
0 c
ale
nd
ar
day
s
from
the
dat
e of
the
dec
isio
n a
nd m
ust
incl
ude
a co
py o
f th
e cl
aim
dec
isio
n.
You
r si
gned
, w
ritt
en r
eques
t m
ust
sta
te t
he
spec
ific
mat
ter
you d
isag
ree
wit
h a
nd m
ust
be
sent to
the
foll
ow
ing a
dd
ress
no lat
er than
90 d
ays
from
the
dat
e of
the
noti
ce:
Expre
ss S
crip
ts, In
c.
P.O
. B
ox 6
09
03
Pho
enix
, A
Z 8
50820
903
Add
itio
nal do
cum
enta
tion i
n s
upport
of
the
appea
l m
ay b
e su
bm
itte
d;
how
ever
, bec
ause
the
reques
t fo
r re
consi
der
atio
n m
ust
be
post
mark
ed o
r re
ceiv
ed w
ith
in 9
0 c
ale
nd
ar
day
s of
the
dat
e of
the
dec
isio
n, do n
ot del
ay
the
reques
t fo
r re
consi
der
atio
n f
or
the
sake
of
add
itio
nal
do
cum
enta
tion. If
add
itio
nal
do
cum
enta
tion w
ill
be
subm
itte
d a
t a
late
r
dat
e, t
he
lett
er r
eques
ting r
econsi
der
atio
n
must
sta
te t
hat
add
itio
nal
do
cum
enta
tion
wil
l b
e su
bm
itte
d a
nd s
pec
ify t
he
exp
ecte
d
dat
e of
subm
issi
on. U
pon r
ecei
vin
g y
ou
r
reques
t, a
ll T
RIC
AR
E c
laim
s re
late
d t
o
the
enti
re c
ou
rse
of
trea
tmen
t are
rev
iew
ed.
SECTION 4
PHARMACY
12
Gett
ing
Care
Fin
din
g a
Provid
er
You m
ay r
ecei
ve
hea
lth c
are
ser
vic
es f
rom
Med
icar
epar
tici
pat
ing a
nd n
onpar
tici
pat
ing
pro
vid
ers,
as
wel
l as
fro
m p
rovid
ers
who
hav
e opte
d o
ut
of
Med
icare
. If
TR
ICA
RE
For
Lif
e (T
FL
) is
the
pri
mary
pay
er, you
must
vis
it T
RIC
AR
Ea
uth
ori
zed p
rovid
ers
and f
acil
itie
s. Y
ou w
ill
incu
r h
igher
out
of
po
cket
cost
s w
hen
you o
bta
in c
are
fro
m
opt
out
pro
vid
ers
or
Vet
erans
Aff
air
s (V
A)
pro
vid
ers.
Cost
s vary
acc
ord
ing t
o t
he
typ
e
of
pro
vid
er y
ou s
ee (
i.e., p
art
icip
ati
ng,
no
np
art
icip
ati
ng, opt
ou
t, V
A).
Med
icare
-Part
icip
ati
ng
Pro
vid
ers
Med
icare
part
icip
atin
g p
rovid
ers
agre
e to
acce
pt
the
Med
icare
appro
ved
am
ou
nt
as
pay
men
t in
fu
ll.
Med
icare
No
np
art
icip
ati
ng
Pro
vid
ers
Nonpart
icip
atin
g p
rovid
ers
do n
ot
acce
pt
the
Med
icare
appro
ved
am
ou
nt as
pay
men
t
in f
ull
. T
hey
may
charg
e up t
o 1
15 p
erce
nt
of
the
Med
icar
eap
pro
ved a
mount. T
FL
pay
s
up t
o t
he
115
per
cent
lim
itin
g c
harg
e.
Op
t-O
ut
Pro
vid
ers
Pro
vid
ers
who o
pt
out
of
Med
icare
ente
r
into
pri
vat
e co
ntr
acts
wit
h p
atie
nts
and a
re
not
all
ow
ed t
o b
ill
Med
icare
. T
her
efore
,
Med
icare
do
es n
ot
pay
for
hea
lth c
are
serv
ices
you r
ecei
ve
from
opt
out
pro
vid
ers.
When
you s
ee a
n o
pt
out
pro
vid
er, T
FL
pay
s th
e am
ou
nt
it w
ou
ld h
ave
paid
if
Med
icar
e had
pro
cess
ed the
clai
m (norm
all
y
20 p
erce
nt
of
the
all
ow
able
ch
arg
e) a
nd
you a
re r
esponsi
ble
for
pay
ing the
rem
ainder
of
the
bil
led c
harg
es. In
cas
es w
her
e ac
cess
to m
edic
al c
are
is
lim
ited
(i.
e., u
nder
serv
ed
are
as)
, T
FL
may
waiv
e th
e se
condp
ayer
stat
us
for
Med
icare
opt
out
pro
vid
ers
and
pay
the
claim
as
the
pri
mary
pay
er.
Vete
ran
s A
ffair
s P
rovid
ers
Med
icare
can
not
pay
for
serv
ices
rec
eived
from
VA
. T
her
efore
, T
RIC
AR
E i
s th
e
pri
mary
pay
er f
or
VA
cla
ims
and y
ou w
ill
be
resp
onsi
ble
for
the
TR
ICA
RE
an
nual
ded
uct
ible
and c
ost
share
s. A
lter
nat
ivel
y,
you m
ay c
hoose
to u
se y
ou
r V
A b
enefi
t.
Mil
itary
Tre
atm
en
t Facil
itie
s
A m
ilit
ary
tre
atm
ent
faci
lity
(M
TF
) is
a
mil
itary
hosp
ital
or
clin
ic u
suall
y l
oca
ted
on o
r nea
r a
mil
itary
bas
e. Y
ou m
ay r
ecei
ve
care
at
an M
TF
on a
spac
eav
ail
able
bas
is.
See
Fig
ure
2.1
for
MT
F a
ppoin
tmen
t
pri
ori
ties
.
MT
F A
pp
oin
tmen
t P
rio
riti
es
Fig
ure
2.1
1A
ctiv
e duty
ser
vic
e m
emb
ers
2A
ctiv
e duty
fam
ily
mem
ber
s (A
DF
Ms)
enro
lled
in
TR
ICA
RE
Pri
me
3R
etir
ed s
erv
ice
mem
ber
s, t
hei
r fa
mil
ies,
and
all
oth
ers
enro
lled
in
TR
ICA
RE
Pri
me
or
TR
ICA
RE
Plu
s
4A
DF
Ms
not en
roll
ed in T
RIC
AR
E P
rim
e
TR
ICA
RE
Res
erve
Sel
ect
mem
ber
s and
thei
r fa
mil
ies
5R
etir
ed s
erv
ice
mem
ber
s, t
hei
r fa
mil
ies,
TR
ICA
RE
Ret
ired
Res
erve
mem
ber
s and
thei
r fa
mil
ies,
and
all
oth
ers
not
enro
lled
in T
RIC
AR
E P
rim
e
13
Overs
ea
s P
rovid
ers
Wit
h T
FL
over
seas
, you m
ay g
ener
all
y u
se
any h
ost
nat
ion p
rovid
er a
nd r
ecei
ve
care
at M
TF
s on a
spac
eav
ail
able
bas
is, u
nle
ss
reg
ion
or
cou
ntr
ys
pec
ific
requ
irem
ents
apply
. W
hen
see
kin
g c
are
fro
m a
host
nat
ion p
rovid
er, you s
hou
ld b
e pre
pare
d
to p
ay u
p f
ront
for
serv
ices
and s
ubm
it a
clai
m t
o t
he
TR
ICA
RE
Over
seas
Pro
gra
m
(TO
P)
claim
s pro
cess
or.
For
more
info
rmat
ion a
bout
get
ting c
are
over
seas
,
call
you
r T
OP
Reg
ional
Call
Cen
ter
or
vis
it w
ww
.tric
are
over
sea
s.co
m.
Em
ergency C
are
TR
ICA
RE
defi
nes
an e
mer
gen
cy a
s a
med
ical
, m
ater
nit
y, o
r psy
chia
tric
condit
ion
that
wou
ld l
ead a
“pru
den
t la
yp
erso
n”
(som
eone
wit
h a
vera
ge
know
ledge
of
hea
lth
an
d m
edic
ine)
to b
elie
ve
that
a s
erio
us
med
ical
condit
ion e
xis
ts; th
at t
he
abse
nce
of
imm
edia
te m
edic
al a
tten
tion w
ould
res
ult
in
a th
reat
to l
ife,
lim
b, or
sight;
when
a p
erso
n
has
sev
ere,
pain
ful
sym
pto
ms
requ
irin
g
imm
edia
te a
tten
tion t
o r
elie
ve
suff
erin
g;
or
when
a p
erso
n i
s at
im
med
iate
ris
k t
o s
elf
or
oth
ers.
The
TR
ICA
RE
hea
lth c
are
ben
efit
cover
s ad
junct
ive
den
tal
care
(i.
e., d
enta
l
care
th
at
is m
edic
all
y n
eces
sary
to t
rea
t
a c
ove
red m
edic
al—
not den
tal—
condit
ion)
.
The
TR
ICA
RE
hea
lth c
are
ben
efit
do
es
not
cover
nona
dju
nct
ive
den
tal
care
,
wh
ich r
efer
s to
any r
outi
ne,
pre
ven
tive,
rest
ora
tive,
pro
stho
donti
c, p
erio
donti
c,
or
emer
gen
cy d
enta
l ca
re t
hat
is
not
rela
ted t
o a
med
ical
cond
itio
n. E
lig
ible
TR
ICA
RE
ben
efici
ari
es m
ay r
ecei
ve
nona
dju
nct
ive
den
tal
serv
ices
if
enro
lled
in t
he
TR
ICA
RE
Den
tal
Pro
gra
m o
r th
e
TR
ICA
RE
Ret
iree
Den
tal
Pro
gra
m.
If y
ou n
eed e
mer
gen
cy c
are
, ca
ll 9
11 o
r go
to t
he
nea
rest
em
ergen
cy r
oom
. M
ake
sure
you p
rese
nt yo
ur
Med
icare
card
so t
hat
you
r
claim
is
file
d w
ith M
edic
are
.
If t
ravel
ing o
r li
vin
g o
ver
seas
, fi
rst
atte
mpt
to s
eek c
are
fro
m t
he
nea
rest
MT
F. If
an
MT
F i
s not
avail
able
, se
ek c
are
fro
m t
he
nea
rest
em
ergen
cy r
oom
. Y
ou c
an c
onta
ct
the
TO
P R
egio
nal
Call
Cen
ter
for
you
r
reg
ion f
or
assi
stance
in fi
nd
ing a
host
nat
ion p
rovid
er.
Note
: M
ost
den
tal
cond
itio
ns
that
may
be
consi
der
ed e
mer
gen
cies
are
not
cover
ed
under
Med
icare
or
TF
L.
Urgent
Care
Urg
ent
care
ser
vic
es a
re m
edic
all
y
nec
essa
ry s
ervic
es r
equ
ired
for
an i
llnes
s
or
inju
ry t
hat
wou
ld n
ot
resu
lt i
n f
urt
her
SECTION 2
GETTING CARE
20
ww
w.p
ec.h
a.o
sd.m
il/f
orm
s_cr
iter
ia.p
hp
for
form
s and m
edic
al
nec
essi
ty c
rite
ria.
For
info
rmat
ion o
n h
ow
to s
ave
money
and
make
the
most
of
you
r pharm
acy b
enefi
t,
vis
it w
ww
.tric
are
.mil
/ph
arm
acy
or
ww
w.e
xp
ress
scr
ipts
.com
/TR
ICA
RE
.
Sp
ecia
lty M
ed
icati
on
C
are
Man
ag
em
en
t
Spec
ialt
y m
edic
atio
ns
are
usu
ally
hig
hc
ost
;
self
adm
inis
tere
d; in
ject
able
, ora
l, o
r in
fuse
d
dru
gs
that
tre
at s
erio
us
chro
nic
cond
itio
ns
(e.g
., m
ult
iple
scl
erosi
s, r
heu
mato
id a
rthri
tis,
hep
ati
tis
C).
Thes
e d
rugs
typic
all
y r
equ
ire
spec
ial
stora
ge
and h
and
ling a
nd a
re n
ot
read
ily a
vail
able
at
you
r lo
cal
pharm
acy.
Sp
ecia
lty m
edic
atio
ns
may
als
o h
ave
side
effe
cts
that
req
uir
e pharm
acis
t and
/or
nu
rse
mon
itori
ng.
The
Sp
ecia
lty M
edic
atio
n C
are
Manag
emen
t pro
gra
m i
s st
ruct
ure
d t
o
impro
ve
you
r hea
lth t
hro
ug
h c
onti
nuous
hea
lth e
valu
atio
n, ongoin
g m
on
itori
ng,
asse
ssm
ent
of
educa
tional
nee
ds,
and
med
icat
ionu
se m
anag
emen
t. T
his
pro
gra
m p
rovid
es:
• A
cces
s to
pro
acti
ve,
cli
nic
all
y b
ased
serv
ices
for
spec
ific
dis
ease
s and i
s
des
igned
to h
elp y
ou g
et t
he
most
ben
efit
from
you
r m
edic
atio
n
• M
onth
ly r
efill
rem
inder
call
s
• S
ched
ule
d d
eliv
erie
s to
spec
ified
loca
tions
• S
pec
ialt
y c
onsu
ltat
ion w
ith a
nu
rse
or
pharm
acis
t at
any p
oin
t du
ring
you
r th
erap
y
Thes
e se
rvic
es a
re p
rov
ided
to
you
at
no a
dd
itio
nal
cost
when
you r
ecei
ve
you
r
med
icat
ions
thro
ug
h T
RIC
AR
E P
harm
acy
Hom
e D
eliv
ery.
Part
icip
atio
n i
s volu
nta
ry.
If y
ou o
r you
r pro
vid
er o
rder
s a
spec
ialt
y
med
icat
ion f
rom
TR
ICA
RE
Pharm
acy
Hom
e D
eliv
ery,
Expre
ss S
crip
ts s
ends
you
add
itio
nal
info
rmat
ion a
bout
the
Sp
ecia
lty
Med
icat
ion C
are
Man
agem
ent pro
gra
m a
nd
how
to g
et s
tart
ed.
Usi
ng T
RIC
AR
E P
harm
acy H
om
e D
eliv
ery
to fi
ll s
pec
ialt
y m
edic
atio
n p
resc
ripti
ons
pro
vid
es y
ou w
ith a
cces
s to
the
Sp
ecia
lty
Med
icat
ion C
are
Manag
emen
t pro
gra
m
ben
efits
pre
vio
usl
y d
escr
ibed
. W
ith s
pec
ific
ing i
nst
ruct
ions
from
you o
r you
r
pro
vid
er, T
RIC
AR
E P
harm
acy H
om
e
Del
iver
y s
hip
s you
r sp
ecia
lty m
edic
atio
n
to y
ou
r hom
e. F
or
you
r co
nven
ience
and
safe
ty, T
RIC
AR
E P
har
mac
y H
om
e D
eliv
ery
conta
cts
you t
o a
rrange
del
iver
y b
efore
the
med
icat
ion i
s sh
ipp
ed.
Note
: S
om
e sp
ecia
lty m
edic
atio
ns
may
not
be
avail
able
th
roug
h T
RIC
AR
E P
harm
acy
Hom
e D
eliv
ery b
ecau
se t
he
med
icat
ion’
s
manu
fact
ure
r li
mit
s th
e d
rug’s
dis
trib
uti
on
to s
pec
ific
pharm
acie
s. I
f you s
ubm
it a
pre
scri
pti
on f
or
a li
mit
edd
istr
ibuti
on
med
icat
ion, T
RIC
AR
E P
harm
acy H
om
e
Del
iver
y e
ither
forw
ard
s you
r pre
scri
pti
on
to a
pharm
acy o
f you
r ch
oic
e th
at c
an fi
ll
it o
r pro
vid
es y
ou w
ith i
nst
ruct
ions
about
wher
e to
sen
d t
he
pre
scri
pti
on t
o h
ave
it fi
lled
.
Pharm
acy C
laim
s
You d
o n
ot
nee
d t
o fi
le p
harm
acy c
laim
s
for
pre
scri
pti
ons
fill
ed a
t M
TF
pharm
acie
s,
thro
ug
h T
RIC
AR
E P
harm
acy H
om
e
Del
iver
y, o
r at
TR
ICA
RE
ret
ail
net
work
pharm
acie
s. H
ow
ever
, if
you fi
ll a
pre
scri
pti
on a
t a
nonn
etw
ork
pharm
acy
in t
he
Un
ited
Sta
tes
or
U.S
. te
rrit
ori
es
19
Pharm
acy P
olicy
Qu
an
tity
Lim
its
TR
ICA
RE
has
est
abli
shed
quanti
ty l
imit
s
on c
erta
in m
edic
atio
ns,
wh
ich m
eans
the
Dep
art
men
t of
Def
ense
(D
oD
) pay
s fo
r a
spec
ified
, li
mit
ed a
mou
nt
of
med
icat
ion
each
tim
e you fi
ll a
pre
scri
pti
on. Q
uanti
ty
lim
its
are
oft
en a
ppli
ed to
ensu
re m
edic
atio
ns
are
safe
ly a
nd a
ppro
pri
atel
y u
sed.
Exce
pti
ons
to e
stab
lish
ed q
uanti
ty l
imit
s
may
be
mad
e if
the
pre
scri
bin
g p
rovid
er
can just
ify m
edic
al n
eces
sity
, or,
in c
ases
of
nat
ura
l dis
aste
rs, a
s ap
pro
ved b
y T
RIC
AR
E.
Pri
or
Au
tho
rizati
on
Som
e d
rugs
requ
ire
pri
or
auth
ori
zati
on
from
Expre
ss S
crip
ts.
Med
icat
ion
s
requ
irin
g p
rior
auth
ori
zati
on m
ay i
ncl
ude,
but
are
not
lim
ited
to,
pre
scri
pti
on
dru
gs
speci
fied
by
the
DoD
Pharm
acy
and
Ther
apeu
tics
(P&
T)
Com
mit
tee,
bra
nd
nam
e m
edic
atio
ns
wit
h g
ener
ic e
qu
ivale
nts
,
med
icat
ion
s w
ith
age
lim
itat
ion
s, a
nd
med
icat
ion
s pre
scri
bed
for
qu
anti
ties
exce
ed
ing
norm
al
lim
its.
If
you
do
not
hav
e In
tern
et a
cces
s, c
all
18
773
63
13
03
to i
nqu
ire
about
a sp
ecifi
c d
rug.
Gen
eri
c D
rug
-Use P
oli
cy
Gen
eric
dru
gs
are
med
icat
ions
appro
ved
by t
he
U.S
. F
oo
d a
nd D
rug A
dm
inis
trat
ion
and a
re c
lin
ical
ly e
quiv
alen
t to
bra
ndn
ame
med
icat
ions.
Gen
eric
dru
gs
pro
vid
e th
e sa
me
safe
, ef
fect
ive
trea
tmen
t as
bra
ndn
am
e
dru
gs.
It
is D
oD
poli
cy t
o u
se g
ener
ic
med
icat
ions
inst
ead o
f bra
ndn
am
e
med
icat
ions
when
ever
poss
ible
. A
bra
nd
nam
e d
rug w
ith a
gen
eric
equ
ivale
nt
may
be
dis
pen
sed o
nly
aft
er t
he
pre
scri
bin
g
physi
cian c
om
ple
tes
a cl
inic
al
asse
ssm
ent
indic
atin
g the
bra
ndn
ame
dru
g is
med
ical
ly
nec
essa
ry a
nd a
fter
Expre
ss S
crip
ts
gra
nts
appro
val.
Pre
scri
ber
s m
ay c
all
18
66
68
44
48
8 t
o s
ubm
it a
req
ues
t
for
a bra
ndn
am
e d
rug t
o b
e d
isp
ense
d
inst
ead o
f a
gen
eric
, or
a co
mple
ted f
orm
may
be
faxed
to:
18
66
68
44
477.
The
Bra
nd o
ver
Gen
eric
Pri
or
Au
thori
zati
on
Req
ues
t F
orm
may
be
fou
nd a
t
ww
w.p
ec.h
a.o
sd.m
il/f
orm
s_cr
iter
ia.p
hp
.
If a
gen
eric
equ
ivale
nt
dru
g d
oes
not
exis
t,
the
bra
ndn
am
e d
rug i
s d
isp
ense
d a
t th
e
bra
ndn
am
e co
pay
men
t.
If y
ou fi
ll a
pre
scri
pti
on w
ith a
bra
ndn
ame
dru
g t
hat
is
not
consi
der
ed m
edic
all
y
nec
essa
ry a
nd w
hen
a g
ener
ic e
qu
ivale
nt
is a
vail
able
, you a
re r
esponsi
ble
for
pay
ing
the
enti
re c
ost
of
the
pre
scri
pti
on.
No
n-F
orm
ula
ry D
rug
s
The
DoD
P&
T C
om
mit
tee
may
rec
om
men
d
to t
he
dir
ecto
r of
TR
ICA
RE
Manag
emen
t
Act
ivit
y t
hat
cer
tain
dru
gs
be
pla
ced i
n
the
thir
d, “n
onf
orm
ula
ry”
tier
. T
hes
e
med
icat
ions
incl
ude
any d
rug i
n a
ther
apeu
tic
clas
s det
erm
ined
to b
e le
ss
rela
tivel
y c
lin
icall
y e
ffec
tive
or
cost
effe
ctiv
e th
an o
ther
dru
gs
in t
he
sam
e
clas
s. F
or
an a
dd
itio
nal
cost
, th
irdt
ier
dru
gs
are
avail
able
th
roug
h T
RIC
AR
E
Pharm
acy H
om
e D
eliv
ery o
r re
tail
net
work
pharm
acie
s. Y
ou m
ay b
e ab
le t
o fi
ll n
on
form
ula
ry p
resc
ripti
ons
at f
orm
ula
ry
cost
s if
you
r pro
vid
er c
an e
stab
lish
med
ical
nec
essi
ty b
y c
om
ple
ting a
nd
subm
itti
ng t
he
appro
pri
ate
TR
ICA
RE
pharm
acy m
edic
al
nec
essi
ty f
orm
for
the
nonf
orm
ula
ry m
edic
atio
n. C
all
Expre
ss S
crip
ts a
t 18
773
63
13
03 o
r vis
it
SECTION 4
PHARMACY
14
dis
abil
ity o
r dea
th if
not tr
eate
d im
med
iate
ly,
but
do
es r
equ
ire
pro
fess
ional
atte
nti
on
wit
hin
24 h
ou
rs. Y
ou c
ou
ld r
equ
ire
urg
ent
care
for
cond
itio
ns
such
as
a sp
rain
, so
re
thro
at, or
risi
ng t
emp
erat
ure
, as
eac
h o
f
thes
e has
the
pote
nti
al
to d
evel
op i
nto
an
emer
gen
cy i
f tr
eatm
ent
is d
elay
ed l
onger
than 2
4 h
ou
rs.
Behavio
ral H
ealt
h C
are
Med
icare
hel
ps
cover
vis
its
wit
h t
he
foll
ow
ing t
yp
es o
f hea
lth c
are
pro
vid
ers:
• A
psy
chia
tris
t or
oth
er d
oct
or
• C
lin
ical
psy
cholo
gis
t
• C
lin
ical
soci
al
work
er
• C
lin
ical
nu
rse
spec
iali
st
• N
urs
e pra
ctit
ioner
• P
hysi
cian’
s as
sist
ant
Med
icare
on
ly c
over
s th
ese
vis
its
when
they
are
pro
vid
ed b
y h
ealt
h c
are
pro
vid
ers
who a
ccep
t M
edic
are
pay
men
t. T
o p
ay e
ven
less
, you s
hou
ld a
lso a
sk y
ou
r hea
lth c
are
pro
vid
ers
if t
hey
acc
ept
assi
gn
men
t, w
hic
h
mea
ns
they
acc
ept
the
Med
icare
appro
ved
am
ou
nt
as p
aym
ent
in f
ull
, b
efore
you
sched
ule
an a
ppoin
tmen
t.
For
more
in
form
atio
n o
n M
edic
are
’s
beh
avio
ral
hea
lth c
are
cover
age,
vis
it
ww
w.m
edic
are
.gov.
Prio
r A
uth
oriz
ati
on f
or C
are
When
TF
L b
ecom
es t
he
pri
mary
pay
er
(e.g
., i
f yo
ur
Med
icare
ben
efits
are
exh
au
sted
), T
RIC
AR
E p
rior
auth
ori
zati
on
requ
irem
ents
apply
.
Pri
or
auth
ori
zati
on i
s a
revie
w o
f th
e
reques
ted h
ealt
h c
are
ser
vic
e to
det
erm
ine
if it
is m
edic
all
y n
eces
sary
at
the
reques
ted
level
of
care
. If
you h
ave
an a
uth
ori
zati
on
from
a T
RIC
AR
E r
egio
nal
contr
act
or
(Hea
lth
Net
Fed
era
l S
ervi
ces,
LL
C;
Hu
ma
na
Mil
ita
ry;
Un
ited
Hea
lth
ca
re
Mil
itary
& V
eter
an
s; o
r In
tern
ati
on
al
SO
S
Ass
ista
nce
, In
c.) t
hat
cover
s th
e d
ates
on
you
r cl
aim
, W
isco
nsi
n P
hysi
cians
Ser
vic
e
(WP
S)
wil
l honor
those
auth
ori
zati
on
s
and n
o T
FL
auth
ori
zati
on i
s re
qu
ired
. T
he
TR
ICA
RE
For
Lif
e A
uth
ori
zati
on R
equ
est
form
is
avail
able
on
the
WP
S W
eb s
ite.
Pro
vid
ers
shou
ld fi
ll o
ut
the
TR
ICA
RE
For
Lif
e A
uth
ori
zati
on R
equ
est
form
and
subm
it i
t to
the
fax n
um
ber
pro
vid
ed i
n
the
top r
ight
corn
er o
f th
e fo
rm.
If y
ou h
ave
ques
tions
about
auth
ori
zati
on
requ
irem
ents
, co
nta
ct W
PS
.
The
foll
ow
ing s
ervic
es r
equ
ire
pri
or
auth
ori
zati
on:
• A
dju
nct
ive
den
tal
serv
ices
• A
ll o
utp
atie
nt
beh
avio
ral
hea
lth c
are
aft
er t
he
firs
t ei
ght
sess
ions
in a
fisc
al
yea
r (O
ctober
1–
Sep
tem
ber
30)
from
an a
uth
ori
zed
, in
dep
enden
t b
ehav
iora
l
hea
lth p
rovid
er
• D
enta
l anes
thes
ia a
nd i
nst
ituti
onal
care
• H
osp
ice
care
• In
pat
ient
beh
avio
ral
hea
lth c
are
ser
vic
es
• O
rgan a
nd s
tem
cel
l tr
ansp
lants
• P
art
ial
hosp
itali
zati
on
• P
sych
oanaly
sis
Note
: T
his
lis
t is
not
all
incl
usi
ve.
15
TR
ICA
RE F
or
Lif
e C
overa
ge
TR
ICA
RE M
edic
al Covera
ge
TR
ICA
RE
For
Lif
e (T
FL
) and M
edic
are
cover
pro
ven
, m
edic
all
y n
eces
sary
, and
appro
pri
ate
care
. T
FL
has
sp
ecia
l ru
les
and
lim
itat
ions
for
cert
ain
ty
pes
of
care
, and
som
e ty
pes
of
care
are
not
cover
ed a
t all
.
TR
ICA
RE
poli
cies
are
ver
y s
pec
ific
about
wh
ich s
ervic
es a
re c
over
ed a
nd w
hic
h a
re
not.
It
is i
n y
ou
r b
est
inte
rest
to t
ake
an
acti
ve
role
in v
erif
yin
g c
over
age.
Note
: M
edic
are
als
o h
as l
imit
s on t
he
am
ou
nt
of
care
it
cover
s and
, in
som
e
case
s, T
FL
may
cover
thes
e hea
lth c
are
serv
ices
aft
er y
ou
r M
edic
are
ben
efits
hav
e
bee
n e
xhau
sted
.
To d
eter
min
e if
Med
icare
cover
s a
spec
ific
serv
ice
or
ben
efit,
vis
it w
ww
.med
icare
.gov
or
call
18
00
633
4227.
To d
eter
min
e if
TF
L c
over
s th
e se
rvic
e or
ben
efit,
vis
it t
he
TR
ICA
RE
Web
sit
e at
ww
w.t
ric
are
.mil
or
conta
ct W
isco
nsi
n P
hysi
cians
Ser
vic
e
(WP
S)
at 1
86
67
73
04
04. S
ee F
igu
re 1
.1
in t
he
How
TR
ICA
RE
For
Lif
e W
ork
s
sect
ion o
f th
is h
andbook f
or
more
info
rmat
ion o
n y
ou
r out
of
po
cket
cost
s.
Exam
ple
s of
serv
ices
that
are
gen
erall
y
not re
imbu
rsab
le b
y e
ither
pro
gra
m i
ncl
ude:
• A
cupu
nct
ure
• E
xp
erim
enta
l or
inves
tigat
ional
serv
ices
(in m
ost
ca
ses)
• E
ye
exam
inat
ions
(rou
tin
e)
• H
eari
ng a
ids*
Note
: T
his
lis
t is
not
all
incl
usi
ve.
* R
etir
ed s
po
nso
rs m
ay
be
elig
ible
for
the
Ret
iree
At
Cost
Hea
ring A
id P
rogra
m. If
yo
u a
re a
reti
red s
ervi
ce m
em
ber
an
d y
ou n
eed a
hea
ring
aid
, yo
u s
ho
uld
ca
ll a
pa
rtic
ipa
ting m
ilit
ary
trea
tmen
t fa
cili
ty. F
or
more
in
form
ati
on
, vi
sit
ww
w.m
ilit
ary
au
dio
log
y.o
rg/r
ach
ap/s
tate
.htm
l.
Denta
l Covera
ge
TR
ICA
RE
off
ers
two v
olu
nta
ry d
enta
l
insu
rance
pro
gra
ms,
the
TR
ICA
RE
Den
tal
Pro
gra
m (
TD
P)
and t
he
TR
ICA
RE
Ret
iree
Den
tal
Pro
gra
m (
TR
DP
).
TR
ICA
RE D
en
tal
Pro
gra
m
The
TD
P p
rovid
es w
orl
dw
ide
den
tal
cover
age
for
fam
ily m
emb
ers
of
all
acti
ve
duty
ser
vic
e m
emb
ers
and
Nat
ional
Guard
and R
eser
ve
mem
ber
s
and t
hei
r fa
mil
ies.
For
more
in
form
atio
n
about
the
TD
P, v
isit
the
TD
P W
eb s
ite
at
htt
ps:
//m
yb
enefi
ts.m
etli
fe.c
om
/tric
are
or
call
Met
Lif
e at
18
55
63
88
371.
SECTION 2
GETTING CARE
SECTION 3
TRICARE FOR LIFE COVERAGE
18
and t
he
pre
scri
pti
on m
ust
be
from
a
U.S
.li
cense
d p
rovid
er.
If y
ou h
ave
pre
scri
pti
on d
rug c
over
age
thro
ug
h o
ther
hea
lth i
nsu
rance
(O
HI)
,
you c
an u
se T
RIC
AR
E P
harm
acy H
om
e
Del
iver
y o
nly
if
the
med
icat
ion i
s not
cover
ed u
nder
you
r O
HI
or
if y
ou e
xce
ed
the
OH
I’s
cover
age
lim
it. R
egis
ter
for
TR
ICA
RE
Pharm
acy H
om
e D
eliv
ery
usi
ng a
ny o
f th
e opti
ons
in F
igu
re 4
.1.
Mem
ber
Ch
oic
e C
en
ter
The
Mem
ber
Choic
e C
ente
r m
akes
it
easy
to r
educe
you
r out
of
po
cket
cost
s
by t
ransf
erri
ng y
ou
r cu
rren
t m
ain
tenance
med
icat
ion p
resc
ripti
ons
to T
RIC
AR
E
Pharm
acy H
om
e D
eliv
ery.
Note
: To u
se the
Mem
ber
Choic
e C
ente
r, y
ou
must
hav
e a
main
tenance
pre
scri
pti
on f
rom
a re
tail
pharm
acy
or
MT
F.
The
Mem
ber
Choic
e C
ente
r co
nta
cts
you
r pro
vid
er to g
et
new
wri
tten
pre
scri
pti
ons
for
hom
e del
iver
y.
TR
ICA
RE R
eta
il N
etw
ork
Ph
arm
acie
s
Anoth
er o
pti
on f
or
fill
ing y
ou
r pre
scri
pti
ons
is t
hro
ug
h T
RIC
AR
E r
etail
net
work
pharm
acie
s. Y
ou m
ay fi
ll p
resc
ripti
ons
(one
cop
aym
ent
per
30
da
y su
pply
) w
hen
you
pre
sent
you
r w
ritt
en p
resc
ripti
on a
nd
unif
orm
ed s
ervic
es I
D c
ard to
the
phar
mac
ist.
Th
is o
pti
on a
llow
s you t
o fi
ll p
resc
ripti
ons
at T
RIC
AR
E n
etw
ork
pharm
acie
s w
ithout
subm
itti
ng c
laim
s. Y
ou h
ave
acce
ss t
o
appro
xim
atel
y 5
6,0
00 r
etail
net
work
pharm
acie
s in
the
Un
ited
Sta
tes
and
U.S
. te
rrit
ori
es o
f G
uam
, th
e N
ort
her
n
Mari
ana
Isla
nds,
Puer
to R
ico, and t
he
U.S
. V
irg
in I
slands.
TR
ICA
RE
ret
ail
net
work
pharm
acie
s are
on
ly l
oca
ted
in t
he
Un
ited
Sta
tes
and U
.S. te
rrit
ori
es.
Cu
rren
tly,
ther
e are
no T
RIC
AR
E r
etail
net
work
pharm
acie
s in
Am
eric
an S
am
oa.
Vis
it w
ww
.exp
ress
scr
ipts
.com
/TR
ICA
RE
or
call
18
77
363
1303 for
cust
om
er s
ervic
e,
incl
ud
ing fi
nd
ing t
he
nea
rest
TR
ICA
RE
reta
il n
etw
ork
pharm
acy.
No
n-N
etw
ork
Ph
arm
acie
s
When
vis
itin
g n
onn
etw
ork
pharm
acie
s,
you p
ay t
he
full
pri
ce o
f you
r m
edic
atio
n
up f
ront and fi
le a
cla
im for
reim
bu
rsem
ent.
Rei
mbu
rsem
ents
are
subje
ct to d
educt
ible
s,
out
of
net
work
cost
share
s, a
nd T
RIC
AR
E
requ
ired
copay
men
ts. A
ll d
educt
ible
s m
ust
be
met
bef
ore
any r
eim
bu
rsem
ent
can b
e
mad
e. F
or
det
ail
s ab
out
fili
ng a
cla
im, se
e
the
Cla
ims
sect
ion o
f th
is h
andbook.
TR
ICA
RE
Ph
arm
acy
Hom
e D
eliv
ery
Reg
istr
ati
on
Met
ho
ds
F
igu
re 4
.1
On
lin
eV
isit
ww
w.e
xp
ress
scr
ipts
.com
/TR
ICA
RE
Ph
on
eC
all
18
773
63
1433
(M
ember
Ch
oic
e C
ente
r) o
r 18
775
40
62
61
(T
DD
/TT
Y)
Ma
ilD
ow
nlo
ad t
he
reg
istr
atio
n f
orm
fro
m w
ww
.ex
pre
sss
crip
ts.c
om
/TR
ICA
RE
,
and
it
to:
Expre
ss S
crip
ts,
Inc.
P.O
. B
ox
521
50
Pho
enix
, A
Z 8
50729
954
17
Ph
arm
acy
Prescrip
tion D
rug C
overa
ge
TR
ICA
RE
off
ers
sever
al
opti
ons
for
fill
ing y
ou
r pre
scri
pti
ons.
TR
ICA
RE
cover
s pro
ven
, m
edic
all
y n
eces
sary
, and
appro
pri
ate
pre
scri
pti
on m
edic
atio
n. T
o fi
ll
a pre
scri
pti
on, y
ou n
eed the
pre
scri
pti
on a
nd
a vali
d u
nif
orm
ed s
ervic
es i
den
tifi
cati
on
(ID
) ca
rd o
r a
Com
mon A
cces
s C
ard
.
When
tra
vel
ing o
ver
seas
, b
e pre
pare
d t
o
pay
up f
ront
for
med
icat
ions
and fi
le a
claim
for
reim
bu
rsem
ent
for
nonm
ilit
ary
trea
tmen
t fa
cili
ty (
MT
F)
and n
onn
etw
ork
pharm
acy s
ervic
es. T
RIC
AR
E F
or
Lif
e
reco
mm
ends
that
you fi
ll a
ll o
f you
r
pre
scri
pti
ons
bef
ore
tra
vel
ing o
ver
seas
.
In c
erta
in o
vers
eas
loca
tions,
reg
ions
pec
ific
or
countr
ysp
ecifi
c re
quir
emen
ts m
ay r
equir
e
usi
ng a
TR
ICA
RE
cer
tifi
ed p
harm
acy.
For
more
in
form
atio
n, co
nta
ct y
ou
r T
RIC
AR
E
Over
seas
Pro
gra
m (
TO
P)
Reg
ional
Call
Cen
ter or vis
it w
ww
.tric
are
over
sea
s.co
m.
Note
: Y
ou d
o n
ot
nee
d a
Med
icare
Part
D
pre
scri
pti
on
dru
g p
lan
to
keep
you
r
TR
ICA
RE
pre
scri
pti
on d
rug c
over
age.
Filling P
rescrip
tions
Milit
ary
Tre
atm
en
t Faci
lity
Ph
arm
acy
An M
TF
pharm
acy i
s th
e le
ast
exp
ensi
ve
opti
on f
or
fill
ing p
resc
ripti
ons.
At
an
MT
F p
harm
acy,
you m
ay r
ecei
ve
up t
o
a 9
0d
ay s
upply
of
most
med
icat
ions
at
no c
ost
. M
ost
MT
F p
harm
acie
s ac
cept
pre
scri
pti
ons
wri
tten
by b
oth
civ
ilia
n a
nd
mil
itary
pro
vid
ers,
reg
ard
less
of
whet
her
or
not
you a
re e
nro
lled
at
the
MT
F.
Nonf
orm
ula
ry m
edic
atio
ns
are
gen
erall
y
not av
ail
able
at M
TF
pharm
acie
s. T
o c
hec
k
the
avail
abil
ity o
f a
part
icu
lar
dru
g, co
nta
ct
the
nea
rest
MT
F p
harm
acy.
TR
ICA
RE P
harm
acy H
om
e D
eli
very
TR
ICA
RE
Pharm
acy H
om
e D
eliv
ery i
s
you
r le
ast
exp
ensi
ve
opti
on w
hen
not
usi
ng
an M
TF
pharm
acy.
Ther
e is
no c
ost
for
hom
e del
iver
y f
or
AD
SM
s. F
or
all
oth
er
ben
efici
ari
es, th
ere
is n
o c
ost
to r
ecei
ve
up
to a
90
day
supply
of
gen
eric
med
icat
ions.
Copay
men
ts a
pply
for
bra
ndn
am
e and
nonf
orm
ula
ry m
edic
atio
ns.
Add
itio
nall
y,
pre
scri
pti
ons
are
del
iver
ed t
o y
ou w
ith f
ree
stand
ard
sh
ippin
g, and r
efill
s ca
n b
e ea
sily
ord
ered
on
line,
by p
hone,
or
by m
ail
.
TR
ICA
RE
Pharm
acy H
om
e D
eliv
ery
als
o p
rovid
es y
ou w
ith r
efill
rem
inder
s,
conven
ient
noti
fica
tions
about
you
r ord
er
stat
us,
and a
ssis
tance
wit
h r
enew
ing
expir
ed p
resc
ripti
ons.
If
you h
ave
ques
tions
about
you
r pre
scri
pti
ons,
pharm
acis
ts a
re
avail
able
24 h
ou
rs a
day
, se
ven
day
s a
wee
k t
o t
alk
con
fiden
tiall
y w
ith y
ou.
For
fast
er p
roce
ssin
g o
f you
r m
ail
ord
er
pre
scri
pti
ons,
reg
iste
r b
efore
pla
cing y
ou
r
firs
t ord
er. O
nce
you a
re r
egis
tere
d, you
r
pro
vid
er c
an fax
or
call
in y
our
pre
scri
pti
ons.
Expre
ss S
crip
ts, I
nc.
(E
xpre
ss S
crip
ts)
sends
you
r m
edic
atio
ns
dir
ectl
y t
o y
ou
r hom
e
wit
hin
about
14 d
ays
of
rece
ivin
g y
ou
r
pre
scri
pti
on.
Note
: O
ver
seas
ben
efici
ari
es m
ust
hav
e
an A
PO
/FP
O o
r em
bas
sy a
dd
ress
to u
se
TR
ICA
RE
Pharm
acy H
om
e D
eliv
ery,
SECTION 3
TRICARE FOR LIFE COVERAGE
SECTION 4
PHARMACY
16
TR
ICA
RE R
eti
ree D
en
tal
Pro
gra
m
The
TR
DP
is
avail
able
to r
etir
ed s
ervic
e
mem
ber
s an
d thei
r el
igib
le f
amil
y m
ember
s,
incl
ud
ing r
etir
ed N
atio
nal
Guard
and
Res
erve
mem
ber
s w
ho a
re e
nti
tled
to
reti
rem
ent
pay
but
do n
ot
beg
in r
ecei
vin
g
it u
nti
l ag
e 60, t
hei
r el
igib
le fam
ily m
ember
s,
cert
ain
su
rviv
ing f
am
ily m
emb
ers
of
dec
ease
d a
ctiv
e duty
sponso
rs, and M
edal
of
Honor
reci
pie
nts
and t
hei
r im
med
iate
fam
ily m
emb
ers
and s
urv
ivors
. F
or
info
rmat
ion a
bout
the
TR
DP,
incl
ud
ing
poss
ible
res
tric
tions,
vis
it t
he
TR
DP
Web
site
at
ww
w.t
rdp
.org
or
call
Del
ta D
enta
l®
of
Cali
forn
ia t
oll
fre
e at
18
88
83
88
737.
Frequentl
y A
sked Q
uesti
ons:
TR
ICA
RE F
or L
ife C
overa
ge
Does
TF
L c
over
lon
gt
erm
ca
re?
No. L
ongt
erm
care
(or
cust
odia
l ca
re)
is n
ot
a co
ver
ed b
enefi
t. H
ow
ever
, you
may
quali
fy t
o p
urc
has
e lo
ngt
erm
care
insu
rance
th
roug
h c
om
mer
cial
insu
rance
pro
gra
ms
or
thro
ug
h t
he
Fed
eral
Long
Ter
m C
are
Insu
rance
Pro
gra
m. F
or
more
info
rmat
ion a
bout
the
Fed
eral
Long
Ter
m C
are
Insu
rance
Pro
gra
m, vis
it
ww
w.o
pm
.gov/i
nsu
re/l
tc o
r ca
ll
18
00
582
3337.
Does
TR
ICA
RE
cover
sk
ille
d
nu
rsin
g c
are
?
TF
L c
over
s re
asonab
le a
nd n
eces
sary
sk
ille
d
nu
rsin
g c
are
and r
ehab
ilit
ativ
e th
erap
ies,
incl
udin
g s
emip
riva
te r
oom
s; r
egula
r nurs
ing
serv
ices
; m
eals
(in
clu
din
g s
pec
ial
die
ts);
physi
cal,
occ
upat
ional,
and s
pee
ch ther
apy;
dru
gs
furn
ished
by th
e fa
cility
; and n
eces
sary
med
ical
suppli
es a
nd a
ppli
ance
s. S
kil
led
nu
rsin
g c
are
is
typic
all
y p
rovid
ed i
n a
skil
led n
urs
ing f
acil
ity (
SN
F).
For
TF
L a
nd M
edic
are
to c
over
SN
F
adm
issi
on, you m
ust
hav
e had
a m
edic
al
cond
itio
n t
hat
was
tre
ated
in a
hosp
ital
for
at l
east
th
ree
conse
cuti
ve
day
s, a
nd y
ou
must
be
adm
itte
d t
o a
Med
icare
cer
tifi
ed,
TR
ICA
RE
par
tici
pat
ing S
NF
within
30 d
ays
of
dis
charg
e fr
om
the
hosp
ital
(wit
h s
om
e
exce
pti
on
s fo
r m
edic
al
rea
son
s). Y
ou
r
do
ctor’
s pla
n o
f ca
re m
ust
dem
onst
rate
you
r nee
d f
or
skil
led n
urs
ing s
ervic
es.
Note
: T
FL
is
the
pri
mary
pay
er f
or
SN
F
care
bey
ond M
edic
are
’s 1
00
day
lim
it a
s
long a
s th
e pat
ient
conti
nues
to r
equ
ire
skil
led n
urs
ing s
ervic
es a
nd n
o o
ther
hea
lth i
nsu
rance
is
involv
ed. S
NF
care
requ
ires
pri
or
auth
ori
zati
on o
n d
ay 1
01,
when
TR
ICA
RE
is
the
pri
mary
pay
er.
TF
L c
over
s an u
nli
mit
ed n
um
ber
of
day
s
as m
edic
all
y n
eces
sary
. S
NF
care
is
not
cover
ed o
uts
ide
the
Un
ited
Sta
tes
and
U.S
. te
rrit
ori
es.