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# BAS Tricare/Champ
# BAS Tricare/Champva
Question | Answer |
---|---|
sponsor | In the military, this is the person with insurance. Same as the subscriber outside the military |
beneficiary | person who may receive benefits from an insurance program |
MTF | Military Treatment facility |
PCM | Primary Care Manager. The primary doctor in the military. Same as a PCP |
Point of Care option (POS) | Allows enrollees to select non-network providers for medical care. This is available to those 50miles away from an MTF |
catastrophic cap | maximum amount of "out of pocket" expense that the insured has to pay. After this amount is reached the insurance pays. |
NAS Statement | Non-availability statement. Depending upon the type of insurance and/or the benefits this statement may be required if to see a civilian provider if medical treatment is not available at a particular MTF |
DEERS | Computerized system that maintains records of all beneficiaries of military ins-shareurance |
OHI | Other health insurance. The insured has another health insurance policy. Coordination of benefits is applied. |
Tricare LA | Lead Agent for Tricare. A military officer that plans the delivery of care. |
"allowed servicers" | The services that Tricare will pay for. These are also called "covered charges" |
cost-share | coinsurance, deductibles and co-pays are all a "cost-share". The beneficiary takes part in paying for a portion of their medical care. |
CMAC | CHAMPUS maximum allowable charge. The most that Tricare will pay for a medical service. |
PAR | A participating provider. This provider accepts assignment of the insurance. |
nonPAR | A non-participating provider. They can charge up to 15% over the allowable charge with Tricare |
PPO | Preferred provider organization. In this type of insurance the patient can see a specialist without being referred by their primary care physician(PCP) |
POS | Point of service An option with TRICARE prime that allows the enrollees to see nln-network providers |
TPR | Tricare Prime Remote. An option for Tricare if the service personnel are 50 miles from an MTF |
Tricare prime | An HMO . Requires a PCM and use of network providers onlly. There is a POS option that allows seeing civilian providers |
Tricare Extra | A PPO insurance. Patient can self refer to any provider.\ |
CHAMPVA beneficiaries can get free care at VA facilities | TRUE |
With CHAMPVA prescription drugs are free | TRUE |
CHAMPVA is a federal program for veterans who are | permenantly and totally disabled and their families |
TRICARE is for | Active duty members and their families |
CHAMPVA will pay for copays of an HMO if the VET has OHI | TRUE |
With CHAMPVA the eligible individual must be permanently disabled due to | A service connected condidtion. |