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# BAS Tricare/Champva

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Question
Answer
sponsor   In the military, this is the person with insurance. Same as the subscriber outside the military  
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beneficiary   person who may receive benefits from an insurance program  
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MTF   Military Treatment facility  
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PCM   Primary Care Manager. The primary doctor in the military. Same as a PCP  
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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  
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catastrophic cap   maximum amount of "out of pocket" expense that the insured has to pay. After this amount is reached the insurance pays.  
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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  
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DEERS   Computerized system that maintains records of all beneficiaries of military ins-shareurance  
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OHI   Other health insurance. The insured has another health insurance policy. Coordination of benefits is applied.  
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Tricare LA   Lead Agent for Tricare. A military officer that plans the delivery of care.  
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"allowed servicers"   The services that Tricare will pay for. These are also called "covered charges"  
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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.  
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CMAC   CHAMPUS maximum allowable charge. The most that Tricare will pay for a medical service.  
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PAR   A participating provider. This provider accepts assignment of the insurance.  
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nonPAR   A non-participating provider. They can charge up to 15% over the allowable charge with Tricare  
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PPO   Preferred provider organization. In this type of insurance the patient can see a specialist without being referred by their primary care physician(PCP)  
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POS   Point of service An option with TRICARE prime that allows the enrollees to see nln-network providers  
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TPR   Tricare Prime Remote. An option for Tricare if the service personnel are 50 miles from an MTF  
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Tricare prime   An HMO . Requires a PCM and use of network providers onlly. There is a POS option that allows seeing civilian providers  
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Tricare Extra   A PPO insurance. Patient can self refer to any provider.\  
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CHAMPVA beneficiaries can get free care at VA facilities   TRUE  
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With CHAMPVA prescription drugs are free   TRUE  
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CHAMPVA is a federal program for veterans who are   permenantly and totally disabled and their families  
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TRICARE is for   Active duty members and their families  
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CHAMPVA will pay for copays of an HMO if the VET has OHI   TRUE  
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With CHAMPVA the eligible individual must be permanently disabled due to   A service connected condidtion.  
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