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TRICARE
| Question | Answer |
|---|---|
| TRICARE Prime is similar in design to what civilian insurance products? | HMO |
| TRICARE Extra users receive a discount when? | when they use providers in the network |
| How many TRICARE regions? | 4 |
| TRICARE Prime point-of-service option is activated when? | the beneficiaries seeks non emergency medical care w/out prior approval |
| Why was the catostrophic cap benefit put into effect? | to protect beneficiary from devastating financial loss due to serious illness or long term treatments |
| Where are TRICARE claims submitted for processing? | TRICARE contractor |
| When reservists are called to active duty, their dependents may be eligible for TRICARE benefits when the reservist is made active for? | 30 days or more |
| TRICARE coverage for spouses of military personnel who have died in the line of duty ceases when? | When they remarry a civilian |
| What is the responsibility of the beneficiary services representative? | A TRICARE employee that provides information about TRICARE and assists with other matters affection access to health care such as scheduling appointments |
| TMA | TRICARE Management Activity |
| What is TMA responsible for? | coordination and administration of TRICARE |
| What is a TRICARE Service Center (TSC) | a business office w/ one or more employee staffed w/ Benif Reps and health care finders to assist w/ health care needs and answer questions |
| TRICARE is what to civilin medical insurance policies. | secondary |
| What office is responsible for military readiness and peacetime health care? | Health Affairs |
| What is the Program Integrity office responsible for? | watch for fraud, waste & abuse activities world wide |
| What beneficiaries are eligible for CHAMPVA? | Servivors of Vets who have died in the line of duty w/out misconduct |
| TRICARE Extra enrollees can save 5% on their program costs share by doing what? | going to participating providers |
| Which TRICARE plan allows the greatest freedom in selecting civilian providers? | TRICARE Standard |
| How is verification of eligibility abtained? | DEERS |
| TRICARE is what to Medicaid? | primary |
| The insured ID on the claim form is actually the sponsor's what? | Social Security Number |
| TRICARE deductibles are applied to the government's fiscal year, which runs from | October 1 to September 30 |
| A certificate insued by a military treatment facility stating that the facility can not provide needed care is a what kind of statement? | nonavailability |
| A comprehensive healthcare program for which the Department of Veterans Affairs (VA) shares costs of covered healthcare services and supplies with eligible beneficiaries is called | CHAMPVA |
| Active duty personnel must enroll in what program to receive guaranteed priority access to care at MTFs | TRICARE Prime |
| If a TRICARE sponsor and spouse divorce, what effect will this have on the TRICARE status of the children? | The children remain eligible for TRICARE even if the parents divorce or remarry |
| Which TRICARE program requires retired military to pay an annual enrollment fee? | TRICARE Prime |
| If the patient is being transferred w/in the next 6 months, TRICARE suggests that... | the provider should accept assignment to prevent collection problems. |
| the purpose of the "good faith policy" established by TRICARE is to allow | a means to recover payment when the enrollee has presented an invalid ID card. |
| TRICARE is a healthcare program for | active duty members of the military and their qualified family members. |
Created by:
theresav