Question

Medical Billing: List and Explain the TRICARE Options, programs and demonstration projects, and supplemental plans.

Answer 1

ANS. TRICARE is the worldwide health care program available to eligible beneficiaries of the seven uniformed services , Commissioned Corps of the U.S. Public Health Service, and the Commissioned Corps of the National Oceanic and Atmospheric Administration. TRICARE-eligible beneficiaries may include active duty service members and their families, retired service members and their families, National Guard and Reserve members and their families, survivors, certain former spouses, and others. TRICARE brings together military and civilian health care professionals and resources to provide high-quality health care services. TRICARE is managed in two stateside regions in the U.S – TRICARE East and TRICARE West. In these U.S. regions, TRICARE is jointly managed by the Defense Health Agency (DHA) and the TRICARE Health Plan. The DHA has partnered with civilian regional contractors in the East and West regions to assist TRICARE regional directors, and military hospital and clinic commanders in operating an integrated health care delivery system.

TRICARE is a major part of the Military Health System that:

• Combines the resources of military hospitals and clinics with civilian health care networks
• Offers several health plan options that:
  • Give you access to high-quality health care
  • Meet the requirements for minimum essential coverage under the Affordable Care Act
• Provides comprehensive health coverage, including prescription drugs
• Supports military operations and readiness

TRICARE offers Special Programs for certain health conditions, populations, or concerns. Some Special Programs:

• Have specific eligibility requirements based on your plan, beneficiary category, or status.
• Are for specific beneficiary populations while others offer services for specific health conditions.
• Are limited to a certain number of participants or to a certain geographic location.