LESSON 1
THE TRIPLE OPTION BENEFIT PROGRAM AND THE
CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE
UNIFORMED SERVICES
Section I. OVERVIEW
1-1.
DEFINITION OF TRICARE
a. TRICARE is the name of the Defense Department's new regional managed
health care program for service families. Under TRICARE, you'll generally have three
choices of ways in which to get your heatlhcare: TRICARE Prime, TRICARE Extra, and
TRICARE Standard.
(1) TRICARE Prime. This is a voluntary health maintenance organization-
type (HMO) option. If you decide to get your health care through TRICARE Prime, you'll
pay an annual enrollment fee (except for active-duty families, who may enroll free) and
enroll for a year at a time. Normally, you'll receive your care from within the Prime
network of civilian and military providers.
(2) TRICARE Extra. In this option, you don't have to enroll or pay an annual
fee. You do have to satisfy an annual deductible for outpatient care, just as you do
under TRICARE Standard.
(3) TRICARE Standard. This option is the regular CHAMPUS program with
a new name. It pays a share of the cost of covered health care services that you obtain
from an authorized non-network civilian health care provider. There is no enrollment in
TRICARE Standard. You will pay the normal TRICARE Standard deductibles for
outpatient care, and your cost-sharing percentages will be the same as for regular
CHAMPUS.
b. Program for Persons with Disabilities. The Program for Persons with
Disabilities (PFPWD) is only for seriously disabled persons who are family members of
active-duty personnel. You must apply and get approval before TRICARE Standard can
help pay the costs of care.
1-2.
DEFINITIONS
a. Uniformed Services. The Uniformed Services includes the Army, Navy,
Marine Corps, Air Force, Coast Guard, Commissioned Corps of the Public Health
Service, and the Commissioned Corps of the National Oceanic and Atmospheric
Administration.
MD0755
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