[HEALTH.MIL] Tricare Presents Plan For Re-Enrolling Some In Prime

  • From: HEALTH.MIL@xxxxxxxxxxxxx
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  • Date: Wed, 16 Apr 2014 09:21:17 -0500

By Patricia Kime 

Staff writer


Tricare announced Tuesday its plans for reinstating thousands of beneficiaries
who lost eligibility for Tricare Prime last October, but by law, not all who
were booted off Prime will be able to re-enroll.


The fiscal 2014 National Defense Authorization Act required the Defense
Department to give affected beneficiaries a one-time option to continue in
Tricare Prime.


And in accordance with the law, Tricare plans to send letters starting April 28
to those eligible to re-enroll. Beneficiaries will have until June 30 to make
their decision.


But while roughly 177,000 Tricare Prime beneficiaries - mainly retirees and
family members - were disenrolled from the Pentagon's health maintenance
organization-style program when DoD reduced the availability of Tricare Prime to
locations within 40 miles of an active or former military base, fewer than half
will receive letters to re-enroll.


According to Tricare, about 35,000 beneficiaries received waivers or moved to
another Prime service area after they were disenrolled and no longer are


But the law passed by Congress in December also stipulated that the one-time
opt-in apply only to beneficiaries who live in a ZIP code that was a designated
Prime service area as of Sept. 30, 2013, and they live within 100 miles of a
current or former military medical treatment facility.


That second condition prevents 66,000 beneficiaries who once had Prime in areas
where the Tricare contract managers offered it but there were no bases,
including much of the Tricare South region and cities like Pittsburgh and
Minneapolis, from opting back in.


Tricare officials said about 76,000 beneficiaries will get letters informing
them of their eligibility and information on how to get back into Prime. They
also will be required to see a primary care doctor who practices within 40 miles
of the present or former military base, should they choose to re-enroll.


Those who don't want to return to Prime will not have to take any action. They
will remain on Tricare Standard.


To re-enroll, the beneficiary must submit an enrollment form and waive drive
time standards. Managed care contractors will help beneficiaries find available
PCMs, according to Tricare.


Enrollment forms are available online at www.tricare.mil/forms
<http://www.tricare.mil/forms> .



SOURCE:  MilitaryTimes article, 16 April 2014,



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