Tricare Online Claim Submission – NOTE: To ensure that TRICARE users receive the most up-to-date information about their health benefits, access the latest version of this report before each presentation. The guidance is regularly updated as performance changes occur. Presentation tip: Review and revise notes before the presentation. Remove any images that are not relevant to your audience. Review the other important information and pricing information to identify any additional photos to include in your presentation. Start reviewing the site with a “slide show”. TRICARE Resources: Go to view, print, or download copies of TRICARE educational materials. Suggested resources include: TRICARE Overseas Program Handbook and TRICARE Plan Overview. Estimated Briefing Time: 45 minutes Target Audience: TRICARE beneficiaries living abroad Purpose: To increase awareness and understanding of TRICARE benefits abroad and inform TRICARE beneficiaries of their overseas program options. Optional Program Manager Comments: Welcome to the TRICARE Overseas, or TOP, program briefing. TOP is the Department of Defense’s health program for geographic areas and territorial waters outside the United States. The goal of today’s presentation is to give you a general understanding of TRICARE benefits abroad. We will have time for questions later; but feel free to ask clarifying questions during the review.
Today’s agenda will discuss what TRICARE is, TRICARE Overseas Program coverage and information about benefits. We’ll also cover other important information, including pharmacy options and dental care programs. Finally, we will provide you with resources to find help and answers to any additional questions. To learn more about your TRICARE options, to receive TRICARE news and publications, to sign up for helpful newsletters, go to
Table of Contents
Tricare Online Claim Submission
What is TRICARE? TRICARE is a uniform health care plan for active duty service members, or ADSMs, family members or ADFMs, National Guard and Reserve members and their family members, retirees and retired family members, survivors and former spouses worldwide. ah. Note: Throughout this presentation, the term “family members” refers to dependents of service members who are eligible to use TRICARE. TRICARE brings together the health resources of the military health system—such as military hospitals and clinics—with a network of civilian health care providers, facilities, pharmacies, and providers to promote, protect, preserve, and restore the health of those entrusted with care. .
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International SOS Government Services, Inc., or International SOS, administers the TRICARE Overseas Program, or TOP, benefit. It is an external region divided into three geographical areas: Latin America and Canada, Eurasia-Africa and the Pacific. Contact information for your area will be provided at the end of this presentation. If you are moving abroad, keep your local contact information.
6 TOP Support There are several ways to get the information and support you need from abroad. For assistance with registration, submission and pre-approval, contact the TOP regional customer center. Agents can also help coordinate emergency, emergency and dental care. Call centers are available 24/7. International SOS provides medical assistance numbers for locations outside the region. Call your local emergency room to find the nearest emergency room or connect to 24/7 emergency care. The TRICARE Global Service Center, or GTSC, helps you understand TOP and provides customer service and telephone assistance for enrollment, disenrollment, changes and general inquiries. There are also 24/7 customer service representatives.
7 Continued TOP Support TRICARE Service Centers, or TSCs, are located in overseas areas, often in military hospitals and clinics, where beneficiary service representatives are available to assist. TSCs are important resources when seeking care from hospitals or health centers or contracted providers, which are approved civilian providers in your overseas area. Your local TSC can help you learn about TRICARE program options, enrolling in transfers, filing complaints, resolving problems, and filing complaints. To obtain a TSC, go to a TRICARE Area Office, or TAO, located in each overseas area to provide operational support to hospitals and health centers and TRICARE users in their geographic area. The TOP Point of Contact, or POC, Program is a service that connects and assists TRICARE users in remote locations overseas. POCs help TRICARE-eligible people enroll in TRICARE and purchase quality health care. They also help TRICARE beneficiaries file medical and dental claims. To obtain a POC, contact your TAO. For contact information, go to You can also get help abroad at US embassies and consulates. Go to find a US embassy or consulate in the area where you live or travel. Note: If you are enrolled in TOP Prime Remote, go to the US Consulate in your area or contact the Benefit Coordinator, or BCAC. To find a BCAC near you, go to our Customer Service Community Directory
Your employer’s office determines whether you are eligible for TRICARE. Once your eligibility is determined, you must take certain steps to remain eligible for benefits: Register in the Defense Enrollment Eligibility Reporting System, or DEERS. Obtain a valid Uniformed Services identification card. By enrolling in DEERS, ADFMs can choose to enroll in the TOP Prime option, which is similar to a managed care or health care option. ADFMs who are not eligible for, or choose not to enroll in, TOP Prime can enroll in TOP Select, which is a preferred provider organization, or PPO, style plan. Note: ADSMs must subscribe to the TOP Prime option. Inactive Reserve and National Guard members may be eligible to purchase TRICARE Reserve Select, or TRS. If you qualify for free Medicare Part A, you must also have Medicare Part B to be covered by TRICARE—even in areas outside Medicare coverage. Pensioners living abroad may be eligible to sign up for TOP Select.
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Overseas program options depend on your recipient’s category and, for active providers, where you live. ADSMs must subscribe to TOP Prime or TOP Prime Remote. ADFMs can enroll in TOP Prime, TOP Prime Remote, TOP Select, or, if they qualify for free Medicare Part A and have Medicare Part B, they can use TRICARE For Life or TFL. . Some ADSM dependents can also purchase TRICARE Young Adult, or TYA. ADFMs who are eligible for Medicare Part A do not need to have Medicare Part B to maintain their TRICARE coverage. To prevent termination of TRICARE coverage, ADFMs eligible for Medicare Part A must have Medicare Part B on or before the sponsor’s retirement date.
Selective reserve members who have been inactive or inactive for 30 days or less, and their families, can choose to enroll in TRICARE Selective Reserves, or TRS. Note: National Guard and Reserve members called or ordered to active duty for more than 30 days are considered ADSM. Retired service members and their family members, survivors, Medal of Honor recipients, unmarried former spouses, and others can enroll in TOP Select, or, if they are eligible for Medicare Part A and have Medicare Part B, TFL. Retirement savings members can also choose to enroll in TRICARE retirement savings, or TRR. Certain dependents of retired service members, National Guard and Reserve members who have purchased a TRS, or retired National Guard and Reserve members who have purchased a TRR may also purchase a premium-based TYA. Note: Upon retirement from either the National Guard or the Reserves, all members of the military are considered retired reserves.
Types of Care TRICARE defines an emergency as a serious medical condition that the average person would consider life, limb, sight or safety a threat. In an emergency, go to the nearest emergency room. Contact your local Medical Assistance by calling your TOP call center. Choose option 1 to find the nearest emergency department or to arrange for emergency care abroad. If you use TOP Prime, you must notify your primary care manager, or PCM, within 24 hours or the next business day of admission to coordinate ongoing care. If you use TOP Prime Remote or TFL, or are enrolled in TOP Select, TRR, TRS or TYA (Prime or Select), you must notify International SOS within 24 hours or the next business day of access to coordinate ongoing care. . Urgent care is the treatment of an illness or injury that requires treatment within 24 hours, for example a sprain, earache or high fever. Note: Going to the emergency department in an urgent care situation does not constitute an emergency and may result in out-of-pocket costs. Routine care, also called primary care, includes general office visits, monitoring ongoing health conditions, and preventive care to maintain your health. Private care is not emergency care that PCM cannot provide. TOP Prime and TOP Prime Remote subscribers need a referral for all personal care. If you do not have a PCM assigned to you, contact the TOP regional call center.
Air evacuation, or air evacuation, is just that
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