Tricare Delta Dental Retiree Program – TRICARE: Your Military Health Plan: Transitioning from Active Duty to Retirement FOCUS: TRICARE Beneficiaries.

Presentation on theme: “TRICARE: Your Military Health Plan: Transitioning from Active Duty to Retirement ATTENTION PRESENTERS: Ensure TRICARE Beneficiaries Receive This Plan.”— Presentation Transcript:

Tricare Delta Dental Retiree Program

ATTENTION PRESENTERS: To ensure that TRICARE beneficiaries receive the most up-to-date information about their health benefits, please visit the most current version of each briefing before each presentation. Information sessions are continually updated as benefit changes occur. Presenter Tips: Review all slides before the briefing. Make sure you set the “Slide Show” setting. Remove any slides that don’t apply to your target audience. Target audience: Active-duty service members approaching military retirement based on years of service and family. Estimated meeting time: 30 minutes TRICARE Resources: Visit to view, print, or download copies of TRICARE training materials. Informational Purpose: To increase understanding of TRICARE benefits and educate beneficiaries about program options as they approach retirement. Optional Presenter Comments: Welcome to the TRICARE Active Duty to Retirement Briefing. As you approach retirement from active duty, there are some important decisions you and your family members must make about health insurance coverage. TRICARE will be with you after retirement, but there are several options to consider and specific steps to take.

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2 Today’s Agenda During today’s briefing, we will discuss information about retirement preparation, TRICARE program options and TRICARE benefits. Finally, we will provide important resources for help and answers to other questions. To learn more about TRICARE options, visit: To receive TRICARE news and publications by: Sign up at: To sign up for benefit correspondence visit:

The Defense Enrollment Eligibility Reporting System, or DEERS, is a database of service members and their dependents worldwide who are eligible for military benefits, including TRICARE. Sponsors can enroll their family members in DEERS in person at the Uniformed Services ID or ID card issuance center. To check eligibility and update information, log on to the milConnect website at MilConnect is the Defense Manpower Data Center’s online portal for accessing DEERS information. Information can also be updated by phone, fax or by visiting a Uniformed Services ID card issuance center. If changes are made, appropriate documentation is required, such as a marriage certificate, divorce decree, birth certificate and/or adoption papers. Note: Only sponsors with a valid power of attorney or individuals designated as sponsors can add a family member. Family members 18 and older can update their own contact information. Note that providers are legally allowed to copy military and dependent ID cards to verify TRICARE eligibility. For more information, visit:

A person may be eligible for Medicare Part A benefits because of age, disability, or illness. If you are retired and you or a family member currently qualifies for Medicare Part A: Enroll in Medicare Part B before your sponsor’s retirement date to avoid interruptions in TRICARE coverage. Medicare Part B goes into effect the month you enroll. Note: If you or a family member is eligible for Social Security disability benefits or is diagnosed with end-stage renal disease and is denied Medicare Part B coverage, you will lose TRICARE eligibility. Beneficiaries under age 65 who qualify for Medicare Part A and have Part B can continue to enroll in TRICARE Prime. In this case, TRICARE Prime waives the annual enrollment fee. You can use TRICARE For Life or TFL. We will cover TFL later in this briefing. For more information about Medicare Part B coverage, visit the Social Security Administration website at. You can find additional Medicare information at:

If you take leave before you retire, you and your family will remain covered by your existing TRICARE program until your retirement date. If you are covered by TRICARE Prime, it will be considered part of your current unit until your retirement date. Active duty service members or ADSM cannot change their military hospital or primary care clinic or their administrator or PCM. If you go on leave and move to another area: You must coordinate all care with your current PCM. If your new location is in a primary service area, or PSA, your family members can transfer to a military hospital or civilian network PCM or clinic in your new area before your retirement date. Be sure to update your information in DEERS to see if you live in a PSA. Use the PSA postcode lookup tool available at

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Your right to be a retired soldier begins the day you retire. Your spouse will also continue to be eligible for TRICARE benefits. Surviving spouses and qualified former spouses who have not remarried are also eligible for TRICARE benefits. Former spouses who have not remarried must contact the service personnel office to determine eligibility. Unmarried dependent children, including stepchildren of retired military members, are eligible for TRICARE benefits. Certain requirements apply. Dependent parents or in-laws are not eligible for TRICARE civilian benefits; However, they may be entitled to care at certain military hospitals and clinics depending on availability.

If you are retired and under age 65, you can re-enroll in TRICARE Prime or get TRICARE Standard and TRICARE Extra coverage. If you live in a PSA in the United States or waive your drive time access standards within 100 miles of an existing PCM, you can re-enroll in TRICARE Prime. You must re-enroll in TRICARE Prime to continue coverage. If you are eligible for Medicare Part A and Part B, you are covered by TRICARE for Life, which we will cover later in this presentation. If you decide to re-enroll in TRICARE Prime, you must re-enroll on or within 30 days of your retirement date to continue TRICARE Prime coverage. The validity date of the insurance will be your retirement date. If you enroll within 30 days of retirement, your application is considered your first TRICARE Prime enrollment and the 20th rule applies. For an initial enrollment in TRICARE Prime received on or before the 20th of the month, your coverage will begin on the first of the following month. For the first registrations made after the 20th of the month, your insurance starts on the first day of the following month. There are three ways to re-enroll in TRICARE Prime: Online: Use the Beneficiary Web Enrollment website On the phone: Call your regional contractor (if your retirement status is reflected in DEERS). Email: Download the TRICARE Prime Primary Line Manager (PCM) Change of Enrollment, Dismissal and Term Form DD Form 2876 and mail it to your regional contractor. With TRICARE Prime, retirees pay enrollment fees and contributions. If you have questions about your enrollment or spending, visit: Retirees and their family members who opt out of TRICARE Prime before the annual enrollment renewal deadline are subject to a 12-month lock-in. Note: The TRICARE Prime Remote and TRICARE Overseas Prime options of the program are not available after retirement.

With TRICARE Prime, your PCM performs routine care and referrals. You can receive care from a PCM at a military hospital or clinic if space permits (ADSMs and their families receive priority at military hospitals and clinics). If space in a military hospital or clinic is not available and you live in a PSA, you can get care from a provider in TRICARE’s civilian network. Beneficiaries also have the right to enroll their primary care physician in a US Family Health Plan, which will be discussed later. For civilian specialty care, get a referral from a primary care manager or PCM before seeking care to avoid higher out-of-pocket expenses. You may be referred to a military hospital or clinic for specialty care based on the military hospital or clinic’s “elective” to provide non-emergency care under the PSA. If a TRICARE Prime beneficiary is seeking specialized care or treatment, the military hospital or clinic should be considered first if services are available there. This means that if the military hospital or clinic has the capacity to provide specialized care, it may choose to treat you instead of referring you to a civilian provider. If you are traveling or moving, arrange maintenance before you leave. Get routine maintenance done before you travel. Before seeking emergency care, contact your PCM or regional contractor for assistance. If maintenance is not coordinated with your PCM or regional contractor, it will be covered by the service point or POS option, resulting in higher out-of-pocket expenses. In an emergency, call 911 or go to the nearest emergency room. Referral is not required, but if accepted, your regional contractor must be notified within 24 hours or the next business day to coordinate ongoing maintenance. If you plan to be away for more than 60 days, consider transferring your registration to maintain routine maintenance and keep your costs low.

The POS option with TRICARE Prime is used to obtain non-urgent care from any TRICARE authorized provider without a PCM referral. Using the point-of-sale option does not require you to choose TRICARE Prime, but it does result in increased out-of-pocket expenses. If you use POS

Tricare Costs: Supplemental Briefing Slides That Provide Additional Information To The Other Tricare Briefings Attention Presenter: This Set Of Slides.

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