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TRICARE 101: Understanding military healthcare

KEESLER AIR FORCE BASE, Miss. --

TRICARE can be a complex creature to some military members and dependents. Luckily, there are professionals right here at Keesler who are in-the-know with TRICARE and can assist with some of the confusion.

Maj. Jeff Kincannon, 81st Medical Support Squadron TRICARE operations and patient’s administration flight commander, and Linda Davis, 81st MDSS contract liaison, are two of these professionals who spent some time out of their day to sit down and help clear up some of the mystery about basic TRICARE questions.

What is TRICARE?

TRICARE is the military’s healthcare insurance. It is your health care benefit for serving in the military. There are three contractors in the U.S. that work for TRICARE. In the South it’s Humana Military, in the North it’s Health Net Federal Services, and in the West it’s United Health Care.

How do I make an appointment?

For an appointment at Keesler Medical Center, call 800-700-8603. Active duty members are encouraged to call between 5:30 a.m. and 6 a.m. in order to receive priority scheduling. After 6 a.m. the appointments are scheduled on a first come, first serve basis.

Who is the TRICARE representative on Keesler?

The Keesler Medical Center has Health Benefit Advisors who can advise Keesler clients with any TRICARE issue. They can be reached at 228-376-4010 and 288-376-4737. There is also the TRICARE hotline number which is 800-444-5445, who can help with enrolment or major issues with TRICARE.

What’s the difference between TRICARE standard, extra and prime?

TRICARE Prime is mandatory for all active duty service members and they have to enroll to that plan. Being active duty does not automatically enroll you into prime. Dependents, on the other hand, have a choice between prime and standard. While enrolled in TRICARE Prime, you must seek your care from your primary care manager.

TRICARE Standard gives you the freedom to seek care outside of the base; however you will have a deductible and copay. Dependents and active duty members are automatically signed up for Standard.

TRICARE Extra is not a standalone plan but refers to a 5 percent discount received when a TRICARE standard dependent elects to use a TRICARE network provider outside of the base.

If I have an emergency am I able to go to any hospital?

If you need urgent care, you must contact your PCM during duty hours at 800-700-8603, the Nurse Advice Line 800-874-2273, option 1 or TRICARE South at 800-444-5445 for authorization to seek care elsewhere. If it’s an emergency, which is considered life, limb or eyesight, go to a hospital emergency room and contact your PCM after you have taken care of your emergency.

How do I get my primary care manager (PCM)?

When you initially register for TRICARE Prime you are assigned a PCM at your hospital. If you live within a 30 minute radius of Keesler you will be assigned to Keesler Medical Center if you have TRICARE Prime. If outside of the 30 minute radius, you can enroll to a network civilian PCM. You can, however, request a specific doctor but that does not mean that PCM will be assigned to you. PCM availability depends on if that doctor has reached her or his limit of enrollees. If you don’t like your PCM you have the option to change them.

How do I change my PCM?

If you are assigned a provider and you wish to change providers in that military treatment facility, simply go to that clinic and request the change.

Does TRICARE cover dependents’ child birth?

When your eligible dependent has a your child, everything is covered the same, the only difference is that if you have the child at a civilian hospital and you have TRICARE Standard, there will be some out-of-pocket cost. Giving birth at Keesler or having Prime and seeing a civilian doctor will not cost you anything out of pocket. Once your child is born they must be enrolled in your Defense Enrollment Eligibility Reporting System information within the first 60 days.

How do I prove I or my dependent is covered by TRICARE?

Your Common Access Card or dependent identification card is your proof that you have insurance. In addition you also have to prove you are covered to the federal government when you file for your taxes. With the Affordable Care Act they ask that you show proof of coverage and you can do that by sending in a Form 1095, which is located in the active duty members’ myPay account, for both the dependent and active duty member.

What if I just had a permanent change of station to Keesler or I’m leaving Keesler?

Once you arrive at your new base, you need to update your DEERS information and contact your contractor for that location. It is important to note that these are two different transactions. You also have to register for enrollment into the hospital of the base you are heading to.

 

For more information on TRICARE call:

The Health Benefit Advisor for Keesler at 228-367-4010 or 228-376-4737

TRICARE South at 800-444-5445

Nurse Advice Line 800-874-2273

Or visit www.TRICARE.mil