TRICARE moves with you during Permanent Change of Station
May 7, 2010
By Lora Sanders-VanNoy, TRICARE Pacific Representative

Permanent Change of Station (PCS) season is now in full swing and will continue over the next few months. Whether TRICARE beneficiaries are enrolled in Standard or Prime, be assured that healthcare coverage will move with them with minimal effort. Before leaving Japan, all beneficiaries should stop by the TRICARE Service Center (TSC) for more information.

The TSC representative can answer questions on enrollment or program benefits. Prime members will also complete a PCS form, which lets TRICARE know the beneficiary is leaving the Pacific Region. Also available is a travel card containing valuable phone numbers if care is needed during a member’s transition back to the United States. TRICARE Prime is designed to be easy and convenient, but there are a few things beneficiaries must keep in mind to avoid unnecessary costs, ensure access to quality care and prevent a break in Prime coverage.

Upon arrival at your new duty station, it is important to update the Defense Enrollment Eligibility Reporting System (DEERS) record upon arrival at the new duty station. If Prime enrollment is available, Prime beneficiaries should transfer their enrollment as soon as possible by simply completing the proper paperwork at the new TSC. Prime beneficiaries have 60 days from when they leave the Pacific to transfer their enrollment to enjoy uninterrupted TRICARE Prime coverage. If beneficiaries do not transfer their enrollment within the 60 days they will revert to TRICARE Standard for their health care coverage.

Standard beneficiaries may want to consider enrolling in Prime at their new duty station if it is available. The TSC at the member’s new duty station can provide information about locally available TRICARE programs, helping beneficiaries to make an informed decision on their family’s health care coverage.

Members that choose Standard enrollment can see any TRICARE authorized provider, but must meet associated deductibles and cost shares. Currently, the annual deductible is $50 per individual and $100 per family for E-1 through E-4; $150 per individual and $300 per family for E-5 through O-10 sponsors. In addition there is a cost-share for outpatient care received outside of the military treatment facility (MTF). For active duty family members, this amount is 20 percent of the TRICARE Maximum Allowable Charge (TMAC).

Receiving health care while in transit, Prime beneficiaries are encouraged to wait until they transfer their enrollment to their new region for any routine appointments. This is to avoid exercising the Point-of-Service option, which results in out-of-pocket costs, deductibles and cost shares for the beneficiary. All beneficiaries needing urgent care during transit can visit the nearest MTF for available appointments. When care is not available at a MTF they should call the responsible regional TSC to obtain a listing of available civilian network providers. This number can be found on the Travel Card. In case of an emergency, all beneficiaries should go immediately to the nearest MTF or civilian equivalent.

If civilian care is obtained during the PCS move, a claim for payment or reimbursement must be submitted to the appropriate claims processor. All network providers will file the claim for the beneficiary. However, beneficiaries may be expected to pay at the time of service and then file a claim if seen by a non-network provider. In either event, claims for Continental United States (CONUS) active duty care and family members enrolled in TRICARE Pacific Prime are managed by two separate addresses.

Claims for active duty members are mailed to WPS-AD Overseas, P.O. Box 7698, Madison WI 53707-7968; and claims for family members are mailed to WPS-Foreign Claims, P.O. Box 7985, Madison, WI 53707-7985.

Families also need to plan for dental care when transitioning back to the United States. TRICARE recommends enrolling the family in the United Concordia TRICARE Dental Program (TDP) at least 30 days prior to leaving Japan. Premiums range from $11.58 for the single plan (one family member) to $28.95 for the family premium (more than one family member). Visit the Web site http://www.tricaredentalprogram.com for enrollment information or call 243-5509.

For more information, visit the TRICARE Service Center located on the first floor of U.S. Naval Hospital Yokosuka or call 243-9528.