Flashcard Set Preview
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catchment area
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A geographical area usually within approximately forty miles of military impatient treatment...
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catastrophic cap
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The maximum annual amount a TRICARE beneficiary must pay for deductible and cost share.
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CHAMPUS
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Now the TRICARE program; formerly the Civilian Health and Medical Program of the Uniformed...
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Civilian Health and Medical Program of the Dept of Veterans Affairs (CHAMPVA)
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The Civilian Health and Medical Program of the Dept of Veterans Affairs (previously known as...
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cost-share
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Coinsurance for a TRICARE or CHAMPVA beneficiary.
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Defense Enrollment Eligiblity Reporting System (DEERS)
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The worldwide database of TRICARE and CHAMPVA beneficiaries.
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Military Treatment Facility (MF)
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Government facility providing medical services for members and dependents of the uniformed...
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nonavailability statement (NAS)
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A form required for preauthorization when a TRICARE member seeks medical services in other...
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Primary Care Manager (PCM)
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Provider who coordinates and manages the care of TRICARE beneficiaries.
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sponsor
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The uniformed service member in a family qualified for TRICARE or CHAMPVA)
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TRICARE
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Government health program that serves dependents of active-duty service members, military...
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TRICARE Extra
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TRICARE's managed care health plan that offers a network of civilian prioviders.
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TRICARE for Life
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Program for beneficiaries who are both Medicare and TRICARE eligible.
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TRICARE Prime
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The basic managed care health plan offered by TRICARE
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TRICARE Prime Remote
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A TRICARE plan that provides no-cost health care through civilian providers for eligible service...
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TRICARE Reserve Select (TRS)
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TRICARE coverage for reservists.
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TRICARE Standard
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The fee-for-service health plan offered by TRICARE
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TRICARE Prime
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The TRICARE plan that is an HMO and requires a PCM is?
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Active duty service members
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______ enrollees receive priority at military treatment facilities.
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65
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A TRICARE for life beneficiary must be at least _______ years old.
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100 %
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A TRICARE Prime enrollede visits a provider outside the network, TRICARE pays _______ per cent...
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HIPAA
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The TRICARE health care program is a covered entity and subject to privacy rules under ___
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25%
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A person enrolled in CHAMPVA is responsible for _______ percent of covered charges.
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115%
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Nonparticipating TRICARE providers cannot bill for more than ________ % of allowable charges.
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TRICARE Prime
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Active duty service members are automatically enrolled in ____ ?
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Medicare
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For individuals enrolled in TRICARE for Life, the primary payer is ________?
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branch of military service.
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Decisions about an individual's eligibility for TRICARE are made by the________?
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