Medical Insurance Ch 12 TRICARE

Medical Insurance Ch 12
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catchment area
A geographical area usually within approximately forty miles of military impatient treatment facilities; under TRICARE, the facility in a patient's area must issue a nonavailable statement before the patient can be treated at a nonmilitary facility.
catastrophic cap
The maximum annual amount a TRICARE beneficiary must pay for deductible and cost share.
Now the TRICARE program; formerly the Civilian Health and Medical Program of the Uniformed Services (Army, Navy, Air Force, Marine Corps, Coast Guard, Public Health Service, and National Oceanic and Atmospheric Administration) that serves spouses and children of active-duty service members, military retirees and their families, some former spouses, and servivors of deceased military members.
Civilian Health and Medical Program of the Dept of Veterans Affairs (CHAMPVA)
The Civilian Health and Medical Program of the Dept of Veterans Affairs (previously known as the Veterans Administration) that shares health care cost for families of veterans with 100 percent service-connected disabilities and the surviving spouses and children of veterans who die from service-connected disabilities.
Coinsurance for a TRICARE or CHAMPVA beneficiary.
Defense Enrollment Eligiblity Reporting System (DEERS)
The worldwide database of TRICARE and CHAMPVA beneficiaries.
Military Treatment Facility (MF)
Government facility providing medical services for members and dependents of the uniformed services.
nonavailability statement (NAS)
A form required for preauthorization when a TRICARE member seeks medical services in other than military treatment facilities.
Primary Care Manager (PCM)
Provider who coordinates and manages the care of TRICARE beneficiaries.
The uniformed service member in a family qualified for TRICARE or CHAMPVA)
Government health program that serves dependents of active-duty service members, military retirees and their families, some former spouses, and survivors of deceased military members; formerly called CHAMPUS.
TRICARE's managed care health plan that offers a network of civilian prioviders.
TRICARE for Life
Program for beneficiaries who are both Medicare and TRICARE eligible.
The basic managed care health plan offered by TRICARE
TRICARE Prime Remote
A TRICARE plan that provides no-cost health care through civilian providers for eligible service members and their families who are on remote assignment.
TRICARE Reserve Select (TRS)
TRICARE coverage for reservists.
TRICARE Standard
The fee-for-service health plan offered by TRICARE
The TRICARE plan that is an HMO and requires a PCM is?
Active duty service members
______ enrollees receive priority at military treatment facilities.
A TRICARE for life beneficiary must be at least _______ years old.
100 %
A TRICARE Prime enrollede visits a provider outside the network, TRICARE pays _______ per cent of the covered charges.
The TRICARE health care program is a covered entity and subject to privacy rules under ___
A person enrolled in CHAMPVA is responsible for _______ percent of covered charges.
Nonparticipating TRICARE providers cannot bill for more than ________ % of allowable charges.
Active duty service members are automatically enrolled in ____ ?
For individuals enrolled in TRICARE for Life, the primary payer is ________?
branch of military service.
Decisions about an individual's eligibility for TRICARE are made by the________?

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