medical insurance Ch 12 TRICARE

27 cards

medical insurance Ch 12


 
  
Created Nov 22, 2009
by
brendara

 

 
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1
catchment area
 
A geographical area usually within approximately forty miles of military impatient treatment...
2
catastrophic cap
 
The maximum annual amount a TRICARE beneficiary must pay for deductible and cost share.
3
CHAMPUS
 
Now the TRICARE program; formerly the Civilian Health and Medical Program of the Uniformed...
4
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...
5
cost-share
 
Coinsurance for a TRICARE or CHAMPVA beneficiary. 
6
Defense Enrollment Eligiblity Reporting System (DEERS)
 
The worldwide database of TRICARE and CHAMPVA beneficiaries.
7
Military Treatment Facility (MF)
 
Government facility providing medical services for members and dependents of the uniformed...
8
nonavailability statement (NAS)
 
A form required for preauthorization when a TRICARE member seeks medical services in other...
9
Primary Care Manager (PCM)
 
Provider who coordinates and manages the care of TRICARE beneficiaries. 
10
sponsor
 
The uniformed service member in a family qualified for TRICARE or CHAMPVA)
11
TRICARE
 
 Government health program that serves dependents of active-duty service members, military...
12
TRICARE Extra
 
TRICARE's managed care health plan that offers a network of civilian prioviders.
13
TRICARE for Life
 
Program for beneficiaries who are both Medicare and TRICARE eligible. 
14
TRICARE Prime
 
The basic managed care health plan offered by TRICARE
15
TRICARE Prime Remote
 
A TRICARE plan that provides no-cost health care through civilian providers for eligible service...
16
TRICARE Reserve Select (TRS)
 
TRICARE coverage for reservists.
17
TRICARE Standard
 
The fee-for-service health plan offered by TRICARE
18
TRICARE Prime
 
The TRICARE plan that is an HMO and requires a PCM is?
19
Active duty service members
 
______ enrollees receive priority at military treatment facilities.
20
65
 
A TRICARE for life beneficiary must be at least _______ years old.
21
100 %
 
A TRICARE Prime enrollede visits a provider outside the network, TRICARE pays _______ per cent...
22
HIPAA
 
The TRICARE health care program is a covered entity and subject to privacy rules under ___
23
25%
 
A person enrolled in CHAMPVA is responsible for _______ percent of covered charges.
24
115%
 
Nonparticipating TRICARE providers cannot bill for more than ________ % of allowable charges.
25
TRICARE Prime
 
Active duty service members are automatically enrolled in ____ ?
26
Medicare
 
For individuals enrolled in TRICARE for Life, the primary payer is ________?
27
branch of military service.
 
Decisions about an individual's eligibility for TRICARE are made by the________?


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