Deployment: Medical Benefits

Active Duty Medical Benefits

As you prepare for deployment, be sure to review your current medical coverage, and decide whether you want to make changes.

Defense Enrollment Eligibility Reporting System (DEERS):

DEERS is a computer-based eligibility data system for personnel entitled to medical care benefits. It is also designed to eliminate fraud, waste and abuse in the use of health benefits and privileges.

The most important thing you can do is make sure all your information in DEERS is accurate. Since DEERS is the system used to determine eligibility for military health care, family members could be denied care if DEERS information is incorrect or incomplete.

TRICARE Options:

Like all health care plans, TRICARE has specific rules concerning what services are covered, the allowable charge for each service and whether the beneficiary needs permission to receive the service. Each military hospital and clinic has a health benefits advisor to provide assistance to you. A brief description is provided for the three plans available to eligible family members. Click here for detailed information or further questions.

a) TRICARE Prime: This option is the lowest in cost but you have to choose your health-care provider from a pre-approved network of providers, including military primary care managers. The primary care manager will provide most of your care, including referrals to specialists. Active duty families do not pay an annual enrollment fee, pay a reduced co-payment (none when using military facilities), and do not have to file claims when using network providers. All active duty members are automatically enrolled in Prime.

b) TRICARE Extra: In this option, you do not have to enroll or pay an annual fee. On a visit-by-visit basis, you can seek care from a provider who is part of the TRICARE Extra network and get a discount on services and reduced cost-shares. Also, you will not have to file claims when using network providers.

c) TRICARE Standard: This option is the same as the old CHAMPUS program. It pays a share of the cost of covered health care services that you obtain from a non-network civilian health care provider. You are responsible for a percentage of health care costs. Family members are automatically enrolled in Standard unless they indicate otherwise.

Dental Benefits:

Active duty military personnel are provided complete dental service at base dental clinics. As with most dental insurance, the plan is not totally free and all dental care is not covered. The monthly fee the family will pay depends on the number of family members. The cost is very low because the government pays the rest of the premium. The plan pays for diagnostic and preventive services. For other covered services, the servicemember will pay 20 percent of the cost.

The insurance carrier for this plan has agreements with many licensed dentists and hygienists to provide the required services. These agreements ensure acceptance by the dentists and hygienists of the plan's allowable charges of covered services plus your costs share, as the full fee for their services. In most cases, they will file the claim for you. A list of participating dentists, as well as more detailed information, can be obtained from your nearest health benefits advisor at the base hospital or clinic.

Reserve and Guard Medical Benefits

If you are a Guard or Reserve member being called up to active duty for more than 30 days, you and your family are eligible for TRICARE benefits the day you are mobilized. Congress recently passed a major change to TRICARE coverage eligibility for Reserve and Guard members. This new law will allow you to enroll in TRICARE for single or family coverage.

Are you eligible? You qualify if you are a Reserve or National Guard member and you are receiving unemployment compensation or if you are not eligible for health care benefits under an employer-sponsored health benefits plan. To verify eligibility, visit https://www.dmdc.osd.mil/Guard-ReservePortal.

How do you enroll? The new law stipulates the Secretary of Defense will provide at least one open enrollment period each year. During an open enrollment period, an eligible Reserve or Guard member may enroll in the TRICARE program, change, or terminate an enrollment in the TRICARE program. These "enrollment dates" have not been determined yet.

For more information, see the TRICARE Reserve Select Overview.

TRICARE Coverage for Guard/Reserve Member

*Contact your Reserve Component personnel office to determine your eligibility for these programs.
**Active duty must be in support of a contingency operation to qualify. Examples of contingency operations include Operations Enduring Freedom, Noble Eagle, and

TRICARE Benefits for the Family:

Family members of reservists and guardsmen activated for 30 days or more have the option to enroll in TRICARE Prime, the military's version of a health maintenance organization. They will receive care in a military medical treatment facility or be assigned to a network provider in their area with no cost-shares or deductibles.

TRICARE Prime is the only one of the TRICARE options that requires pre-enrollment on the part of the family members. Enrollment information can also be found on the TRICARE Website or by contacting a local TRICARE benefits counselor. Enrollment has to occur by the 20th of the month in order to be eligible for care on the 1st of the following month. For instance, reserve component members who might be mobilized in coming weeks must have their enrollment forms in to TRICARE by Feb. 20 in order for their families to start receiving care on March 1 under the Prime option. The family would be covered under TRICARE Standard or Extra until enrolled in Prime.

The most important thing you can do is make sure all your information in the Defense Enrollment Eligibility Reporting System (DEERS) is accurate. Since DEERS is the system used to determine eligibility for military health care, family members could be denied care if DEERS information is incorrect or incomplete. For more information, visit www.tricare.osd.mil/DEERSAddress or call 1-800-538-9552 (California: 1-800-344-4162) Monday
through Friday, 9 a.m. to 6:30 p.m. Eastern Standard Time.

Activated reservists are given a chance to review and make changes to their families' DEERS enrollments during the mobilization process. Personnel will verify eligibility for DEERS benefits when you apply for your DD Form 1172, Application for Uniformed Services Identification Card. You must present marriage and birth certificates for all children ages 21 and under (ages 21and over if handicapped, 21-22 if in college) and present a copy of your orders for identification purposes.

Activated Reserve component members and their families are also eligible to enroll in the TRICARE Dental Program. Reserve members who had previously enrolled in the program are automatically removed when mobilized because they receive dental care from military providers while on active duty.

Families who had previously declined TRICARE dental coverage but who wish to enroll after their sponsors are mobilized will be able to join at active-duty rates during the first 30 days. Enrollment forms and information are available online.

When Your Family Is Covered

Mobilization Checklist

Before receiving deployment notification:

• Enroll family members in DEERS and/or update information as needed.
• Get your Will and other legal documents in order.
• Contact your command or unit family readiness representative for help with completing your family care plan.
• Review your TRICARE options.
• Review your civilian employer's health and dental coverage options while on active duty.
• Determine costs and benefits of both TRICARE and civilian options before choosing one or the other.

Upon receiving deployment orders:

• Confirm that your family's DEERS information is current.
• Get military ID cards for eligible family members.
• Give your family copies of your orders.
• Visit https://tricare.mil/Plans/Eligibility/NGRMandFamilies/Activated for information on TRICARE.
• Contact your civilian employer to continue or discontinue your employer health and/or dental coverage.
• Contact your military legal assistance office to appoint your power of attorney and update your Will.
• Contact your command or unit family readiness representative for help in updating your family care plan.
• Contact your finance office to set up an allotment, if applicable.
• Make other financial arrangements as required.
• Review life insurance for spouse and yourself.