Reserve, Guard Can Seek Reimbursement
of Medical, Dental Claims
WASHINGTON (7/27/2004) -- National Guard and reserve
members who paid their medical and dental bills and saved their
receipts may now seek reimbursement from Tricare, officials of the
military health care system announced July 23.
Officials said the system will begin processing medical and dental
claims for Guard and Reserve members who meet certain eligibility
requirements.
Only guardsmen and reservists issued "delayed-effective-date
active-duty orders" for more than 30 days in support of a contingency
operation, and their families, may be eligible to have medical claims
reimbursed.
And according to Tricare, only those medical expenses incurred during
the military member's "early eligibility" period --
up to 60 days prior to reporting to active duty -- from Nov. 6,
2003, to the present are eligible for reimbursement.
This temporary entitlement is part of the Defense Department's
2004 Temporary Reserve Health Benefit Program, which sought to enhance
benefits for Guard and reserve members called to active duty.
Normally, under Tricare guidelines, Reserve and Guard members cannot
be enrolled into Tricare until they reach their final duty location.
The temporary entitlement gives them access upon receipt of activation
orders, up to 60 days in advance.
Last year, President Bush signed legislation authorizing three new
temporary provisions for guardsmen and reservists and their families
that provided enhanced access to for a limited time during contingency
activation. The provisions were made retroactive to Nov. 6, 2003.
A second provision temporarily extended eligibility for Tricare
benefits to 180 days for those guardsmen and reservists who separated
from active duty status during the period Nov. 6, 2003, through
Dec. 31, 2004.
The third provision extends Tricare medical benefits to reserve-component
sponsors and family members who are either unemployed or employed
but not eligible for employer-provided health coverage.
All temporary provisions will end on Dec. 31, 2004.
However, the measure did include three provisions for permanent
health
benefits: making benefit counselors available for Guard and Reserve
members in each Tricare region, authorizing medical and dental screening
and care for members alerted for mobilization, and providing Tricare
eligibility for reserve officers pending orders to active duty following
commissioning.
Guardsmen, reservists and their family members must be registered
in the Defense Enrollment Eligibility Reporting System and be Tricare
eligible to qualify for the temporary benefit.
In order to apply for reimbursement, eligible members must submit
a Tricare
(CHAMPUS) claim form, a copy of their itemized bill, an explanation
of benefits, and proof of payment (if the bill was already paid)
to their regional Tricare claims processor.
Claims processing instructions and a downloadable Tricare claims
form, DD Form 2642, are available at local Tricare service centers
or from Tricare regional contractors, or may be downloaded from
the Tricare Web site.
(Based on a Tricare Activity release.)
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