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The Department of Defense has several transitional health care programs to assist service members and their families as they prepare for civilian life.
Transitional benefits bridge the gap between military and civilian life and allow time for members to research and explore other health insurance options.
While eligibility varies, it is normally associated with the type of separation and the characterization of the service member’s discharge. The 86th Force Support Squadron can assist members in determining their specific eligibility.
Preparation is crucial when transitioning to civilian life, particularly if you have family members with special needs or if they are enrolled in the Exceptional Family Member Program.
On March 23, 2010, the Affordable Care Act was signed into law to ensure access to affordable health insurance options for all individuals.
Under the Affordable Care Act, insurance carriers cannot limit or deny benefits/coverage because of pre-existing conditions for a child, however, it is vitally important members research available health care options.
Below is a list of available health care options, not all-inclusive, with a summary of the program and links to additional information:
Transitional Assistance Management Program, www.tricare.mil
• Provides 180 days of transitional health benefits to separating members and their families.
• You are not eligible for TAMP while on terminal leave or permissive TDY.
• On terminal leave/permissive TDY, you continue to receive active duty (AD) coverage benefits.
• If one of the below conditions are met, you may be eligible for this program:
» Involuntarily separating from AD under honorable conditions.
» A National Guard/Reserve member separating from a period of AD that was more than 30 consecutive days in support of a contingency.
» Separating from AD following involuntary retention in support of a contingency.
» Separating from AD due to sole survivorship discharge.
• TAMP benefits begin the day after your DOS from active duty.
• You and your family members will automatically be covered by TRICARE Standard, TRICARE Extra or TRICARE Overseas Program Standard (if overseas).
• If in an area where TRICARE Prime is available, you may enroll in this option.
• During TAMP, you and your family are covered under the medical benefit as active duty family members and all rules for that beneficiary category apply (deductibles/cost-shares).
Continued Health Care Benefit Program, www.Humana-Military.com
• CHCBP is a bridge between military benefits and civilian health plan.
• If eligible, CHCBP provides 18-36 months of health care coverage after your military sponsored programs (i.e. AD, TAMP, etc.) eligibility ends.
• CHCBP is available to former uniformed service members, their qualified family members, former spouses who have not remarried, adult children and unmarried children by adoption or legal custody.
• CHCBP is not a TRICARE program, but offers similar coverage to TRICARE Standard.
• The main difference is premium payments are required and CHCBP enrollees are not legally entitled to routine, urgent, or specialty care at military hospitals or clinics.
• Individual premium coverage costs $1,193 per quarter.
• Family premium coverage costs $2,682 per quarter.
• Under this program, you will be responsible for paying annual deductible and cost-shares.
• CHCBP coverage is purchased in 90-day increments, premiums are billed quarterly.
• Best to use TRICARE network provider under CHCBP as they have signed contracts with TRICARE and have agreed to file claims on your behalf.
• Non-network participating providers accept the TRICARE-allowable change (less any cost-shares paid by you) as payment in full for their services.
• Non-network, non-participating providers have not agreed to accept the TRICARE allowable charges or to file claims and have the legal right to charge 15 percent above the TRICARE allowable charge for their services.
Department of Veterans Affairs, www.va.gov
• VA provides a wide range of health care services to veterans.
• VA provides free healthcare for veterans who served in a theater of combat operations after Nov. 11, 1998, for any illness possibly related to their service in that theater.
Health Insurance Marketplace (also known as health insurance exchange), www.healthcare.gov/what-is-the-health-insurance-marketplace
• New way to find quality health coverage based on income.
• Will tell you if you qualify for free or low-cost coverage available through Medicaid or the Children’s Health Insurance Program (CHIP).
• Insurance plans in the marketplace are offered by private companies.
• No plan can turn you away or charge more money because of a medical condition.
• You will be able to compare health plans side-by-side and choose what is best for you and your family.
Children’s Health Insurance Program (CHIP) www.healthcare.gov/
are-my-children-eligible-for-chip/
• CHIP provides low-cost health coverage to children in families that earn too much to qualify for Medicaid.
• Each state offers CHIP coverage
• CHIP benefits are different in each state, but it provides comprehensive coverage.
• Cost varies by state. Some states charge a monthly premium for coverage. Routine, well child visits are free, but some services may require co-payments.
• CHIP may also provide coverage for children whose parents earn too much money to qualify for Medicaid.
Medicaid www.healthcare.gov/do-i-qualify-for-medicaid/
• Provides coverage for some low-income individuals, families and children, pregnant women, the elderly and people with disabilities.
• If you qualify for Medicaid, your children will qualify for either Medicaid or CHIP.
If a member separates and the member/family requires ongoing medical care (special needs and certain EFMP cases), our case manager will provide a warm hand-off to the accepting physician in the civilian community as long as the service member/spouse signs a release of information form.
Contact 86th MDG Case Management Services, 479-2168, for details.
For questions about transitional health care benefits, TRICARE provides walk-in hours from
9 a.m. to 3 p.m. Monday through Friday. Note: Closed on federal holidays, family days, goal/down days and weekends. Contact the 86th MDG TRICARE Service Center at 479-2008 for more
information.
