The Emergency Supplemental Appropriations Act and the National Defense Authorization Act (NDAA) for fiscal 2004 authorized new health benefits, some permanent and some temporary. The 2004 Temporary Reserve Health Benefit Program includes three temporary Tricare benefit provisions; some are effective as of Nov. 6, 2003, and all expire Dec. 31, 2004. Total expenditures for these new provisions may not exceed the $400 million limit established by Congress for fiscal 2004. Tricare Management Activity will implement the new provisions in phases starting in the spring.
These new temporary provisions were designed by Congress to improve readiness and enhance access to care for Reserve servicemembers and their families, said Dr. William Winkenwerder Jr., assistant secretary of defense for health affairs. We are implementing these new provisions as soon as possible, he said.
One provision temporarily authorizes Tricare medical and dental coverage for Reserve component sponsors activated for more than 30 days and their family members. Eligibility begins either on the day the sponsor receives delayed-effective date active duty orders or 90 days prior to the date the active duty period begins, whichever is later.
A second provision temporarily extends eligibility for Tricare benefits to 180 days under the Transitional Assistance Management Program for Reserve component sponsors who separate from active duty status during the period Nov. 6, 2003 through Dec. 31, 2004, and their eligible family members.
The third provision temporarily 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.
These temporary provisions end on Dec. 31, 2004.
We encourage Reserve component sponsors and family members to save health care receipts, claims and explanation of benefits for dates of service from Nov. 6, 2003, through Dec. 31, 2004. This is necessary in the event the sponsor is determined to be eligible and the care qualifies for retroactive Tricare reimbursement once the 2004 Temporary Reserve Health Benefit Program begins, said Winkenwerder.
The three permanent health benefit provisions of the NDAA include: benefit counselors for the Reserve component in each Tricare region; authorization for medical and dental screening and care for members alerted for mobilization; and Tricare eligibility for reserve officers pending orders to active duty following commissioning.
Additional information for Reserve component families, who have questions regarding the Tricare benefit or need assistance processing Tricare claims, are available on the Tricare Web site at http://www.tricare.osd.mil/ and the Reserve Affairs Web site at http://www.defenselink.mil/ra. Each Tricare region will soon have a designated beneficiary counseling and assistance coordinator available to assist members and families with understanding and using their enhanced Tricare benefits.