VA & Tricare                                    NewsletterMAY 17, 2012                                                    ...
DTF.Referrals/AuthorizationsUnited Concordia is required to track all referrals andauthorizations for the ADDP. Referrals ...
scheduled to initiate care. The determination of       the authorization request can take from to three       to five busi...
VA BenefitsHEALTH BENEFITS ADVISOR                                             Traumatic Service member’s Group Life Insur...
by the Branch of Services TSGLI Offices, benefits will notCONTACT:                                        be paid until Oc...
SERVING WOUNDED WARRIORS AND THE SURVIVORSOF OUR FALLEN HEROES BY Gina Ramer, Regional Communications Director,Social Secu...
The men and women of the Armed Forces serve us each    and every day. At Social Security, we’re here to serve    you too. ...
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TAA May 2012 Newsletter

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TAA May 2012 Newsletter

  1. 1. VA & Tricare NewsletterMAY 17, 2012 VOLUME 1, NUMBER 67 A LOOK AT ACTIVE DUTY DENTAL PROGRAM The Active Duty Dental Program (ADDP) is program that does dental claims processing. Its purpose is to augment-not replace- dental care that is provided by Military Dental Treatment Facilities (DTF’s). There are two distinct components one is DTF referred and Remote Active Duty Dental Program (RADDP). Authorized users will be required to use a United Concordia network dentist, unless otherwise designated by United Concordia. Websites: Who is eligible? ADDP Website: Active Duty Personnel of 5 uniformed services who live and work within 50 miles of a military www.addp-ucci.com DTF Customer Service: Guardsmen and Reservists on orders >30 days 1-866-984-2337 Foreign military personnel stationed in the U.S. Early Activators/delayed effective date active orders Line of Duty Personnel Service members on TAMP that came off orders in support contingency operation (ex. OEF/OIF, Operation Dawn) Program Components DTF referred care – provides private sector dental care for ADSMs referred for private sector dental care from a military DTF. Included are ADSMs who have a duty location or residence with 50 miles of a DTF. Remote ADDP – provides private sector dental care for ADSMs with a duty location and residence greater than 50 miles from a military
  2. 2. DTF.Referrals/AuthorizationsUnited Concordia is required to track all referrals andauthorizations for the ADDP. Referrals are made by amilitary DTF for care not available in that DTF. RemoteADSMs may personally coordinate their own routine careif all guidelines are followed. Authorizations aresubmitted from a civilian provider for remote ADSMspecialty and other care. DTF Referral – When an ADSM requires dental care that cannot be provided by the DTF, the DTF will prescribe a referral (that the ADSM will bring to the civilian network dentist appointment). The DTF referral should be accepted as a treatment plan, which is indicated on the referral form. However, if the civilian dentist finds clinical reasoning for alternative treatment, a modified referral is required. Referral modifications are obtained by contacting the DTF. Remote ADDP Self-Referrals – Remote ADSMs self-refer for routine covered benefits (non- specialty dental care such as examinations, cleanings, fillings), unless that care is over $500 per appointment or cumulative total of $1500 or more for treatment plans completed within a consecutive 12 month period. Remote ADSMs cannot self-refer for any specialty procedures, regardless of cost. Remote ADSMs must use a United Concordia network dentist and obtain an Appointment Control Number (ACN) from United Concordia prior to scheduling any private sector dental appointment. To coordinate routine dental care, remote ADSMs must complete an Appointment Request Form (available at www.addp-ucci.com). United Concordia will provide the remote ADSM with a CAN after form submission. Remote ADDP Authorization – Authorizations are required for all care for which the remote ADSM cannot self-refer. A civilian dentist will request an authorization for a remote ADSM using the Authorization Request Form (available at www.addp-ucci.com). This form must indicate the procedures desired in order to initiate the authorization request. Upon authorization approval, the remote ADSM and civilian dentist will be notified and an appointment can be
  3. 3. scheduled to initiate care. The determination of the authorization request can take from to three to five business days.If you are requiring more information on this programplease go to the website: www.addp-ucci.com .To Contact United Concordia ADDP, you can contact byemail, mail or phone. It is as follows:United Concordia Companies, Inc.ADDP UnitPO Box 69430Harrisburg, PA 17106-9430Email: addpdcf@ucci.comPhone: 1-866-984-2337Source: Tricare Active Duty Dental Program Website
  4. 4. VA BenefitsHEALTH BENEFITS ADVISOR Traumatic Service member’s Group Life InsuranceAmador ―Rod‖ Rodriguez678-569-7174 (TSGLI)amador.rodriguezjr@us.army.mil Traumatic Service member’s Group Life Insurance is a Congressionally-mandated insurance program that OR provides short-term financial support to traumatically Transition Assistant Advisor injured Soldiers and their families through a one-time (TAAs) Marvin Thomas/Darrell payment effective December 1, 2005. TSGLI is bundled Partee with SGLI- premium was increased by $1 to accommodate traumatic coverage. TSGLI provides The TAA is the TRICARE and VA liaison for the state. payments of $25,000 up to $100,000 to members of the uniformed services covered by SGLI who sustain certain Assistance provided for: specified losses as a result of a traumatic injury. Like TRICARE for Life SGLI, TSGLI covers a service member 24/7. TRICARE Reserve How TSGLI helps injured Soldiers Select TSGLI is designed to assist with unanticipated expenses TRICARE Retired and/or help with a head start on life after recovery. Reserve Payment amount varies depending on the injury. Free financial counseling is available for Soldiers from TRICARE Dental, Active Duty Dental Financial Point. TSGLI is a one-time financial assistance—NOT income replacement. TSGLI does not VA Services and replace any other VA benefits. Benefits Who Is Eligible For TSGLI Filing assistance for benefits with VA, DOD Soldiers who elect Service members Group Life and Tricare Insurance (SGLI) coverage and incur a qualifying The TAA is available* traumatic injury after 1 December 2005, regardless of to provide in-person their component (Active, Reserve or National Guard) or briefings for TRICARE and/or VA benefits. the location in which they incurred the injury. Survivors (Available during drill of service members who died more than seven days weekends) after their injuries are also eligible to receive TSGLI payment if the member had a covered loss. Retroactive TSGLI As of October 1, 2011, the Service members’ Group Life Insurance Traumatic Injury Protection Benefit will be payable for all qualifying injuries incurred during the period October 7, 2001 to November 30, 2005, regardless of where they occurred and regardless of whether the member has SGLI coverage at the time of the injury. The Veterans’ Benefit Act of 2010 removes the requirement that injuries during this period be incurred in Operations Enduring or Iraqi Freedom. Applications for the retroactive TSGLI can be accepted
  5. 5. by the Branch of Services TSGLI Offices, benefits will notCONTACT: be paid until October 1, 2011, the effective date of theMr RODRIQUEZ (address shown above) law. OR A Qualifying Traumatic Injury is an injury or loss caused by application of external force or violence (a• MARVIN THOMAS traumatic event) OR a condition whose cause can be• OFFICE 678-569-8193 directly linked to a traumatic event. Examples would be loss of hand or foot by severance at or above the wrist• BB: 678-656-4115 or ankle; loss of speech, or paraplegia.• marvin.w.thomas@us.army.mil Claim Process• www.facebook.com/MarvinThomasTAA Obtain a TSGLI Claim form by downloading a claim form with complete information packet from this website• CONTRACTOR www.insurance.va.gov, or• SKYLINE-Ultd http://www.insurance.va./gov/sgliSite/TSGLI/TSGLI.htm then submit to your branch of service point of contacts:• DARRELL PARTEE Army (All Components) – Phone (800) 237-1336, Fax• OFFICE 478-803-3149 (502) 613-4513, email: tsgli.calims@conus.arm• BB: 404-840-5792 Navy (All Components) – Phone (800) 368-3202, Fax• darrell.partee@us.army.mil (901) 874-2265 , email: MILL_TSGLI@navy.mil• www.facebook.com/DarrellParteeTAA Air Force – Phone (800) 433-0048, Fax (210) 565-2348, email: afpc.casualty@randolph.af.mil• CONTRACTOR Air Reserve – Phone (800) 525-0102, Fax (303) 676- SKYLINE-Ultd 6255, email: afpc.dppedl@arpc.denver.af.mil Air National Guard - Phone (703) 607-5093, Fax (703) 607-0033, email: ngb.a1ps@ang.af.mil Marine Corps (All Components) – Phone (877) 216-0825 or (703) 432-9277, Fax (888)858-2315, email: t- sgil@usmc.mil Coast Guard – Phone (202) 493-1931, Fax (202) 493- 1939, email: ARL-PF-CGPSC-PSDFS- COMPENSATION@uscg.mil Public Health Service - Phone (301) 594-2963, Fax (301)594-2973, email: compensationbranch@psc.hhs.gov NOAA Corps – Phone (301) 713-3444, Fax (301) 713- 4140, email: Director.cpc@noaa.gov Source: VA website and VA news release
  6. 6. SERVING WOUNDED WARRIORS AND THE SURVIVORSOF OUR FALLEN HEROES BY Gina Ramer, Regional Communications Director,Social Security AdministrationIt’s an American tradition to pay tribute to the men andwomen of the Armed Forces each Memorial Day —especially honoring those who have made the ultimatesacrifice while serving our country.If you are a military service member who was woundedand needs to apply for Social Security disability benefits,it’s important to know that you will receive expeditedprocessing. Our wounded warrior’s initiative is formilitary service members who become disabled while onactive duty on or after October 1, 2001, regardless ofwhere the disability occurs. Depending on the situation,some family members of military personnel, includingdependent children and, in some cases, spouses, may beable to receive benefits. Learn more about it atwww.socialsecurity.gov/woundedwarriors. Did you know that May also is National MilitaryAppreciation Month? Even more reason to let membersof our military know how much we value what you do forus and our nation. To learn more about the SocialSecurity benefits for those who have served in themilitary, read our publication, Military Service and SocialSecurity. You can find it online atwww.socialsecurity.gov/pubs/10017.html, or send us anemail at OPI.Net.Post@ssa.gov, or call us at 1-800-772-1213 (TTY 1-800-325-0778) to ask for a free copy to bemailed to you. Memorial Day also is a good time to remind families offallen military heroes that we may also be able to paySocial Security survivors benefits. If the person youdepended on for income has died, you should apply forsurvivors benefits. Learn more about Social Securitysurvivors benefits atwww.socialsecurity.gov/pgm/survivors.htm .
  7. 7. The men and women of the Armed Forces serve us each and every day. At Social Security, we’re here to serve you too. Watch out for the June newsletter which will contain information about Line of Duty and Guide and Service Dogs. The newsletter can be found on the TAA face book page www.facebook.com/USATAA If there is any material on Tricare, VA or DoD program you would like to see me address in my next newsletter please feel free to contact us using our email address listed above.1

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