Active Duty Service Member Benefits

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Active Duty Service Member Benefits

  1. 1. Active Duty Service Member Benefits SFC Paul Weinstein Phone 318-641-5420 Fax 318-641-3295
  2. 2. Medical Benefits General Overview
  3. 3. The first step to obtaining medical care 1. Update DEERS
  4. 4. How to update DEERS -Report to nearest ID card office -Go to www.tricare.osd.mil/DEERSAddress/ to update address only
  5. 5. <ul><li>TRICARE North 877-874-2273 </li></ul><ul><li>TRICARE South 800-444-5445 </li></ul><ul><li>877-249-9179 ADSM only </li></ul><ul><li>TRICARE West 888-874-9378 </li></ul>TRICARE Regions
  6. 6. Pharmacy Benefits Military Treatment Facilities Civilian Retail Pharmacies TRICARE Mail Order Pharmacy 1-866-363-8667 All Active Duty Service Members have a $0.00 copay
  7. 7. Active Duty Service Member (ADSM) Medical Care -Military Treatment Facility medical care for all ADSMs who live OR work within 50 miles or 1 hour drive time -TRICARE Prime Remote for all others ( Go to www.tricare.osd.mil/remote to check eligibility for TRICARE Prime Remote)
  8. 8. ADSM Steps to Enroll into TRICARE Military treatment facility (MTF) enrollment: Different for every MTF- see Region Phone number list TRICARE Prime Remote Enrollment: Choose a primary care manager Complete enrollment form and mail or fax to contractor
  9. 9. Active Duty Service Member Dental Care Entitlements - Military Dental Treatment Facilities - TRI-Service Remote (MMSO Program) - Not eligible for TRICARE Dental Program
  10. 10. Military Dental Treatment Facilities An option for all service members regardless of duty station Requirement for all soldiers who live OR work within 50 miles or one hour drive time (by zip code)
  11. 11. Military Medical Support Office PO Box 886999 Building 38-H Great Lakes, IL 60088-6999 MMSO
  12. 12. TRI-Service Remote Dental Program NOT a TRICARE Program Only soldiers who live and work greater than 50 miles or 1 hour drive time from the nearest Military Dental Facility are eligible
  13. 13. TRI-Service Remote Dental -Use any licensed civilian dentist -Routine dental -Emergency dental -Specialty dental -No cost share or co-payment - Dentists paid at 100% billed
  14. 14. Emergency Dental -Requires no pre-authorization -Definition: the immediate treatment, including prescription medicine, required to relieve pain or prevent serious infection or loss of tooth structure
  15. 15. Routine Dental -Includes: diagnostic preventative procedures, routine restorations, tooth extraction, root canal treatments, and minor periodontal treatment -Up to $1500 per year without requiring pre-authorization -Up to $500 per treatment episode (visit) without requiring pre-authorization
  16. 16. Specialty Dental Always requires pre-authorization Includes crowns, bridges, veneers, implants, surgery, and TMD treatment
  17. 17. Pre-authorization -Required for all specialty dental -Required for all routine dental above $500 per treatment episode and/or $1500 per year
  18. 18. How to Obtain Pre-Authorization from MMSO Send memo to MMSO with the following enclosures - pretreatment estimate from dentist - dental x-rays/photos - copy of last military dental exam -OR- Have dentist forward pretreatment estimate and dental photos to Health Systems, LAARNG and we do the rest
  19. 19. Dental Claims -Complete the MMSO Dental Information Sheet prior to every dental visit -Have the dentist forward the claim along with the MMSO Claim Form directly to MMSO Unless: You are the only service member at your duty station
  20. 20. QUESTIONS?

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