Will Tricare cover spouse’s long-term Alzheimer’s care? - Getting out, military health issues - Navy Times

Will Tricare cover spouse’s long-term Alzheimer’s care?

Q. My wife has Alzheimer’s disease and I had to put her in a nursing home. My cost is $2,500 a month. Is there any way that Tricare for Life can help me?

A. Tricare covers skilled nursing care, home health care and hospice care, but generally does not cover long-term care (also known as custodial care) for patients with degenerative conditions, such as Alzheimer’s.

Full or partial exceptions to the “no coverage” guidance should be discussed with the managed-care contractor for the Tricare region where you live. See www.tricare.mil/welcome/aboutus/regions/ for contact information.

Q. My wife got a bill for a recent visit to the emergency room, but we have Tricare Prime. What should I do?

A. There are times when Tricare beneficiaries who receive emergency care must pay upfront and file for reimbursement from Tricare. Assuming you told the ER staff you’re in Prime, this may have been such a time.

To verify that, call the managed-care contractor for your Tricare region — see www.tricare.mil/welcome/aboutus/regions/. If your contractor says you should pay the bill and file a claim for reimbursement, you must file the claim within one year of the date the medical care was provided.

To file a claim, you need to complete and submit a Tricare claims form, DD Form 2642. You can get details and forms from www.tricare.mil/gettingcare/claims or from the website of your Tricare regional contractor. You can also get forms at any Tricare Service Center or military treatment facility. Send your claim to the claims processor for your Tricare region.

Beneficiaries who receive emergency care should contact their Tricare Prime primary care manager as soon as possible after the care is received, preferably by the next business day.

Q. Retirees in Europe have no medical insurance card. All we can obtain from Tricare is a letter stating in English that we are covered. I understand there is a medical insurance card for retirees in the U.S. Is this true, and if so, why is there no such thing for retirees in Europe?

A. There is no “medical insurance card” for retired Tricare beneficiaries, either in the U.S. or overseas. All you really need to show that you are a Tricare beneficiary is your U.S. uniformed services retiree ID card. On the back is a “medical” block indicating your eligibility for U.S. military medical care.

If you’re having problems accessing health care in your area, you should contact International SOS, the managed-care contractor for the Tricare Overseas program. Contact information can be found at www.tricare.mil/welcome/aboutus/regions/overseas.

Write to Tricare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or tricarehelp@militarytimes.com. In email, include the word “Tricare” in the subject line and do not attach files. Get Tricare advice anytime at www.militarytimes.com/tricarehelp.