Tricare Overseas eliminates up-front payments - Navy News | News from Afghanistan & Iraq - Navy Times

Tricare Overseas eliminates up-front payments

Overseas Tricare Prime beneficiaries will no longer have to pay up front for services under a new Tricare Overseas contract that begins Sept. 1.

In certain countries, health care providers traditionally require full payment at the time of services, and Prime enrollees have had to pay and then file a claim for reimbursement. The new Tricare contract with International SOS Assistance calls for a “guarantee of payment” agreement with providers to ensure Prime beneficiaries have access to routine, urgent and emergency care without having to pay up front.

Under this contract, International SOS establishes and manages networks of host nation providers around military treatment facilities (MTFs) and in remote locations worldwide. This will make referrals easier and remove the requirement for individual memorandums of understanding between MTFs and local providers, according to a Tricare Management Activity point paper.

MTFs will retain clinical oversight and primary responsibility for their enrolled beneficiaries.

The process for MTF appointments remains the same — call centers will coordinate the appointment. Active-duty members and command-sponsored active-duty family members will continue to be eligible for Tricare Prime enrollment in MTFs or designated remote locations.

The contract allows for routine screenings to help identify conditions early.

Overseas beneficiaries should be aware of some other changes in the new contract. For example, prior authorizations will be required for any care received during stateside travel.

The contract consolidates several previous overseas contracts, including those for overseas enrollment, overseas claims processing, Tricare service center operations, Tricare Global Remote Overseas, and Tricare Puerto Rico. Tricare officials said this will provide better customer service by consolidating service center operations worldwide.

There is no need for anyone to re-enroll. But officials strongly urge Tricare beneficiaries to make sure their information is up to date in the Defense Enrollment Eligibility Reporting System (DEERS).

A disease management program is being added for overseas Prime Remote enrollees to help those with health issues such as diabetes and asthma.

Service center call numbers will change, but new numbers will be available online. Those numbers are scheduled to change on Aug. 31, said Tricare spokesman Austin Camacho.

Tricare beneficiaries living overseas should have received letters updating them on the new program contract, with contact information, an updated enrollment card and an informational program flyer.