Life After TRICARE
By CWO4 Lewis Tolleson, USCG-Ret., Director; Lt. Col. William A. Pierce, USA-Ret.; and Capt. Bud Schneeweis, USCG-Ret. Benefits Information

What medical insurance is offered to children who are too old for TRICARE?

Individuals who lose TRICARE eligibility or other coverage under the Military Health System can get temporary health coverage in the Continued Health Care Benefits Program (CHCBP). CHCBP is not a part of TRICARE, but it provides similar benefits and operates under most of the same rules.

CHCBP is offered to people who are losing their TRICARE eligibility for various reasons, including members who separate (not retire) from the military or spouses who divorce from a military member but do not meet the requirements to maintain TRICARE benefits as an un-remarried former spouse. Dependent children who are not full-time students when they turn 21 or who turn 23 while full-time students also lose their TRICARE benefits. To obtain CHCBP coverage, individuals must enroll within 60 days of becoming ineligible for military health care.

The Department of Defense (DoD) has contracted with Humana Military Healthcare Services Inc. to help administer the CHCBP. To get information about eligibility for enrollment in the program and the health care benefits that are available, or to request a copy of the CHCBP enrollment application or obtain information regarding the premiums and out-of-pocket costs, call (800) 444-5445 and select option No. 4, or visit the CHCBP's Web site at www.tricare.osd.mil/chcbp/default.htm. You also can write to Humana Military Healthcare Services Inc., Attn: CHCBP, P.O. Box 740072, Louisville, KY 40201.

Express Scripts

If I register with the new TRICARE Mail Order Pharmacy (TMOP) contractor, Express Scripts, can I still use military and retail pharmacies?

Yes. Using TMOP (Express Scripts) does not restrict access to military pharmacies or retail pharmacies. In fact, using a military pharmacy is recommended because it's the most cost-effective way - for both you and DoD - to get prescription drugs. You also should use a military or retail pharmacy for prescriptions you will take only once or need to begin immediately, such as antibiotics.

When can I get prescriptions refilled under TRICARE?

In general, refills can be requested when 75 percent of the prescription has been used in accordance with instructions. Local military treatment facility (MTF) commanders may have different guidelines; your local MTF can give you that information. The guidelines for civilian pharmacies can be obtained from the Managed Care Support Contractor in your area.

The TMOP also allows refills when 75 percent of the prescription has been used in accordance with instructions. Because you order a three-month supply, that should be several weeks before the prescription is used up. Express Scripts recommends patients order two weeks before their prescription runs out and suggests allowing a few extra days if shipping to an APO or FPO address. For additional pharmacy information, call the DoD pharmacy call center at (877) DOD-MEDS (363-6337).

Advance Beneficiary Notice

Why does my physician or supplier give me an Advance Beneficiary Notice (ABN) for certain services?

ABNs may be issued for services or items that are covered by Medicare with limitations - for example, only up to a certain number of times within a specified amount of time. Examples of these services include laboratory tests, preventive screening tests, and vaccinations. If you receive an ABN that gives a frequency limit, Medicare will not pay if you exceed that limit on the service. For more information, contact Medicare at (800) MEDICARE (633-4227) or visit its Web site at www.medicare.gov.