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Tricare Help: Getting benefits for dependents

Jun. 18, 2014 - 10:59AM   |  

Q. If I can get my mother, three brothers and sister listed under me as dependents in DEERS, would they be eligible for Tricare coverage?

A. Anyone formally listed as a dependent under a service member’s sponsorship in the Defense Enrollment Eligibility Reporting System is eligible for Tricare coverage — although yours would be one of the most expansive cases of “dependents” in recent Tricare Help history.

Tricare does not make these kinds of eligibility determinations; only the military services may do that, and they do it through DEERS.

You can engage that agency by visiting the ID Card/DEERS office on any U.S. military installation or by calling the main DEERS support office in California toll free at 800-538-9552.

Q. I got married two years ago to an airman. I have a child from a previous relationship. My job does not offer insurance, and my child’s father can’t keep a job for more than 90 days. Can my daughter and I get health insurance through my husband? I would ask him, but he’s deployed to Kuwait.

A. As the spouse and step-child of an active-duty member, both you and your daughter are entitled to Tricare coverage. But before either of you can use Tricare, your husband, as your family’s military sponsor, must ensure both of you are properly registered in DEERS. In his absence, you can call the DEERS main support office in California and get further guidance and information. The toll-free number is 800-538-9552.

Q. I am an active-duty spouse. Will Tricare pay for me to get my tubes tied?

A. Tricare covers vasectomies for men and tubal ligations for women when prescribed by a Tricare-authorized provider. But Tricare will not pay to reverse such procedures, so consider that before making a final decision. Some military treatment facilities may perform reversals of tubal ligations and vasectomies for active-duty members and dependents enrolled in Tricare Prime, but such MTFs are few in number and wait times may be lengthy.

Q. My mom is covered under Tricare for Life. What home health care benefits does TFL offer?

A. Tricare covers part-time and intermittent skilled nursing care; home health aide services; physical, speech and occupational therapy; and medical social services. Medicare, the primary payer under Tricare for Life, also covers those services. Beneficiaries must get prior authorization from Medicare and from the managed-care contractor for the Tricare region in which they live before using home health care services.

Also:

■ All care must be provided by a participating home health agency.

■ Home health care coverage is available in the 50 states, District of Columbia, and U.S. territories; it is not covered in any other overseas areas.

■ Separate charges may apply for durable medical equipment, prosthetics and specific drugs, with their applicable co-payments and cost shares.

You can get more information from the TFL contractor, Wisconsin Physician Services, toll free at 866-773-0404.

Write to tricarehelp@militarytimes.com. Include the word “Tricare” in the subject line and do not attach files.

Answers by RallyPoint

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