1.0 Application
1.1 This section
provides general guidance for all contractors that interface with
the DEERS in support of their contractual requirements
1.3 For the
purpose of defining geographical areas the 50 United States (U.S.)
and the District of Columbia are hereafter referred to as the Continental
United States or CONUS; all areas Outside of CONUS are considered
OCONUS.
1.4 This section describes the following:
• Terminology
used within DEERS (also, see the TRICARE Operations Manual (TOM),
Appendix A).
• Methodology for identifying
individuals and their roles within DEERS.
• Functional data components
within DEERS (e.g., eligibility, enrollment (Health Care Delivery Program
(HCDP) plans with premiums/fees, claims, Catastrophic Cap and Deductible
Data (CCDD), Other Health Insurance (OHI)).
3.0 DEERS
Data Use Concepts
3.1 All DEERS data provided by the Defense Manpower
Data Center (DMDC) to the DHA for the use of determining medical
eligibility, enrollment, and health care claims payment are subject
to the Privacy Act of 1974, as amended. DEERS data includes all
data that is provided for test and/or production activities.
3.2 Release
is made to all globally executed TRICARE program support contractors
(hereafter referred to as “contractors”) in accordance with the
provisions of the Privacy Act allowing for intra-department release
when an appropriate “need to know” exists. As such, the authorized
organizations are responsible for using the protected Privacy Act
data in accordance with the applicable provisions of the Privacy
Act or the DHA comparable approved or accepted security check process
for overseas contractors accessible by personnel with at least an
Automated Data Processing/Information Technology-II (ADP/IT-II)
designation.
3.3 This includes:
3.3.1 Only personnel (military,
civilian, contractor) with a need to know in the official performance
of their duties may be given access, and the data may only be used
for the specific purposes agreed to by DMDC and DHA.
3.3.2 The contractors/organizations
to which these data are provided shall insure that sufficient physical
and procedural safeguards are in place to satisfy the requirements
of the Privacy Act.
3.3.3 These data should be returned
to DMDC or destroyed when the approved use has been accomplished
and no copies should be retained.
3.3.4 Any additional intended uses
must first be submitted through DHA to DMDC for approval and are
prohibited unless and until favorably coordinated with DMDC.
3.3.5 In addition,
DMDC only provides the DEERS data for specific purposes, such as:
3.3.5.1 Eligibility
data is for reporting the eligibility of a beneficiary on DEERS
as of the time of the eligibility inquiry.
3.3.5.2 Enrollment
data is for the authorized enrollment of beneficiaries into valid
HCDPs as defined under the provisions of the respective Request
For Proposal (RFP)/contract.
3.3.5.3 Claims
data is for the processing and resolution of claims submitted for
reimbursement of health care received.
3.3.5.4 CCDD for
the processing and resolution of Catastrophic Cap and Deductible
(CC&D) information resulting from heath care services received.
3.3.5.5 OHI and
Standard Insurance Table (SIT) data for the processing and resolution
of OHI resulting of and from heath care services received.
4.0 DEERS
System Overview
4.1 Program
Description
4.1.1 DEERS serves as a centralized Department of
Defense (DoD) data repository of personnel and medical data. The
DEERS database contains detailed personnel eligibility information
for benefits and entitlements distribution to Uniformed Services
members; U. S. sponsored Foreign Military members;
DoD and Uniformed Services civilians; other personnel as directed
by the DoD; and their eligible family members. DEERS supports essential
day-to-day operations in a broad range of functional areas, including
personnel, benefit entitlements, pharmacy, dental, medical, and
finance.
4.1.2 DEERS is updated by transactions from the Uniformed
Services’ personnel, finance, medical, and mobilization management
systems, the Department of Veterans Affairs (DVA), and the Centers
for Medicare and Medicaid Services (CMS). DEERS is also accessed
and updated by on-line DEERS client applications, such as the Real-Time
Automated Personnel Identification System (RAPIDS), and interfacing
client systems of the Military Health System (MHS), such as Military
Treatment Facility (MTF)/Enhanced Multi-Service Market (eMSM) clinical,
patient appointing, and Referral Management (RM) systems/applications.
DEERS helps detect and prevent fraud and abuse in DoD benefits and entitlements
distribution.
4.1.3 DEERS provides and receives
updates to enrollment and eligibility verification data from existing
DEERS’ applications and interfacing information systems, as well
as from other DoD, Uniformed Services, and non-DoD information systems,
in accordance with DoD Directive (DoDD) 8000.01. It provides statistical
and demographic data to support DoD and Uniformed Services peacetime
and wartime missions. DEERS maintains casualty identification data
on members of the Uniformed Services, and other personnel as designated
by DoD, to support casualty identification and verification of entitlement
eligibility for surviving family members.
5.0 DEERS
System Description
DEERS is a person-centric
system that contains information about all DoD beneficiaries plus information
about some people who are not eligible for DoD benefits. Within
DEERS, interfaces with external systems are based on commercial
standards where it supports the business requirements or standardized
DEERS defined messages where needed. DEERS data provided by DMDC
to DHA is also considered “Protected Health Information” (PHI) as
the term is defined in the Health and Human Services (HHS) Health
Insurance Portability and Accountability Act (HIPAA) Privacy Final
Rule and accordingly is subject to the requirements of DoD 6025.18-R
which implements that rule for DoD and through the use of DHA business
associate agreements to contractors and other non-DoD entities.
6.0 TRICARE
Populations
The TRICARE programs serve a
wide range of beneficiaries holding various statuses throughout their
lifetime. The following information details the populations covered
by the TRICARE benefit. The definition of the populations may be
modified as legislation or DHA requires. These populations include:
6.1 Service
members and Active Duty Family Members (ADFMs). These may include
members from both the active duty and RC.
Note: The term “active duty” is inclusive of full-time
active duty and RC on orders of 30 days or more. Plus, the term
RC is inclusive both the Reserves and NG.
6.2 Transitional
Assistance Management Program (TAMP) sponsors and family members.
6.3 Selected
Reserve members and their family members.
6.4 Retired sponsors and family
members. Retirees eligible for retirement pay and their family members
as well as Medal of Honor (MOH) recipients.
6.5 Survivors
of Service members. When an active duty sponsor dies (Includes activated
NG/Reserve members), spouses and children become “transitional survivors.”
As transitional survivors, surviving family members remain eligible
for TRICARE as “ADFMs.” This means that health plan options and
costs will not change. After three years, the surviving spouse's
coverage will change to be the same as retired family members. Children
remain covered as active duty family members until they lose eligibility
due to age or other reasons
6.6 Survivors of retired Service
members. If a sponsor dies after retiring from active duty (either regular
or a medical retirement) their surviving family members remain eligible
for TRICARE with the same health plan options and costs they had
before their sponsor passed away.
6.7 Survivors of non-activated
NG/Reserve members. If an NG or Reserve sponsor dies when not on active
duty, surviving family members are only eligible for continued TRICARE
health benefits if the sponsor was covered by TRICARE Reserve Select
(TRS) or under the TAMP when he or she died.
6.8 Survivors
of retired NG or Reserve members. If a retired NG or Reserve member
dies, surviving family members may qualify for TRICARE benefits
if the sponsor was covered by TRICARE Retired Reserve (TRR) at the
time he or she passed away.
7.0 Identification
Schema For Electronic Data Interchange (EDI)
7.1 Primary And Secondary Identifiers
Identification of persons in the DEERS database
is established via the two DoD required identifiers; DoD Identification
Number and DoD Benefits Number (DBN). See
Section 3.1 for
additional information on beneficiary identification. The use of
these two identifiers allows for proper exchange between systems
and software.
7.2 Beneficiary Identification
7.2.1 DEERS is
the definitive system for person identification for DoD benefits
and entitlements. Every beneficiary in DEERS that is authorized
DoD benefits will have a DBN. See also
paragraph 9.3.
7.2.2 A person
may have more than one DBN, stemming from multiple entitlements
over time and some of these instances are described in
paragraph 9.3.
7.3 Patient Identification
As discussed in
paragraphs 9.3 and
9.4,
there are situational difference between a beneficiary and a patient,
which can affect the data storage/retrieval within the MHS information
systems. The contractor is to use the identifiers of DoD Identification
Number and DBN to support their execution of contracted health care
service delivery.
7.4 Person Identification and
Secondary Identification
7.4.1 Should a beneficiary or patient
not show a DBN, secondary identifiers may be used. The secondary
identifiers are:
• Sponsor’s Social Security
Number (SSN) or DoD Identification Number.
• First three characters
of the last name.
• Date of Birth (DOB).
7.4.2 Any one
secondary identifier, such as the sponsor SSN, could be duplicated
across several beneficiaries. Therefore, each beneficiary must be
positively identified using a DMDC interface/application and at
least two secondary identifiers.
8.0 Types
Of Data That DEERS Uses And Stores
DEERS
stores different categories of information, including Person/Personnel,
Beneficiary, and Health Care Benefit. Each is detailed below.
8.1 Person/Personnel
Information
This is basic characteristic
data about individuals, including both affiliations to DoD organizations
or organizations designated by DoD, and affiliations within family
units. Although historical data is available for longitudinal studies
and demographic trend analysis, only current data is required for
day-to-day health care operations.
8.1.1 Person Data
• Primary (internal)
identification - A mutually agreed-upon internal identifier shared between
the repository and DoD approved external interfacing systems, i.e.,
Electronic Data Interchange Personal Identifier (EDIPI), also known
as the DoD Identification Number.
• Secondary (external)
identification - Name, DOB, and SSN (contractors use of SSN is by DEERS
and DHA approval only).
• General characteristics
- Sex, blood type, etc.
• Person-based programs
- Organ donor.
• Family
association - Self, child, etc.
• Contact information
- Address, telephone number.
8.1.2 Personnel
Data
• Personnel
category - active duty, reserve, retired, etc.
• Service or organization
- Army, Navy, DoD civilians, etc.
• Position - Rank.
• Personnel readiness
programs - Deoxyribonucleic Acid (DNA), blood type.
8.2 Beneficiary
Information
8.2.1 This information combines the underlying rules-based
system that captures DoDI 1000.13 “Identification (ID) Cards for
Members of the Uniformed Services, Their Dependents, and Other Eligible Individuals”
and other applicable regulations and procedures with enrollment
information, as maintained by the MHS community. When the beneficiary
is eligible for DoD benefits, they will have a DBN. This data is
provided for past, current, and future periods from the inquiry
date, and consists of specific HCDP information.
8.2.2 Examples
of this information are:
• DoD HCDPs: DoD HCDPs
are defined by DEERS as the methods of providing basic health benefits.
These HCDPs indicate eligibility and/or enrollment for the following. (examples
only); TRICARE Pharmacy (TPharm), TRICARE Prime, TRICARE Plus, TRS,
and Continued Health Care Benefit Program (CHCBP).
• Other Government Programs
(OGPs): OGP are defined by DEERS as programs or plans provided and
supported by a U.S. Government agency other than the DoD.
• Commercial OHI: OHI
information is stored in DEERS to support third party collections.
8.3 Health Care
Benefit Information
8.3.1 General
Policy
Examples of health care benefit information
that DEERS tracks on a policy level include:
• Enrollment fee accumulation
and fee details (including fee exceptions).
• Deductible accumulation.
8.3.2 Person Related
Examples of health care benefit information
that DEERS tracks on a person level include:
• Enrollment fee waiver
information.
• OHI.
9.0 Specific
DEERS Beneficiary Roles
9.1 Person
Role
An individual exists within DEERS as
a person who may have multiple roles, including but not limited
to: a sponsor, a family member, a beneficiary, and a patient. This
implies the existence of certain attributes tied to a person that
do not normally change as his or her role within the system changes.
For example, a person has a name, DOB, weight, height, hair color,
eye color, and an SSN. These attributes make up the information
associated with the primary person identifier DoD Identification
Number. Both sponsor and family member are possible but not mutually
exclusive roles of a person in the DEERS database. The family member
role is supported by person association and condition data that
is cross-referenced to the family member’s sponsor. This family
affiliation is associated with the DBN identifier.
9.2 Sponsor And
Family Member Roles
9.2.1 A sponsor is any person who, as a direct affiliate
or Service member of an organization within the DoD, is entitled
to benefits from the DoD and who, through that affiliation or membership, may
entitle his or her family members to benefits. Members of non-DoD
organizations whose employees are authorized DoD benefits are also
sponsors, and often accord eligibility to their family members.
9.2.2 Unremarried
Former Spouses (URFSs) who meet eligibility requirements are considered
as sponsors and are identified by their individual identifiers;
DoD Identification Number and DBN. TRICARE entitlement for an URFS
is ended with the existence of an employer sponsored health plan. Contractors
can identify an URFS on the DEERS claims response from their DoD
Identification Number and/or DBN.
9.2.3 Abused dependents also have
a distinct member category (reflected in the DBN) indicating their
status. The presence of OHI does not remove an abused dependent’s
entitlement to TRICARE (see 32 CFR 199).
9.2.4 DEERS defines which relationships
to sponsors make individual family members eligible for benefits.
Some restrictions that influence the definition of a child family
member include age, degree of support by the sponsor, physical disability,
and educational status.
9.3
Beneficiary
Role - Multiple Entitlements/Dual Eligibility
9.3.1 DEERS considers both sponsors
and family members as beneficiaries (i.e., recipients of DoD benefits).
The role of beneficiary is ambiguous, a person may be entitled to
DoD benefits via his or her simultaneous association to more than
one sponsor or by being a sponsor in one family while being a member
of another. An example is a person that is a family member in two
sponsored families at the same time. This situation occurs when
both spouses in a family are sponsors. This condition is known as multiple
entitlements. DEERS supports multiple entitlements by not only storing
persons but any combination of their current and past associations.
9.3.2 Entitlement
periods may be sequential, such as when a son or daughter of a sponsor
joins a Uniformed Service and he or she becomes a sponsor. Becoming
a sponsor terminates the individual’s previous eligibility for benefits
as a family member.
9.3.3 In some cases, the roles leading
to multiple entitlements may change back and forth. For example,
a child of a married reservist who moves in and out of active duty
assignments may have transitory periods of entitlement to health
care benefits under each sponsor. Each sponsor in this family has
the potential to provide health care benefits for the family member
(child) for various periods of time. Therefore, this multiple-entitled
child will reflect different DBNs for each sponsorship/situation and
the contractors need to ensure they have the correct DBN for the
health care service encounter being reviewed or executed. The concept
of dual eligibility occurs when multiple entitlements are concurrent.
This situation can occur when a sponsor is both a retired sponsor
and a civil servant on overseas assignment. The beneficiary would
have a coverage plan as the retired sponsor and another coverage
plan as the civil servant. Hence, dual eligibility results when
a person is associated with more than one DoD affiliation.
9.3.4 All instances
of family membership and/or sponsorship are stored as the DBN, see
Section 3.1 for additional information on
beneficiary identification. All information about TRICARE enrollments and
policies to and from DEERS and contractors must be done using the
DoD Identification Number and/or DBN (as prescribed by DEERS and
DHA). Updates of all other secondary attributes including SSN (on
DEERS/DHA approval), Name, or DOB are exchanged using the DoD Identification
Number and/or DBN (as prescribed by DEERS and DHA) as the primary
means of identification.
9.4
Patient Role
The patient role results from an association
or interaction between a person and a DoD health care delivery provider
(Note: Civilian providers contracted by a TRICARE Program support
contractor are considered DoD health care delivery providers.).
It is important to note that a person is not required to be currently
eligible for DoD benefits to be considered a patient. For example,
the patient may have been a beneficiary in the past but is no longer
eligible for DoD benefits. In certain cases, an individual who is
not an authorized DoD beneficiary may be treated in an emergency
situation at a DoD MTF/eMSM, and is therefore a patient. Persons
on DEERS and on clinical systems within the DoD are identified in
the patient role by the DoD Identification Number. All clinical
data must be exchanged using the DoD Identification Number. Thus,
in addition to the DBN, contractors must also store the DoD Identification
Number associated with each beneficiary on their database.
9.5 Beneficiary
Roles Within HCDPs
9.5.1 Subscriber
Role
A subscriber is an individual who is
the primary holder of a DoD policy (i.e., the primary holder of
a DoD entitlement) for health care benefits based on his or her
affiliation with the DoD. The subscriber is the sponsor.
9.5.2 Insured Role
An insured is an individual who is covered
by a Uniformed Services health benefits program (i.e., an HCDP)
for health care coverage. The individual is entitled to these programs
based upon his or her association to a subscriber. A person may
be both a subscriber and an insured. For example, under TRICARE
Prime Individual Coverage for Retired Sponsors and Family Members,
the sponsor is both the subscriber and an insured. However, other
sponsors may be a subscriber and not be an insured. For example,
a sponsor on active duty may be the subscriber for his or her family
members that are insured under TRICARE Prime Family Coverage for
ADFMs.
9.6 Sponsor, Subscriber, Beneficiary,
And Insured Roles
As a sponsor, the person
may also be the subscriber who holds the DoD “policy” for health
care benefits. As a beneficiary, the person may also be an insured
who is covered by a DoD “policy” for health care benefits.
9.7 Family Member,
Beneficiary, and Insured Roles
As a sponsor,
the person may also be the subscriber who holds the DoD policy for
health care benefits. Another person, through associations and relationships,
may be a family member to the sponsor, which implies a role as a
beneficiary. As a beneficiary, the person may also be an insured
who is covered by a DoD policy for health care benefits.
10.0 TYPES
OF HCDP PLANS
HCDP plans are methods of providing
pharmacy, dental, and medical benefits. Coverage under these programs
may be either individual or family, depending on the number of beneficiaries
enrolled and beneficiaries’ affiliation to the sponsor, as well
as the program definition.
10.1 There are two types of plans
within DEERS: Assigned and Enrolled.
10.1.1 Assigned
plans represent the base entitlement of a beneficiary (e.g., TRICARE For
Life (TFL) and Pharmacy). Dental plans (e.g., TRICARE Dental Program
(TDP), is done by enrollment and thus not assigned (see
paragraphs 10.1.2 and
10.3).
Assigned plans are based on a sponsor’s affiliation to a DoD organization
(e.g., Army active duty); therefore, when a sponsor’s DoD affiliation
changes (e.g., Army active duty to Army Reserves), a new assigned
plan is created for both the service member and family members.
10.1.2 Enrolled
plans represent another level of benefit into which the beneficiary
has elected enrollment (e.g., TDP, TRICARE Prime, TRICARE Select, TRS,
TRICARE Young Adult (TYA), etc).
10.2 Pharmacy HCDP (Assigned And
Enrolled)
10.2.1 Contractors are required to implement a system
that allows changes to pharmacy plans and HCDP plan coverage codes
as legislation and regulation require.
10.2.2 TPharm
benefits, assigned only at this time.
10.2.2.1 The TPharm
benefit includes MTF/eMSM, mail order, and retail prescription services, medications
provided by physicians and other appropriate clinicians, and pharmaceutical
agents provided in support of home health care.
10.2.2.2 The TPharm
Benefits Program is available to all TRICARE eligible beneficiaries.
Eligible beneficiaries need not enroll in order to use the pharmacy
program. The TPharm contractor will use DEERS to verify TRICARE
eligibility prior to dispensing pharmaceuticals (or paying any claim)
for all beneficiaries. The TPharm contractor will also update OHI
and CC&D.
10.3
Dental
HCDP (Assigned And Enrolled)
Contractors
are required to implement a system that allows changes to dental
plans and HCDP plan coverage codes as legislation and regulation
require.
10.3.1 Active
Duty Dental Program (ADDP) (And Associated Remote Active Duty Dental Program
(RADDP))
10.3.1.1 The ADDP provides worldwide dental coverage
to all Service Members of the Uniformed Services, eligible members
of the Reserves and NG, and those Foreign Force Members (FFMs) eligible for
care pursuant to an approved agreement (e.g., reciprocal health
care agreement, North Atlantic Treaty Organization (NATO) Status
of Forces Agreement (SOFA), Partnership for Peace (PFP) SOFA). The Uniformed
Services include the USA, the USN, the USAF, the USMC, the USCG,
the Commissioned Corps of NOAA, and the Commissioned Corps of USPHS.
The Commissioned Corps of the USPHS is not included in this program.
The ADDP shall supplement care provided in the DoD’s Dental Treatment Facilities
(DTFs), and shall provide care to those Service members living in
regions without access to DTFs (i.e., RADDP).
10.3.1.2 The ADDP
has two components:
• Service members referred
from military DTFs for civilian dental care; and
• Service members having
a duty location and residence greater than 50 miles from a DTF will
be required to comply with the requirements and limitations of the
RADDP before receiving dental care.
10.3.2 TDP
10.3.2.1 The TDP
is a voluntary dental insurance program that is available to ADFMs,
Selected Reserve and Individual Ready Reserve (IRR) members, and
their eligible family members.
10.3.2.2 TDP offers
worldwide (CONUS and OCONUS) coverage to all eligible family members
of Uniformed Service active duty personnel and to members of the
Selected Reserve and IRR and their eligible family members. Service
Members, former spouses, parents, in-laws, disabled veterans, foreign personnel,
and retirees and their families are not eligible for the TDP.
10.3.3 TRICARE Retiree
Dental Program (TRDP)
10.3.3.1 The TRDP
was authorized by Congress to provide a basic dental program for
Uniformed Services retirees and their family members. Further legislation
has allowed the program to be enhanced to include more comprehensive
coverage. The TRDP is a voluntary dental benefits program with enrollee-paid
premiums.
10.3.3.2 The TRDP offers coverage to all eligible personnel
retired from the Uniformed Services, unremarried surviving spouses,
eligible dependents, and former members of the armed forces who
are MOH recipients and their immediate dependents. The TRDP currently
has two programs: the Basic program which is closed to new enrollments
and the Enhanced program to which all TRDP enrollees shall be enrolled.
The TRDP is a worldwide program. The TRDP Basic program offers coverage
for dental services rendered in CONUS, Puerto Rico, Guam, the U.S.
Virgin Islands, American Samoa, the Commonwealth of the Northern
Mariana Islands, and Canada. TRDP enhanced program benefits are offered
worldwide.
10.4 Medical HCDP (assigned and
enrolled)
Contractors are required to implement
a system that allows changes to medical health care plans and HCDP
plan coverage codes as legislation and regulation require.
10.4.1 Assigned
Plans
These plans are the defaults assigned
by DEERS for beneficiaries based on their eligibility status. Assigned
plans do not require enrollment actions.
10.4.1.1 Service Members - TRICARE
Prime, No Primary Care Manager (PCM) Selected
TRICARE
Prime for Active Duty Sponsors, No PCM Assigned is the default coverage
assigned by DEERS for active duty sponsors. They are entitled to
Direct Care (DC), Civilian Health Care (CHC) under the Supplemental
Health Care Program (SHCP), and pharmacy benefits. This plan is
the default for Service members who are not enrolled in a specific
MTF/eMSM or TRICARE Prime Remote (TPR). These enrollees are deemed
Prime but do not have a PCM.
10.4.1.2 TRICARE Standard Prior to
January 1, 2018
The TRICARE Standard HCDP
is the basic coverage assigned by DEERS for eligible beneficiaries
and results when a beneficiary under the age of 65, or 65 and over
but not Medicare eligible, is entitled to both DC and CHC.
10.4.1.3 DC Only
This plan identifies beneficiaries who are
entitled only to DC in MTFs/eMSMs, on a space available basis or
under TRICARE Plus enrollment (see the TOM). Beginning January 1,
2018, this is the assigned plan for all non-active duty beneficiaries. Examples
of this population include dependent parents and parents-in-law,
or Non-Active Duty Family Members (NADFMs) who are eligible for Medicare
benefits that do not have both Medicare Parts A and B.
10.4.1.4 TRICARE For
Life (TFL)
Beneficiaries eligible for TRICARE
under 10 USC 1086(d) with Medicare Parts A and B are eligible for
the TFL benefit.
10.4.1.5 Care Plans for DoD Affiliates
DoD affiliates are a conglomerate category
of individuals entitled to DC or CHC at different levels than the
groups defined in other HCDPs. The most commonly defined DoD Affiliates
follow (may not be all-inclusive):
10.4.1.5.1 DC within
the CONUS DoD Affiliates. This health care plan is available for
the following population(s):
• NATO Sponsored, PFP,
and NATO non-sponsored Foreign Military and their family members.
• Non-NATO sponsored
Foreign Military and their family members.
10.4.1.5.2 DC For
OCONUS DoD Affiliates. This health care plan is available for the
following population(s):
• NATO and non-NATO
Foreign Military and their family members.
• Civilian personnel
of DoD and other Government agencies and their accompanying family
members.
• Civilian
contractors under contract to the DoD or the Uniformed Services.
• Uniformed and non-uniformed
full-time personnel of the Red Cross and their family members.
• Area executives, center
directors, and assistant directors of the United Service Organization
(USO) and their family members.
• United Seaman’s Service
(USS) personnel and their accompanying family members.
• Military Sealift Command
(MSC) Civil Service personnel.
10.4.2 Enrolled
Plans
See the TRICARE Policy Manual (TPM)
and TOM for types of CONUS and OCONUS plans and eligibility requirements.
They include:
• TRICARE Prime (Service
member)
• TRICARE Select
• TPR (Service member)
• TRICARE Prime
• TPRADFM
• TRICARE Plus
• USFHP
• CHCBP
• TRS Program
• TRR Program
• TYA Standard (Effective
January 1, 2018, TYA Select)
• TYA Prime
10.5 Special Health
Care Programs
DEERS supports any special
health care program mandated by the DoD. These special health care
programs are programs into which a beneficiary can enroll or register
concurrently with other assigned or enrolled health care coverage
plans to which they are entitled. Contractors may also utilize a
Government furnished web-based general inquiry of DEERS system/application
to obtain special program coverage information. See the TPM and
the TOM for details regarding these special programs. They include,
but may not be limited to:
• TRICARE Extended Care
Health Option (ECHO).
• Wounded Ill and
Injured (WII).