Eligibility And Enrollment
Chapter 10
Section 10.1
TRICARE Coverage For Certain
Members Of The National Guard (NG)
Issue Date: September 6, 2018
Revision: C-33, September 7, 2018
1.0 DESCRIPTION
If an NG member and family is TRICARE-eligible
due to the sponsor being on full-time NG Duty and is placed on State
Active Duty (SAD) orders for disaster response, their TRICARE eligibility
is removed. The State may request extension of TRICARE eligibility
for the NG member and family on a fully reimbursable basis. This
provision does not create any new class of beneficiaries or changes
in coverage.
2.0 BACKGROUND
National Defense Authorization Act for Fiscal
Year 2017 (NDAA FY 2017), Section 711 (Public Law 114-136) established
authority to extend the period of time that a Guardsman performing
SAD in support of a disaster response is considered to be on active
duty as an Active Duty Service Member (ADSM) for the purpose of
TRICARE eligibility.
3.0 POLICY
3.1 During
a period in which a member of the NG is performing State disaster
response duty, the member may be treated as being on active duty
for a period of more than 30 days for purposes of the eligibility
of the member and their family members for health care benefits
under the TRICARE program if:
• Disaster response
duty immediately follows a period in which the member served on
full-time NG duty (32 United States Code (USC) 502(f) including
pursuant to Chapter 9 of Title 32); and
• The Governor of the
State (to include the four United States Territories (or mayor of
the District of Columbia)) requests extension of TRICARE eligibility
for the member and family and agrees to reimburse Department of
Defense (DoD) for all health care services.
3.2 The State
is responsible for identifying these Guardsmen and providing their
individual information and period of state duty to the NG Bureau,
who in turn will forward this information to the Defense Manpower
Data Center (DMDC) to continue TRICARE eligibility in the Defense
Eligibility Enrollment Reporting System (DEERS).
3.3 For health
care provided by a civilian provider, claims shall be processed
under current TRICARE reimbursement rules.
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