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)/Veterans Health Administration
(VHA), 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).