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.
- END -