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 “the contractor”)
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 shall use 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 Granting access
only personnel (military, civilian, contractor) with
a need to know in the official performance of their duties, and using the
data only for
the specific purposes agreed to by DMDC and DHA.
3.3.2 The contractor/organization to
which these data are provided shall ensure sufficient physical
and procedural safeguards are in place to satisfy the requirements
of the Privacy Act.
3.3.3 The contractor
shall return data to
DMDC or destroy data when
the approved use has been accomplished. The contractor
shall not retain copies.
3.3.4 The
contractor shall first submit any additional intended
uses through DHA to DMDC for approval
and shall not proceed until the
request is 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 is 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 is 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 Market/Military
Treatment Facility (MTF) 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 Program serves a
wide range of beneficiaries holding various statuses throughout their
lifetime. The following information details the populations covered
by the TRICARE benefit. The Government may modify
the definition of the populations 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 for 30
days or more. Plus, the term RC includes both
the Reserves and National Guard (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
Person identification
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
shall use the
DoD
Identification Number and DBN
as identifiers 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,
the contractor shall use secondary identifiers
. 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, the contractor shall positively identifyeach
beneficiary 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): DEERS
defines OGP 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 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. The
contractor can identify
an URFS on the DEERS claims response from their DoD Identification Number
and/or DBN.
9.2.3 Abused family
members also have a distinct member category (reflected
in the DBN) indicating their status. The presence of OHI does not
remove an abused family member’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 contractor shall 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
the contractor
shall 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 Market/MTF, 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. The contractor shall exchange all
clinical data by using the DoD Identification
Number. Thus, in addition to the DBN, the contractor shall 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 The contractor shall 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 Market/MTF, 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 shall use DEERS to verify
TRICARE eligibility prior to dispensing pharmaceuticals (or paying
any claim) for all beneficiaries. The TPharm contractor shall also
update OHI and CC&D.
10.3
Dental
HCDP (Assigned And Enrolled)
The contractor shall 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 U.S. Army, the U.S.
Navy, the U.S. Air Force, the U.S. Marine Corps, the U.S.
Space Force, the U.S. Coast Guard, 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 contractor 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 with 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)
The contractor shall 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 Market/MTF or
TRICARE Prime Remote (TPR). These enrollees are deemed TRICARE Prime
but do not have a PCM.
10.4.1.2 DC Only
This plan identifies beneficiaries
who are entitled only to DC in Markets/MTFs, on
a space available basis or under TRICARE Plus enrollment (see the
TOM). 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.
10.4.1.3 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.
10.4.1.4 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):
10.4.1.4.1 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.
10.4.1.4.2 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.
• United Service
Organization (USO) area executives, center directors,
and assistant directors 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. The contractor may
also use 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).