End
of Processing. TRICARE For Life (TFL) beneficiary cost-shares shall
be based on the following when TRICARE is the primary payer. If
the services were received by a TRICARE Prime enrollee (as indicated
on DEERS), the TDEFIC contractor shall calculate the Prime copayments
applicable on the date services were received. For a beneficiary
who is not a Prime enrollee, if a provider is known to be a network
provider (e.g.,
Veterans Health Administration (VHA)
medical facility) the Extra cost-shares shall be
applied to services received prior to January 1, 2018; if the provider
is not a known network provider, the TRICARE Standard cost-share
shall be applied. For a beneficiary who is a TRICARE Select enrollee,
services received from a known network provider on or after January
1, 2018, will have the TRICARE Select network copayments applied;
if the provider is not a known network provider, the TRICARE Select
out-of-network cost-share shall be applied. For a TFL beneficiary
who is not a Prime enrollee, services received on or after January
1, 2018, shall have the TRICARE Standard copayment (see TRM,
Chapter 2) applied as if TRICARE Standard
were still being implemented.