1.0 General
All TRICARE requirements regarding
the TAMP shall apply to the TOP unless specifically changed, waived,
or superseded by this section; the TRICARE Policy Manual (TPM),
Chapter
12; or the TRICARE contract for health care support services
outside the 50 United States (US) and the District of Columbia (hereinafter
referred to as the “TOP contract”). See the TPM,
Chapter 10, Section 5.1 for additional instructions.
2.0 Eligibility
2.1 TAMP eligible
beneficiaries are eligible for the TOP per the enrollment provisions
described in this section.
2.2 The TOP contractor shall determine
TRICARE eligibility during the TAMP period based on eligibility
in the Defense Enrollment Eligibility Reporting System (DEERS).
2.3 The military
services are responsible for eligibility entries/updates in DEERS.
3.0 Enrollment
3.1 The provisions
of TPM,
Chapter 10, Section 5.1 regarding the “twentieth
of the month rule” for enrollment are waived for the TOP. New enrollments
for TOP Prime are normally effective on the date the application
is signed. Refer to
Section 5 for additional guidance.
3.2 TAMP eligibles
who were enrolled in TOP Prime immediately prior to their change
in status may continue their enrollment in TOP Prime with no break
in coverage. A re-enrollment application must be completed prior
to the TAMP expiration period in order to continue with TOP Prime.
The effective date shall be the date the sponsor separated from
active duty, as the intent is to ensure that TOP Prime coverage
is seamless.
3.3 10 USC 1145 authorized Military
Medical Treatment Facility (MTF) and Civilian Health Care (CHC)
for certain Reserve Component (RC) personnel “in the same manner”
and “subject to the same rates and conditions” as a dependent of
a Service member during the TAMP eligibility period. Transitioning
RC personnel who were ordered to active duty under Executive Order
13223, 10 USC 12302, 10 USC 12301(d), or 32 USC 502(f) may either
continue in TOP Prime or enroll during the TAMP period per the provisions
of 10 USC 1145.
3.4 RC family members who were
eligible for TOP Prime during the member’s activation may either
continue in TOP Prime or enroll during the TAMP period.
3.5 RC family
members who were not eligible for TOP Prime enrollment during the
member’s activation (e.g., the member was not ordered to active
duty for more than 30 calendar days, or the dependents were not
Command Sponsored to accompany the member in their overseas assignment)
are not eligible to enroll in TOP Prime during the TAMP period.
3.6 TAMP-eligible
members and family members who are not eligible for TOP Prime, or
who choose not to enroll in TOP Prime upon change in status may
elect to enroll in TOP Select. If not enrolled in TOP Prime or Select, TAMP-eligible
members and family members are not eligible for TRICARE purchased
care.
3.7 TAMP beneficiaries may not
enroll in TOP Prime Remote.