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.