The term “contractor” applies
to the Managed Care Support (MCS) contractor, TRICARE Overseas Program
(TOP) contractor, and Uniformed Services Family Health Plan (USFHP)
Designated Providers (DPs) whose enrollees are TRlCARE-eligible
for civilian care.
1.0 Split enrollment involves different
members of the same family enrolled in the same health plan (TRICARE
Prime or TRICARE Select) with different contractors. Split enrollment
does not apply to unremarried former spouses.
Example: Sponsor
and spouse who live and are enrolled in TRICARE Prime in one region
and a college age child who lives and is enrolled in TRICARE Prime
in a different region or a TRICARE eligible USFHP enrollee and other
members of the same family enrolled in TRICARE Prime with one or
more contractors.
2.0 Split enrollment provisions
apply to TRICARE Prime and TRICARE Select enrollments in all areas.
3.0 A family
subject to enrollment fees will pay enrollment fees totaling no
more than the family enrollment fees according to the elected plan(s)
regardless of the enrollment locations of family members. Individual
and family enrollment fees for TRICARE Prime are separate from individual
and family enrollment fees for TRICARE Select. The enrollment fee
billing contractor shall be determined based on the following list
of potential enrollees in descending order of precedence:
• Sponsor.
• Spouse.
• Oldest enrolled child.
4.0 If the
family enrollment fee is not paid on time and the family is disenrolled,
individual family members who are enrolled in different regions
(and who have not paid single enrollment fees) shall be disenrolled
as well.