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, and 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 to 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 identify each 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
ExamplesAn
example of health care benefit information that DEERS
tracks on a person level
include: is enrollment
fee waiver information.
• 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 develop,
maintain, and update pharmacy
Other Health Insurance
(OHI
) (see TOM, Chapter 8, Section 1) 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).