TRICARE (69)    HEALTH BENEFIT PLAN (25.11)

Name Value
NAME TRICARE
PLAN CODE 229
SHORT DESCRIPTION
TRI
LONG DESCRIPTION
TRICARE Health Plan
     Retiree Family and Reserve Select enrollees
 
 * VA/DoD Health Care Resource Sharing Agreements not applicable (ref. 
   VA/DoD Direct Resource Sharing Agreements)
   - (e.g. dual eligible Veteran elects Veteran benefit vs TRICARE 
     Health Plan) 
 
 * If patient has a Veteran status and on Active Duty Orders, then all 
   Active Duty rules apply   
   - Even if treatment is Service Connected - Patient considered TRICARE 
-------------------
     Prime enrollee   
   - Includes active Reserve and National Guard - Federal orders must 
     exceed 30 days
Patient receiving care at a VAMC as a TRICARE patient of the Department 
of Defense:
 
 * TRICARE Authorization:
   - Required for TRICARE Prime patients - Retiree and Retiree Family 
     enrollees
   - NOT required for TRICARE Select patients - AD Family, Retiree, 
COVERAGE CODE AC01001