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F. Administration
1. General. Except as provided below, all basic TRICARE benefits and procedures apply to CHCBP. In addition, any DoD-sponsored preferred provider organization program which provides for reduced cost sharing, etc., such as the TRICARE Extra option is also available to CHCBP beneficiaries.
2. Exceptions: 
a. Nonavailabilty Statements and Use of MTFs.
(1) Since CHCBP beneficiaries pay premiums for coverage and since they must have lost their eligibility for all other DoD health care benefits in order to be eligible for CHCBP, there is no requirement that they use any medical facility of the uniformed services or that they obtain a nonavailability statement.
   
(2) The date the member became ineligible for medical and dental care under a military health care plan as an active duty member or the date the member first ceases to be eligible for care under TAMP, whichever is later, if the former spouse first meets the requirements for being considered an unremarried former spouse during a period of continual coverage of the member for self and dependents.
b. Beneficiary Liability.
(1) For purposes of CHCBP deductible and cost sharing requirements, and catastrophic CAP limits, amounts applicable to the category of beneficiary (active duty or retired) to which the CHCBP enrollee’s sponsor last belonged shall continue to apply. Because separating active duty members were not eligible for TRICARE, amounts applicable to dependents of active duty members shall apply to this category of enrollee.
 
(2) Active duty dependent or active duty family member cost-shares shall apply to emancipated children and dependents placed in legal custody whose sponsor is an active duty member at the time of enrollment. If the sponsor retires during the period of enrollment of the emancipated child or dependent placed in legal custody, retirees’ cost-shares shall apply to the enrollee as of the date of retirement of the sponsor.
 
(3) Former spouses of active duty sponsors are responsible for active duty dependent or active duty family member cost-shares; former spouses of retired sponsors are responsible for retiree cost-shares just as they are under TRICARE.
 
(4) Deductible and cost-sharing amounts for CHCBP must be met independent of TRICARE deductible and cost-sharing amounts. Any deductible and cost-sharing amounts previously paid under TRICARE cannot be carried over to CHCBP.
 


Last Reviewed:  May 14, 2007