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Childhood is meant to be a time of innocence. However, the formative years also can be a time fraught with emotional difficulties.
When a child shows signs of depression, anxiety or compulsive behavior,or cannot concentrate or behave at school, how do parents distinguish between the everyday challenges of growing up and a behavioral health problem that requires professional assessment? Just as with our adult beneficiaries, children are entitled to eight unmanaged behavioral health outpatient visits with a network provider per fiscal year without a referral or prior authorization. These visits are per beneficiary and not per provider.
If ongoing treatment is needed, your child’s behavioral health care provider will submit a report with that request.
Military Children Face Unique Challenges
Frequent moves and the stress of having a loved one in harm’s way can take their toll on children.
During this time of deployment in the Middle East, many family members are worried about their loved ones and are having difficulty adjusting to the many changes in their lives. Over time, this can cause anxiety and stress in children.
Finding the Right Provider
Experts stress the importance of finding an age-specific provider who specializes in the type of disorder you believe your child may have. Clinicians also emphasize that behavioral health care for children is shown to be most successful when every family member is committed to the outcome and is willing to participate.
When seeking an outpatient therapist for your child, be careful to select a provider in the TRICARE network. Otherwise, you may incur additional charges under the TRICARE Prime point-of-service (POS) option. To obtain names of TRICARE providers in your area, call 1-800-700-8646.
Please note: States have different regulations governing the release of behavioral health information. In many circumstances the patient (based on age) must authorize release before agents can give information to anyone other than the patient.
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When separating from active duty (AD), understanding the transitional health care options offered by TRICARE is critical.
Transitional Assistance Management Program (TAMP)
You and your family members may be eligible for TAMP benefits if you are a service member involuntarily separating from AD under honorable conditions; separating from AD following involuntary retention (stop-loss) in support of a contingency operation; or separating from AD following a voluntary agreement to stay on AD for a period of less than one year in support of a contingency operation. In addition, a reservist (National Guard and Reserve) separating from an AD period of more than 30 days in support of a contingency operation (OEF, OIF and Noble Eagle) may also be eligible for TAMP benefits.
TAMP provides health care coverage as you transition to civilian life. Beginning on your separation date, you and your eligible family members are covered by TAMP for 180 days. Under TAMP, you may choose to re-enroll in TRICARE Prime if available. If you re-enroll in TRICARE Prime, you must submit a new TRICARE Prime Enrollment Application and PCM Change form on or before your release from AD to avoid a lapse in coverage. As a TRICARE Prime enrollee, you will not have enrollment fees. The TRICARE Prime Remote (TPR) and TPR for Active Duty Family Members health plan options are not available under TAMP. Beneficiaries who do not enroll in TRICARE Prime will be covered under TRICARE Extra/ Standard and will be responsible for applicable cost-shares and a deductible. The annual deductible is waived for TAMP-eligible reservists and their families for as long as the TRICARE Reserve Family Demonstration Project remains in effect.
National Guard/Reserve members should note that during the 180-day TAMP period, if the sponsor is called again to AD in support of a contingency operation for more than 30 consecutive days, the sponsor becomes eligible for a new 180-day TAMP period upon deactivation. However, the original 180-day TAMP period does not stop if a sponsor is on AD for 30 days or less.
Continued Health Care Benefit Program (CHCBP)
The CHCBP provides additional, longer-term transitional benefits (18-36 months) to former service members and their families, some unremarried former spouses, and emancipated children (living on their own). CHCBP benefits can be purchased once your TAMP eligibility ends (if applicable; you do not have to qualify for TAMP to qualify for CHCBP). Those who qualify must enroll and pay quarterly premiums—currently $933 for one person or $1,996 for a family. Premiums are subject to annual increases. CHCBP benefits are similar to TRICARE Standard. Although not part of Standard, CHCBP operates under most of the same rules. TRICARE Prime is not available under CHCBP.
To receive CHCBP coverage, eligible persons must complete an application within 60 days after separating from AD or losing their eligibility for TRICARE, including TAMP. Beneficiaries who are using TAMP should enroll in CHCBP at the end of the 180-day TAMP period if they wish to continue receiving TRICARE health care benefits.
The DoD has partnered with Humana Military to administer CHCBP. Contact Humana Military in writing or by phone for more information about CHCBP: Humana Military Healthcare Services, CHCBP, P.O. Box 740072, Louisville, KY., 40201 or 1-800-444-5445.
Certificate of Creditable Coverage
When you are no longer eligible for TRICARE, you will automatically receive a certificate of creditable coverage. This document serves as evidence of prior health care coverage during the time of your service. Most civilian health insurance programs impose a waiting period for pre-existing conditions for all new or reinstated members. The certificate of credible coverage proves you were continuously covered under a qualifying health care plan and enables a waiver of any waiting period related to a pre-existing condition.
If you’ve lost your certificate, you may request a new one free of charge. Certificates cannot be requested by phone. Requests must be submitted in writing to: Defense Manpower Data Center Support Office, Certificate of Creditable Coverage, 400 Gigling Road, Seaside, California., 93955-6771. The request must include the following: sponsor’s name and Social Security number; name of person for whom the certificate is requested; reason for the request; name and address to whom and where the certificate should be sent; and signature of the requester.
For more information about the certificate of creditable coverage, call the Defense Manpower Data Center Support Office at 1-800-538-9552 (TTY/TDD 1-866-363-2883), e-mail the TRICARE Management Activity HIPAA Program Office at www.tricare.mil/certificate/index.cfm.
For additional information about your health care options when you separate from active duty, contact a beneficiary counseling and assistance coordinator (BCAC). To find a BCAC near you, visit the BCAC directory online at www.tricare.mil/bcacdcao/ or contact Humana Military for assistance at 1-800-444-5445.
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