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If you’ve adopted or had a baby in recent years, you may recall having 120 days to enroll the child in TRICARE Prime. Anyone expecting a new addition to the family this year should know that the enrollment time frame has changed.
As of Jan. 1, 2005, TRICARE Prime beneficiaries have 60 days after the birth date or date of adoption to enroll a new child in TRICARE Prime.
During that first 60 days, the child is covered automatically as a TRICARE Prime beneficiary as long as another member of the family is enrolled in TRICARE Prime.
Register in DEERS First
Before you can enroll your child in TRICARE Prime, you must register him or her in the Defense Enrollment Eligibility Reporting System (DEERS). To do so, you must submit either a legal birth certificate or a certificate of live birth from a hospital or TRICARE-approved birthing center. You must also provide a copy of a verified and approved DD Form 1172 (Application for Uniformed Services Identification Card and DEERS Enrollment form), signed by the sponsor. You can download a copy of the DD Form 1172 from www.dtic.mil/whs/directives/infomgt/forms/eforms/dd1172-2.pdf or pick one up from a uniformed services ID card facility.
You can register your child in DEERS by submitting the above paperwork in one of the following ways:
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Visit a local uniformed services ID card facility. (Find the nearest one online at online.)
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Fax to DEERS at 1-831-655-8317.
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Mail to DEERS at:
Defense Manpower Data Center Support Office
Attn: COA
400 Gigling Road
Seaside, CA 93955-6771
Then Enroll in TRICARE Prime
Once your child is registered in DEERS, simply complete a TRICARE Prime Enrollment Application form, or from any TRICARE Service Center (TSC), and follow the directions on the form for returning it to Humana Military. You may also submit the form to the nearest TSC.
After your application is processed, you will receive a TRICARE Prime Enrollment Card for your child. Until you receive that card, keep a copy of your enrollment application and take it with you when accessing care from your child’s primary care manager (PCM).
If you complete the application within 60 days, your baby’s enrollment date will be retroactive to the date of birth or adoption. If the application is not completed in 60 days, you can still enroll your newborn in TRICARE Prime at a later date, but there will be a lapse in TRICARE Prime coverage.
If your child is not enrolled in TRICARE Prime within 60 days, his or her coverage will revert to the TRICARE Standard program option, which carries additional deductibles and cost-shares. Coverage under TRICARE Standard ends 365 days after birth or adoption if the child is not properly registered in DEERS.
For more information, call Humana Military at 1-800-444-5445.
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The Federal Medical Recovery Act allows the government to be reimbursed for costs associated with treating you if you are injured in an accident caused by someone else (a third party). For any claim that appears to have possible third-party involvement, you are required to complete and submit a Statement of Personal Injury—Possible Third- Party Liability Form (DD Form 2527).
For that reason, it is important that you understand how the third-party liability process works. Humana Military is responsible for identifying and investigating all potential third-party recovery claims. Claims submitted with diagnosis codes indicating an accidental injury or illness will be held for further research. The following steps occur when a claim is suspected to have third-party liability:
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The DD Form 2527 will be sent to you.
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Within 35 days, you must complete and sign this form and return it to the appropriate claims processor. Be sure to keep a copy of your completed form in case you need to refer back to it later.
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The claim will be processed when the DD Form 2527 is completed and returned.
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If your completed form is not received, the claim may be denied.
The claims processor for Humana Military will send you the DD Form 2527 if it is suspected that your claim has potential third-party liability. You can also access this form online. From the home page, scroll over “Your TRICARE Benefit,” then click the “Claims” link. On that page is a list of forms in the right-hand column. Simply click on the “Third-Party Liability” link.
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