Transitional Health Care Benefits
TRICARE offers the following program options for beneficiaries separating from active duty.
Continued Health Care Benefit Program
The Continued Health Care Benefit Program (CHCBP) provides transitional benefits for a specified period of time (18–36 months) to former service members and their families, some unremarried former spouses, and emancipated children (living on their own) who enroll and pay quarterly premiums.
DoD has contracted with Humana Military to administer the CHCBP. Humana Military issues beneficiaries a CHCBP ID card (shown in Figures 4.5 and 4.6) after enrollment is completed.
This card is different from a uniformed services ID card or a CAC, which may no longer be valid. All questions regarding CHCBP eligibility verification can be addressed through the CHCBP web portal or by calling 1-800-444-5445.
Figures 4.5 and 4.6 CHCBP ID cards (front and back)
CHCBP Coverage
The benefits available under CHCBP are similar to TRICARE Standard, and although it is not part of TRICARE Standard, it operates under most of the same rules. When providing care, the main differences to remember are that, under CHCBP, providers are not required to utilize or coordinate with MTFs, and nonavailability statements from an MTF are no longer required. These differences exist because a CHCBP beneficiary is no longer eligible to receive military care or use MTFs (except in the case of emergency care).
Referrals and Authorizations
All CHCBP referrals and authorizations are coordinated through Humana Military. Providers must seek authorization for care that is deemed medically necessary. Medical necessity rules for CHCBP beneficiaries follow the same guidelines as those in the TRICARE Standard plan. Use one of the following numbers to coordinate CHCBP referrals and/or authorizations:
Phone: 1-800-444-5445
Fax: 1-877-270-9113
Humana Military has partnered with PGBA, LLC (PGBA) for CHCBP claims processing. See the Claims Processing and Billing Information section for more information about filing CHCBP claims.
Transitional Assistance Management Program
TAMP offers certain uniformed services members and their family members transitional health care benefits when the sponsor separates from active duty service.
The beneficiary can be enrolled in TRICARE Prime or may be using TRICARE Standard and TRICARE Extra. All referral, authorization, and claims-filing processes continue to apply. TRICARE Prime rules and access standards are the same during TAMP coverage. These beneficiaries should have a valid uniformed services ID card or a CAC. See the TRICARE Eligibility section of this handbook for information about verifying eligibility.
Note: TAMP deductibles do not apply to National Guard and Reserve members during this period. Additionally, LOD care is not covered under TAMP. See “ Line-of-Duty Care for National Guard and Reserve Members” earlier in this section.
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