Providers must verify TRICARE eligibility at the time of service. Several identification (ID) and enrollment cards can be used to verify a patient’s eligibility for TRICARE. Providers must ensure beneficiaries have valid Common Access Cards (CACs), uniformed services ID cards, or eligibility authorization letters. Check the expiration dates on CACs and ID cards, and make copies of both sides of the cards for your files. See “Copying Identification Cards” later in this section for additional information.
Note: A CAC or ID card alone does not prove TRICARE eligibility. Providers must verify the card bearer’s TRICARE eligibility by logging into Humana Military’s secure “
MyHMHS for Providers” portal, or by calling Humana Military at 1-800-444-5445. Use the sponsor’s Social Security number (SSN) to verify eligibility. If you are verifying online, retain a printout of the eligibility verification screen for your files.
Note: The Department of Defense (DoD) is removing SSNs from ID-cards. Refer to the “Social Security Numbers Reduction Plan” in the Important Provider Information section of this handbook.
Common Access Card
ADSMs and drilling National Guard and Reserve members carry CACs. Before providing care, check the CAC expiration date. Although CACs are valid uniformed services ID cards, they do not, on their own, prove TRICARE eligibility. You must verify patient eligibility at the time of service, as described earlier in this section.
Uniformed Services Identification Card
The uniformed services ID card incorporates a digital photographic image of the bearer, barcodes containing pertinent machine-readable data, and printed ID and entitlement information.
The beneficiary category determines the ID card’s color:
- Active duty family members (ADFMs):
Uniformed Services Identification and Privilege Card (DD Form 1173)—tan
- National Guard and Reserve family members:
Department of Defense Guard and Reserve Family Member Identification Card (DD Form 1173-1)—red
- Retirees:
United States Uniformed Services Identification Card (Retired) (DD Form 2 [RET])—blue
- Retiree dependents:
DD Form 1173—tan
- Transitional Assistance Management Program (TAMP) beneficiaries:
Department of Defense/Uniformed Services Identification and Privilege Card (DD Form 2765)—tan
ID cards include the following information:
- SSN or sponsor SSN (or last 4 digits of SSN): Providers should use the SSN when verifying the card bearer’s TRICARE eligibility.
- Expiration date: Check the expiration date. It should read “INDEF” (i.e., indefinite) for retirees. If expired, the beneficiary must immediately update his or her information in DEERS and get a new card.
- Civilian: Check the back of the ID card to verify eligibility for TRICARE civilian care. The center section should read “YES” under the box titled “CIVILIAN.” A TRICARE For Life (TFL) beneficiary with an ID card that reads “NO” in this block may still use TFL if he or she has both Medicare Part A and Medicare Part B coverage.
Note: A beneficiary’s valid photo ID presented with a copy of the sponsor’s activation orders (when activated for more than 30 consecutive days) may serve as proof of the patient’s TRICARE eligibility.
Beneficiaries under age 10 are usually not issued ID cards; the parent’s proof of eligibility may serve as proof of eligibility for the child.
Identification Cards for Family Members Age 75 and Over
All eligible family members and survivors age 75 or older are issued permanent ID cards. These cards should read “INDEF” (i.e., indefinite) in the box titled “Expiration Date.”
Copying Identification Cards
To prevent identity theft and protect information from being used by individuals impersonating U.S. military personnel, TRICARE beneficiaries are instructed as a general rule not to lose or allow others to use their CACs or ID cards.
However, it is legal and advisable for providers to copy CACs and ID cards for specific authorized purposes, which may include:*
- Facilitating medical care eligibility determination and documentation
- Cashing checks
- Administering other military-related benefits
- Verifying TRICARE eligibility
The DoD recommends that providers retain photocopies of both sides of CACs and ID cards for future reference.
*Title 18, United States Code, Section 701 prohibits photographing or possessing uniformed services ID cards in an unauthorized manner. Unauthorized use exists only if the bearer uses the card in a manner that would enable him or her to obtain benefits, privileges, or access to which he or she is not entitled.
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