UPDATE ON EXPANDED HEALTH CARE BENEFITS FOR RESERVISTS
Date Signed: 5/20/2004 | MARADMINS Number: 233/04
Cancelled
MARADMINS : 233/04
R 202201Z MAY 04
FM CMC WASHINGTON DC(uc)
TO AL MARADMIN(uc)
MARADMIN
BT
UNCLASSIFIED
MARADMIN 233/04
MSGID/GENADMIN/CMC WASHINGTON DC//RAP-23//
SUBJ/UPDATE ON EXPANDED HEALTH CARE BENEFITS FOR RESERVISTS//
REF/A/DOC/PUB.L.NO.108-136,117STAT.1392/24NOV2003//
REF/B/DOC/DOD/07JAN2004//
REF/C/DOC/CMC(RAP)/07MAY2004//
POC/MACE C./MAJ/CMC(RAP)/LOC:QUANTICO VA/TEL:7037849139
/EMAIL:MACECK@MANPOWER.USMC.MIL//
NARR/REF A IS THE NATIONAL DEFENSE AUTHORIZATION ACT FOR FISCAL
YEAR 2004.  REF B IS USD P&R MEMO "HEALTHCARE BENEFITS FOR
RESERVE COMPONENT MEMBERS AND THEIR DEPENDENTS".  REF C IS
MARADMIN 205-04, EXPANDED HEALTH CARE BENEFITS FOR RESERVISTS.//
GENTEXT/REMARKS/1.  PURPOSE.  TO PROMULGATE UPDATED GUIDANCE,
BASED ON REFERENCES A AND B, REGARDING EXPANDED HEALTHCARE
COVERAGE FOR MEMBERS OF THE READY RESERVE AND THEIR FAMILY
MEMBERS.  THIS MARADMIN REPLACES REF C WHICH IS HEREBY
CANCELLED.  THIS UPDATE CORRECTS ERRONEOUS INFORMATION
CONTAINED IN REF C AND CONTAINS ADDITIONAL INFORMATION NOT
PREVIOUSLY PROVIDED.
2.  BACKGROUND.
   A. SECTIONS 701, 703, AND 704 OF REF A EXPANDED HEALTHCARE
COVERAGE FOR MEMBERS OF THE READY RESERVE AND THEIR FAMILY
MEMBERS.  THIS HEALTHCARE COVERAGE APPLIES TO THE FOLLOWING
CATEGORIES OF THE READY RESERVE: MEMBERS OF SELECTED MARINE
CORPS RESERVE (SMCR) UNITS, INDIVIDUAL MOBILIZATION AUGMENTEE
(IMA) DETACHMENTS, AND THE INDIVIDUAL READY RESERVE (IRR) WHO
ARE ACTIVATED IN SUPPORT OF A CONTINGENCY OPERATION.  THIS
COVERAGE DOES NOT APPLY TO MEMBERS OF THE ACTIVE RESERVE (AR)
PROGRAM.
   B.  CORRECTIONS.  PARAGRAPHS 3C(4) AND 3C(4)(D) OF REF C
ARE INCORRECT.  THESE PARAGRAPHS STATE THAT FAMILY MEMBERS OF
ACTIVATING RESERVISTS ARE AUTOMATICALLY ENROLLED IN DEERS
PROVIDED THAT THEIR INFORMATION HAS BEEN ENTERED INTO THEIR
SPONSOR'S RECORD OF EMERGENCY DATE (RED).  ANY RESERVE MEMBER
WHO IS ADVISED BY THEIR UNIT THAT THEY ARE ELIGIBLE FOR THE
SUBJECT BENEFIT MUST ALSO ENSURE THAT BOTH THEIR PERSONAL
INFORMATION AND THEIR FAMILY MEMBER INFORMATION IS UPDATED
IN THE DEERS-RAPIDS SYSTEM.  THIS COORDINATION MUST BE MADE
VIA THE UNIT ADMIN SEECTION.
   C.  NEW INFORMATION.  NEW VERBIAGE HEREIN ADDRESSES HOW
TO ADD NEW JOIN SMCR UNIT MEMBERS TO THE DEERS DATA BASE AS
WELL AS CORRECT ERRORS OR OMISSIONS IN THE CURRENT ELIGIBILITY
LIST.
3.  DESCRIPTION OF EXPANDED HEALTHCARE COVERAGE AND
CORRESPONDING MARINE CORPS POLICY.
   A.  NOTIFICATION.  MEMBERS OF THE READY RESERVE WHO ARE
NOTIFIED OF THEIR UPCOMING ACTIVATION FOR A PERIOD OF MORE
THAN 30 DAYS, WILL ALSO IMMEDIATELY BE INFORMED OF THEIR
ELIGIBLITY FOR THE SECTION 701 AND 703 HEALTHCARE BENEFITS
DISCUSSED IN THIS MARADMIN.  THIS NOTIFICATION MAY BE EITHER
ORAL OR WRITTEN AND CANNOT TAKE PLACE PRIOR TO THE RELEASE
OF EITHER A COMMARFORLANT REPORT FOR PLANNING GUIDANCE
MESSAGE, CMC ACTIVATION MESSAGE, MAILGRAM, OR SET OF
ACTIVATION ORDERS.
   B.  NO COST MEDICAL OR DENTAL SCREENING OR CARE FOR
MEMBERS OF THE READY RESERVE ONLY.  SECTION 701 OF REF A
AUTHORIZES MEMBERS, WHILE IN MILITARY DUTY STATUS, TO BE
PROVIDED ANY MEDICAL OR DENTAL SCREENING OR CARE THAT IS
NECESSARY TO ENSURE THE MEMBER MEETS THE APPLICABLE MEDICAL
AND DENTAL STANDARDS FOR DEPLOYMENT.  SECTION 701 HEALTHCARE
COVERAGE HAS NO ASSOCIATION WITH THE TRICARE PROGRAM, IS
ONLY AVAILABLE AT MILITARY TREATMENT FACILITIES, AND SHOULD
NOT BE CONFUSED WITH HEALTHCARE COVERAGE AUTHORIZED BY
SECTIONS 703 AND 704.
       (1) ELIGIBLITY CRITERIA.  MEMBERS BECOME ELIGIBLE FOR
SECTION 701 CARE WHEN:
           (A) THE MEMBER IS NOTIFIED, ON OR AFTER 6 NOV 2003,
THAT HE OR SHE WILL BE ACTIVATED IN SUPPORT OF A CONTINGENCY
OPERATION; AND
           (B) THE PERIOD OF ACTIVATION WILL BE FOR A PERIOD
OF MORE THAN 30 DAYS.
       (2) COMMAND GUIDANCE.  MEMBERS WILL ONLY SEEK THIS
CARE BASED ON GUIDANCE PROVIDED BY THEIR CHAIN OF COMMAND.
   C.  EARLIER ELIGIBILITY DATE FOR TRICARE BENEFITS FOR
MEMBERS OF THE READY RESERVE AND THEIR FAMILY MEMBERS.
NORMALLY, MEMBERS OF THE READY RESERVE ARE NORMALLY NOT
ELIGIBLE FOR TRICARE COVERAGE UNTIL THEY ARE ON ACTIVE DUTY.
HOWEVER, REF B AUTHORIZES TRICARE COVERAGE FOR MEMBERS OF THE
READY RESERVE AND THEIR FAMILY MEMBERS STARTING AS EARLY AS
60 DAYS PRIOR TO THE MEMBER'S ACTIVATION DATE.
       (1) TRICARE COVERAGE.  UNDER SECTION 703, MEMBERS ARE
ELIGIBLE FOR TRICARE PRIME.  TRICARE OPTIONS AVAILABLE TO
FAMILY MEMBERS ARE TRICARE PRIME (IF IN A PRIME AREA), OR
TRICARE PRIME REMOTE FOR ACTIVE DUTY FAMILY MEMBERS (TPRADFM)
(IF NOT IN A PRIME AREA).  FAMILY MEMBERS WHO CHOOSE NOT TO
ENROLL IN TRICARE PRIME OR TPRADFM MAY USE TRICARE EXTRA OR
TRICARE STANDARD, AND ARE ELIGIBLE FOR THE NATIONWIDE TRICARE
RESERVE FAMILY MEMBER DEMONSTRATION PROJECT.  SEE PARAGRAPH
5 FOR SOURCES OF INFORMATION ON TRICARE COVERAGE AND PROGRAMS.
       (2) ELIGIBILITY CRITERIA.  MEMBERS AND THEIR FAMILY
MEMBERS WILL BE ELIGIBLE FOR TRICARE COVERAGE WHEN:
           (A) THE MEMBER IS NOTIFIED, ON OR AFTER 6 NOV 2003,
THAT HE OR SHE WILL BE ACTIVATED IN SUPPORT OF A CONTINGENCY
OPERATION; AND
           (B) THE PERIOD OF ACTIVATION WILL BE FOR MORE THAN
30 DAYS.
           (C) MEMBERS OF THE READY RESERVE WHO ARE RECRUITED
TO AN SMCR UNIT AFTER ITS ACTIVATION DATE ARE NOT AUTHORIZED TO
THIS ENTITLEMENT UNTIL THE ASN(RA), VIA CMC(PO), APPROVES THEIR
ACTIVATION.
       (3) COMMENCEMENT OF TRICARE COVERAGE.  MEMBERS AND THEIR
FAMILY MEMBERS BECOME ELIGIBLE FOR TRICARE COVERAGE NO EARLIER
THAN 60 DAYS PRIOR TO THE MEMBER'S ACTIVATION DATE.
           (A) EXAMPLE#1, CMC ACTIVATION MSG DIRECTS THE
ACTIVATION OF 1ST BATTALION, 25TH MARINES ON 1 AUG 2004.  THE
MSG IS DATED 1 APR 2004.  THE MEMBERS OF THIS UNIT ARE NOTIFIED
BY THEIR CHAIN OF COMMAND ON 2 APR 2004 OF THEIR UPCOMING
ACTIVATION.  MEMBERS OF THIS UNIT AND THEIR FAMILY MEMBERS ARE
NOT ELIGIBLE FOR TRICARE COVERAGE UNTIL 1 JUN 2004.
           (B) EXAMPLE#2, CMC ACTIVATION MSG DIRECTS THE
ACTIVATION OF THE SAME UNIT ON 1 MAY 2004.  THE MSG IS DATED
1 APR 2004.  THE MEMBERS ARE NOTIFIED BY THEIR CHAIN OF COMMAND
ON 2 APR 2004 OF THEIR UPCOMING ACTIVATION.  MEMBERS AND THEIR
FAMILY MEMBERS ARE ELIGIBLE FOR TRICARE COVERAGE ON 1 APR 2004.
       (4) ENROLLMENT IN DEERS.  RESERVISTS AND THEIR FAMILY
MEMBERS WILL BE ENROLLED IN DEERS AS FOLLOWS:
           (A) SMCR UNITS AND SMCR INDIVIDUAL AUGMENTEES (IA'S).
UPON THE PUBLICATION OF A CMC ACTIVATION MESSAGE, MARFORRES WILL
PROVIDE A LISTING TO CMC (MI) OF THE RUC'S FOR SMCR UNITS AND DETS
IDENTIFIED IN THE MESSAGE.  RUC LISTS ARE DEVELOPED (PER PARAGRAPH
3C(4)(C) BELOW) AND FORWARDED TO DMDC ONLY ONCE.  IF AN SMCR UNIT
JOINS A NEW MEMBER AFTER THE RUC ELIGIBILITY LIST IS SENT TO DMDC,
THE SUBJECT NEW JOIN WILL NOT GET PASSED TO DMDC, AND THEREFORE
WILL NOT APPEAR TO BE ELIGIBLE FOR SECTION 703 COVERAGE.  IF ANY
UNIT OR INDIVIDUAL MEMBER BELIEVES THAT MEMBER ELIGIBILITY
INFORMATION MUST BE UPDATED (INCLUDING SITUATIONS WHERE A MEMBER
IS NO LONGER ELIGIBLE PER PARA 3C(5) BELOW) OR WAS NOT CORRECTLY
PASSED, THE UNIT SHALL CONTACT THE DMDC MARINE CORPS LIAISON.
POC IS SSGT CRUZ, AT COMM 831-583-2400, EXT 4224.  CHANGES THAT
ARE REPORTED BY THE UNIT WILL BE PROMPTLY ENTERED INTO, OR
REMOVED FROM DEERS UPON RECEIPT.  THIS MANUAL PROCESS IS EXPECTED
TO BE AUTOMATED FOR UNIT REPORTING DURING JULY 2004.
           (B) MEMBERS OF THE IMA AND IRR.  CMC(MPP-60) WILL
PROVIDE TO CMC(MI) A LIST OF MEMBERS OF THE IMA AND IRR APPROVED
BY ASN M&RA FOR ACTIVATION.  ACTIVATED MEMBERS WHO LOSE THEIR
ELIGIBILITY WILL BE HANDLED PER PARAGRAPH 3C(4)(A) ABOVE.
           (C) CMC ACTIONS.  USING THE INFO PROVIDED, CMC(MI)
WILL MANUALLY CREATE A FLAT FILE, ENTITLED "EARLY IDENTIFICATION
OF SERVICE MEMBERS CALLED UP IN SUPPORT OF A NAMED CONTINGENCY."
THIS FILE WILL BE BASED ON DEFENSE MANPOWER DATA CENTER (DMDC)
SPECIFICATIONS AND WILL CONTAIN THE MEMBER'S NAME, SSN, DATE OF
NOTIFICATION, AND PROJECTED ACTIVATION DATE.  THE FILE WILL THEN
BE FORWARDED TO CMC(RA) WHICH WILL THEN POST IT ON THEIR FILE
TRANSFER PROTOCOL (FTP) SITE.  DMDC WILL THEN PULL THE FILE
INTO THEIR SYSTEM FOR TRANSMISSION INTO DEERS.
           (D) FAMILY MEMBERS.  RESERVISTS ARE RESONSIBLE FOR
ENSURING THAT THEIR FAMILY MEMBERS ARE ENROLLED IN DEERS AT A
DEERS-RAPIDS SITE.  SEE PARAGRAPH 5 FOR INFORMATION ON HOW
TO LOCATE THE NEAREST SITE.  THIS COORDINATION MUST BE MADE VIA
THE ADMIN SECTION OF THE AFFECTED RESERVIST'S UNIT.
           (E) VERIFICATION OF ENROLLMENT ONLY.  RESERVISTS
AND THEIR FAMILY MEMBERS MAY VERIFY THEIR ENROLLMENT IN DEERS BY
CONTACTING THE DEERS SUPPORT OFFICE AT 1-800-538-9552.
       (5) LOSS OF ELIGIBILITY.  MEMBERS NOTIFIED OF THEIR
IMPENDING ACTIVATION ARE STRENUOUSLY URGED TO CONTINUE THEIR
EXISTING (CIVILIAN) HEALTH AND DENTAL SERVICE FOR THEMSELVES AND
THEIR FAMILY MEMBERS UNTIL THEY HAVE COMPLETED THEIR 31ST DAY OF
ACTIVE DUTY.  THIS PROTECTS AGAINST THE LOSS OF HEALTHCARE
COVERAGE IF THE MEMBER LOSES HIS/HER TRICARE ELIGIBLITY.  LOSS
OF TRICARE ELIGIBILITY OCCURS UPON ANY OF THE FOLLOWING EVENTS.
           (A) MEMBER FOUND NOT MEDICALLY QUALIFIED FOR
ACTIVATION.  THE MEMBER IS FOUND NOT MEDICALLY QUALIFIED FOR
ACTIVATION BEFORE THE ACTIVATION DATE OR PRIOR TO THE 31ST DAY
OF ACTIVATION.
           (B) MEMBER DEACTIVATED.  UPON DEACTIVATION, MEMBERS
AND THEIR FAMILY MEMBERS ARE NO LONGER ELIGIBLE FOR TRICARE
COVERAGE.  HOWEVER, MEMBERS AND THEIR FAMILY MEMBERS ARE ELIGIBLE
FOR TRANSITIONAL HEALTH CARE BENEFITS IF THE MEMBER SERVED ON
ACTIVE DUTY IN SUPPORT OF A CONTINGENCY OPERATION FOR MORE THAN
30 DAYS.  SEE PARAGRAPH 3D BELOW.
           (C) UNLESS EXTENDED BY LAW, SECTION 703 COVERAGE
EXPIRES ON 31 DEC 2004.
   D.  TEMPORARY EXTENSION OF TRANSITIONAL HEALTH CARE BENEFITS.
SECTION 704 OF REF A EXTENDS THE PERIOD OF TRICARE COVERAGE
OFFERED UNDER THE TRANSITIONAL ASSISTANCE MANAGEMENT PROGRAM
(TAMP).  NORMALLY TRANSITIONAL HEALTH CARE COVERAGE IS LIMITED
TO 60 OR 120 DAYS DEPENDING ON THE MEMBER'S YEARS OF CUMULATIVE
ACTIVE SERVICE.  HOWEVER UNDER SECTION 704, THE PERIOD OF
COVERAGE HAS BEEN INCREASED TO 180 DAYS FOR THOSE MEMBERS OF
THE READY RESERVE ACTIVATED IN SUPPORT OF A CONTINGENCY
OPERATION FOR A PERIOD OF MORE THAN 30 DAYS.  THE PERIOD OF
COVERAGE BEGINS ON THE MEMBER'S DEACTIVATION DATE.
       (1) TYPE OF TRICARE COVERAGE AVAILABLE.  MEMBERS AND THEIR
FAMILY MEMBERS ARE ELIGIBLE FOR TRICARE PRIME (IF IN A PRIME AREA),
TRICARE EXTRA, OR TRICARE STANDARD AND FOR THE NATIONWIDE TRICARE
RESERVE FAMILY MEMBER DEMONSTRATION PROJECT.  MEMBERS ARE NOT
ELIGIBLE FOR TRICARE PRIME REMOTE.  FAMILY MEMBERS ARE NOT ELIGIBLE
FOR TRICARE PRIME REMOTE FOR ACTIVE DUTY FAMILY MEMBERS.
       (2) MEMBERS AND THEIR FAMILIES ARE ELIGIBLE FOR EXTENDED
TRANSITIONAL HEALTH CARE COVERAGE WHEN:
           (A) THE MEMBER SERVED ON ACTIVE DUTY IN SUPPORT OF A
CONTINGENCY OPERATION FOR MORE THAN 30 DAYS.
           (B) THE MEMBER IS DEACTIVATED ON OR AFTER 6 NOV 2003.
           (C) ENROLLMENT IN DEERS.  ACTIVATED RESERVISTS
SHOULD KEEP IN MIND THAT UPON THEIR DEACTIVATION THEY WILL BE
AUTOMATICALLY DISENROLLED FROM DEERS.  IN ORDER TO BE ELIGIBLE
FOR TRANSITIONAL HEALTH CARE BENEFITS, DEACTIVATED RESERVISTS
MUST REENROLL IN ORDER TO RECEIVE THESE BENEFITS.  REENROLLMENT
CAN BE DONE AT A DEERS-RAPIDS SITE.  MEMBERS SHOULD BE SURE TO
MENTION THAT THEY ARE REENROLLING FOR THE PURPOSE OF RECEIVING
TRANSITIONAL HEALTHCARE BENEFITS.  SEE PARAGRAPH 5 FOR INFORMATION
ON HOW TO LOCATE THE NEAREST DEERS-RAPIDS SITE.
       (3) UNLESS EXTENDED BY LAW, THE PERIOD FOR WHICH A MEMBER
IS PROVIDED TRANSITIONAL HEALTH CARE BENEFITS WILL REVERT BACK TO
THE STANDARD 60 OR 120 DAYS BEGINNING ON 1 JAN 2005.
4.  RETROACTIVE BENEFITS.  MEMBERS AND THEIR FAMILY MEMBERS WHO
MEET THE ELIGILBITY CRITERIA UNDER SECTIONS 703 AND 704 COVERAGE
ARE STRONGLY ENCOURAGED TO SAVE THEIR HEALTHCARE RELATED RECEIPTS,
CLAIMS AND EXPLANATION OF BENEFIT FORMS DATING FROM 6 NOV 2003.
THIS IS NECESSARY IN THE EVENT THAT THE MEMBER IS DETERMINED TO BE
ELIGIBLE FOR RETROACTIVE REIMBURSEMENT FROM THE DEPARTMENT OF
DEFENSE.  FURTHER GUIDANCE ON THIS ISSUE WILL BE FORTHCOMING IN A
FUTURE MARADMIN.  EXAMPLE: CMC ISSUED AN ACTIVATION MSG ON 3 NOV
2003, DIRECTING THE ACTIVATION OF RESERVE UNITS IN SUPPORT OF OIF
II-1 AND OIF II-2.  OIF II-1 UNITS WERE ACTIVATED ON 1 JAN 2004.
OIF II-2 UNITS WILL ACTIVATE ON 1 JUN 2004.  MEMBERS OF OIF II-1
UNITS MAY BE ELIGIBLE FOR RETROACTIVE REIMBURSEMENT FOR HEALTHCARE
COSTS THEY INCURRED ON OR AFTER 6 NOV 2003.  MEMBERS OF OIF II-2
UNITS MAY BE ELIGIBLE FOR RETROACTIVE REIMBURSEMENT FOR HEALTH
CARE COSTS THEY INCURRED ON OR AFTER 1 APR 2004.
5.  ADDITIONAL TRICARE INFORMATION.  THE FOLLOWING IS A LIST OF
SOURCES FOR ADDITIONAL TRICARE INFORMATION.
   A.  ACCESS THE TRICARE WEBSITE AT WWW.TRICARE.OSD.MIL OR CALL
1-888-DOD-CARE (363-2273).
   B.  TO CONTACT YOUR NEAREST REGIONAL TRICARE BENEFICIARY
COUNSELING AND ASSISTANCE COORDINATOR (BCAC), ACCESS THE LIST OF
BCAC NAMES AND TELEPHONE NUMBERS AVAILABLE AT
WWW.TRICARE.OSD.MIL/BCACDIRECTORY.HTM
   C.  BENEFICIARIES ALSO MAY CONTACT A CUSTOMER SERVICE
REPRESENTATIVE.  A LIST OF REPRESENTATIVES IS AVAILABLE AT
WWW.TRICARE.OSD.MIL/TRICARESERVICECENTERS/DEFAULT.CFM .//