Having problems getting doctor appointments?

  • Published
  • By Brian P. Smith
  • TriWest Healthcare Alliance
Some Elmendorf Air Force Base Airmen and their families are having trouble getting appointments at the 3rd Medical Group because they are not correctly enrolled in TRICARE.

"This sometimes happens when Soldiers head into harm's way and their families move, or when military children from around the state move to the post to attend the Alaska Military Youth Academy," said TRICARE benefits expert Jenny Hall of TriWest Healthcare Alliance, which administers the military's healthcare plans in Alaska and 20 other western states.

"When addresses are not current in the system, it can affect access to appointments," Hall said.

How to update addresses
There are four ways to keep addresses current in the Defense Enrollment Eligibility Reporting System (DEERS) to ensure TRICARE coverage is there when it's needed.
· Phone: 1-800-538-9552
· Fax: 1-831-655-8317
· In Person: Visit a local ID card office
· Online at: www.tricare.mil/deers

TRICARE also offers a convenient Beneficiary Web Enrollment tool where most patients can manage enrollment and DEERS information online 24/7. Logon to https://www.dmdc.osd.mil/appj/bwe/ to enroll in Prime, update personal information and request enrollment cards.

Eligible beneficiaries can also choose primary care managers through BWE. They can logon using a common access card, a Defense Finance and Accounting Service "myPay" personal identification number, or a Department of Defense self-service logon PIN.

The installation's clinic or hospital assigns primary care managers to active-duty servicemembers, so they cannot change a primary care manager through BWE.

When to disenroll in Prime
Families moving to an area where Prime is not available should disenroll from Prime and use standard or extra coverage to avoid out-of-pocket costs of up to 50 percent. Those moving to a different TRICARE region need to contract the TRICARE contractor for the region before disenrolling.

Keep in mind that Prime beneficiaries who voluntarily disenroll may not be eligible to re-enroll in Prime for 12 months, so be sure it's the right choice.

Avoid unnecessary costs
If family members move without their service member to an area where Prime is not available, disenroll from Prime and use the Standard or Extra option to avoid point of service charges.

Point of service charges may apply when seeing a doctor without a referral from the assigned primary care manager. Using the point of service option results in higher out-of-pocket costs:
· Point of service outpatient Deductible ($300 for individual or $600 for families)
· Point of service outpatient and inpatient cost: 50 percent of the maximum allowable charge

It is generally less expensive to use a TRICARE network provider rather than a non-network provider. A list of network providers is available through the Online Provider Locator at www.triwest.com.

TRICARE cost-shares and deductibles are subject to change at the beginning of each fiscal year (Oct. 1). The current costs are online for each TRICARE plan at www.tricare.mil/costs.

For more information about TRICARE benefits, eligibility or costs or coverage, visit www.triwest.com or call 1-888-TRIWEST (874-9378).