TOP Standard is similar to the TRICARE Standard program offered stateside, including cost-shares and deductibles. Active duty family members living overseas with their sponsors, who have relocated with service sponsored/funded orders, may choose between TOP Prime and TOP Standard. Retirees and their families who reside overseas are not eligible to enroll in TOP Prime and are only covered by TOP Standard. The following is a summary of the TRICARE Overseas Program:
- Accessing Health Care
- TRICARE Global Remote Overseas Call Center
- TRICARE Area Office Contact Information
- Costs and Fees
- National Guard and Reserve Care under TRICARE Standard
- TRICARE Enrollment and Claims Forms
Accessing Health Care
The TOP Standard option is a fee-for-service option. Enrollment is not required and beneficiaries may receive care from any qualified host nation provider. Beneficiaries should contact the nearest:
- military treatment facility (MTF);
- TRICARE Service Center (by visiting the TRICARE Service Center); or
- American Embassy Health Unit to find a host nation provider (by visiting the U.S. Department of State to get embassy phone numbers).
TRICARE Global Remote Overseas Call Center
Beneficiaries in remote overseas locations may call the TRICARE Global Remote Overseas Call Center by using the contact information below.
|
TGRO Call Centers | |
|
TRICARE Europe |
Phone: 00-44-20-8762 8133 |
|
TRICARE Latin America and Canada |
Phone: 1-800-834-5514 |
|
TRICARE Pacific |
Phone: Singapore +65-6338-9277 |
TRICARE Area Office Contact Information
Although beneficiaries are not generally required to have a referral for specialty care, some procedures may require prior authorization. They must check with the TRICARE Area Office listed below for details about services requiring prior authorization.
|
TRICARE Area Office Contact Information | |
|
TRICARE Europe |
TRICARE Area Office Europe |
|
TRICARE Pacific |
TRICARE Area Office Pacific Toll Free: 1-888-777-8343 option #4 |
|
TRICARE Latin America and Canada |
Director |
Costs and Fees
When using TOP Standard, beneficiaries are responsible for annual deductibles and cost-shares. They may be required to pay for care up front and file claims with Wisconsin Physician Services, the TRICARE Overseas claims processor.
The following chart lists the costs currently associated with TRICARE Standard for fiscal year 2005. The catastrophic cap limits beneficiaries' out-of-pocket expenses for TRICARE each fiscal year.
|
TOP Standard |
Active Duty Family Members |
Retirees and Their Family Members |
|
Annual Deductible |
E-4 and below $50 per person $100 per family E-5 and above $150 per person $300 per family |
$150 per person $300 per family |
|
Cost-share |
· Civilian Outpatient Visit: 20% of covered services · Civilian Inpatient Admission: $13.90 per day or $25 minimum, which ever is greater · Civilian Inpatient Behavioral Health: $20 per day |
· Civilian Outpatient Visit: 25% of covered services · Civilian Inpatient Admission: 25% of institutional charges; 25% of covered services; plus 25% of professional fees · Civilian Inpatient Behavioral Health: 25% of institutional charges; 25% of covered service; plus 25% of professional charges |
|
Catastrophic Cap |
$1,000 |
$3,000 |
The fiscal year is October 1-September 30. Cost-share amounts are subject to change each fiscal year. Beneficiaries may visit www.tricare.osd.mil/tricarecost for the most up-to-date cost information.
Despite its increased out-of-pocket costs, TOP Standard may be the right choice for some beneficiaries, especially those who prefer to get their care directly from host nation providers. By choosing TOP Standard, beneficiaries may select any provider for outpatient care.
National Guard and Reserve Care under TRICARE Standard
If National Guard and Reserve members and/or eligible family members reside overseas during the 90-day early TRICARE benefit period, they are eligible for TRICARE Standard (once at the mobilization site, the active duty National Guard and Reserves will obtain screening and health care services through the installation MTF). National Guard and Reserve family members who live overseas while their sponsor is on active duty for more than 30 consecutive days are entitled to TRICARE Standard benefits.
