Reserve forces can seek medical, dental reimbursement

WASHINGTON  -- National Guard and Reserve members who paid their medical and dental bills and saved their receipts may now seek reimbursement from TRICARE, officials of the military health-care system announced July 23.

Officials said the system will begin processing medical and dental claims for Guard and Reserve members who meet certain eligibility requirements.

Only guardsmen and reservists issued "delayed-effective-date active-duty orders" for more than 30 days in support of a contingency operation, and their families, may be eligible to have medical claims reimbursed.

And according to TRICARE officials, only those medical expenses incurred during the service member's "early eligibility" period -- up to 60 days before reporting to active duty -- from Nov. 6, 2003, to now are eligible for reimbursement.

This temporary entitlement is part of the Defense Department's 2004 Temporary Reserve Health Benefit Program, which sought to enhance benefits for Guard and Reserve troops called to active duty.

Normally, under TRICARE guidelines, Reserve and Guard members cannot be enrolled into TRICARE until they reach their final duty location. The temporary entitlement gives them access upon receipt of activation orders, up to 60 days in advance.

Last year, President Bush signed legislation authorizing three new temporary provisions for guardsmen and reservists and their families that provided enhanced access to TRICARE for a limited time during contingency activation. The provisions were made retroactive to Nov. 6, 2003.

A second provision temporarily extended eligibility for TRICARE benefits to 180 days for those guardsmen and reservists who separated from active-duty status Nov. 6, 2003, through Dec. 31, 2004.

The third provision extends TRICARE medical benefits to reserve-component sponsors and family members who are either unemployed or employed but not eligible for employer-provided health coverage.

All temporary provisions will end on Dec. 31.

However, the measure did include three provisions for permanent health benefits: making benefit counselors available for Guard and Reserve members in each TRICARE region, authorizing medical and dental screening and care for members alerted for mobilization, and providing TRICARE eligibility for reserve officers pending orders to active duty following commissioning.

Guardsmen, reservists and their family members must be registered in the Defense Enrollment Eligibility Reporting System and be eligible for TRICARE to qualify for the temporary benefit.

In order to apply for reimbursement, eligible members must submit a TRICARE (CHAMPUS) claim form, a copy of their itemized bill, an explanation of benefits, and proof of payment (if the bill was already paid) to their regional TRICARE claims processor.

Claims processing instructions and a downloadable TRICARE claims form, DD Form 2642, are available at local TRICARE service centers or from TRICARE regional contractors, or may be downloaded from the TRICARE Web site.