TRICARE Beneficiaries Overseas to See Improved Care and Service

By Marqeis Sparks Health.mil

The 500,000-plus TRICARE beneficiaries who live outside the United States will soon see changes in the way they access health care as a result of a new contract awarded for the management of the TRICARE Overseas Program (TOP). The changes will lead to consolidations in the program that will improve customer service and access to health care for beneficiaries overseas, said Rear Adm. Christine Hunter, deputy director of TRICARE Management Activity, on a recent episode of the Military Health System’s Dot Mil Docs podcast.

The new contract, awarded to International SOS, will consolidate the current overseas contracts, including those for TRICARE Puerto Rico and TRICARE Global Remote Overseas, into a standardized health care program available to all service members and their families living in other countries.

International SOS will support the TRICARE Overseas Program Office, TRICARE Area Offices and military treatment facility (MTF) commanders, which will essentially combine the resources of the military’s direct medical care system overseas with the contractor’s services in host nations. The transition will take about 10-months to complete.

“We hope to add consistency and continuity to the relationships with the host nation providers, so that both [TRICARE] and International SOS are in a trusted relationship with our valued host nation providers,” said Hunter. The new contract aims to allow beneficiaries, particularly those who may require emergency attention, or a specialist, to have access to adequate care at local medical facilities.

Under previous overseas contracts, claims payments have either been paid in full to the provider at the time services are rendered or billed to the patient weeks, or even months, following their visit. TOP will ensure that all claims are taken care of in a timely matter, said Hunter.

An adjustment to the contract secures a “guarantee of payment” agreement with providers that ensures TOP Prime-enrolled beneficiaries have access to routine, urgent and emergency services without having to pay for services immediately or file claims.

Officials also expect support services to improve substantially after TRICARE Service Center operations are consolidated worldwide, strengthening communication and service stability. Call centers will be available 24-hours-a-day and will offer extensive translation capabilities.

“We’ve been using different contracts, one for enrollment, and another for claims. Everything will process through the single overseas contract,” said Hunter. “That should make it much easier for beneficiaries no matter where their location is, because they are dealing with one entity, and can get the care they need a little bit closer to where they call home, at the time.”

International SOS, has an established relationship with TRICARE as a partner in the TGRO program.

More information on TRICARE is available at www.tricare.mil