Chapter 12-Tricare and Champva
Key Words
Catastrophic Cap-Limit on total medical expenses that beneficiaries are required to pay in a year.
Maximum amount
Civilian Health and Medical Program of the Uniformed Services CHAMPUS-Replaced by Tricare-Cost share
Civilian Health and Medical Program of the Department of Veterans Affairs CHAMPVA-Service for 100%
disabled veteran and their families
Cost Share-Portion of every charge that a Tricare or Champva Beneficiary must pay
Defense Enrollment Eligibility Reporting System DEERS-Information regarding patient eligibility
Military Health System MHS
Military Treatment Facility MTF-Government hospitals and clinics whose first priority is to serve active duty
personal
Non-Availability Statement NAS-Electronic document stating that the required service is not available at the
nearby military treatment facility
Non-Par charge only up to 115% of allowed charge
Par-provider-Required to file claims on behalf of their patients, paid MFS
Primary Care Manager PCM-Coordinates and manages patient’s medical care
Sponsor-Uniformed services member
TRICARE-Serves spouses/children of Active Duty service members. Formerly called CHAMPUS
Tricare Extra-Receive services in civilian facilities
Tricare for Life-Medicare eligible
Tricare Prime-Offers HMO like plan requiring no annual deductible
Tricare Reserve Select TRS-Program that offers benefits to active duty reservists
Tricare Standard-Offers fee-for-services