Travis has a check-up next month with his neurosurgeon at Stanford. When we got the insurance approval in the mail I noticed on the bottom of the letter from TriCare that it mentioned that travel reimbursement maybe be available if you are traveling more than 100 miles from your PCP. Travis called the number on the letter and already has his flight booked through SATO.
Below are details about getting TriCare to pay for travel expenses to attended a medical appointment:
TRICARE Prime and Non-Medical Attendant Travel Entitlements
Under provisions of the 2001 National Defense Authorization Act, TRICARE Prime beneficiaries referred by their primary care manager for services at a location more than 100 miles from their PCM may be eligible to have their “reasonable travel expenses” reimbursed by TRICARE. The travel reimbursement entitlement is retroactive to Oct. 30, 2000.
Eligibility for the TRICARE Prime Travel Entitlement:
The TRICARE Prime travel entitlement is available to non-active duty TRICARE Prime enrollees and TRICARE Prime Remote family members when they are referred for medically necessary, non-emergent specialty care more than 100 miles from their primary care manager location. The “greater than 100 mile rule” is stated in statute and isn’t negotiable when determining applicability of the Prime travel benefit.
Beneficiaries must have a valid referral and travel orders from a TRICARE representative at the military treatment facility where they are enrolled or from their TRICARE Regional Offices if their primary care manager is a TRICARE network provider.
Note: This entitlement doesn’t apply to expenses experienced by active duty uniformed services members, or active duty family members living with their sponsors overseas, which are reimbursed by other travel entitlements.
Reasonable Travel Expenses:
Reasonable travel expenses are the actual costs incurred by beneficiary when traveling to their specialty provider-not in an emergency status. Costs include meals, gas, tolls, parking, and tickets for public transportation (i.e. airplane, train, bus, etc.). Beneficiaries are required to submit receipts for all expenses.
Government rates will be used to estimate the reasonable cost. Beneficiaries are expected to use the least costly mode of transportation. The actual costs of lodging (including taxes and tips) and the actual cost of meals (including taxes and tips, but excluding alcoholic beverages) may be reimbursed up to the government rate for the area concerned.
General Process for Receiving Travel Reimbursement:
If the beneficiary is referred by a provider at a military treatment facility, he/she should contact a military treatment facility point-of-contact for a briefing on the entitlement process and beneficiary responsibilities.
If the beneficiary is enrolled to and referred by a civilian primary care manager, he/she should contact a point-of-contact at the TRICARE Regional Office.
Beneficiaries must obtain official travel orders from the military treatment facility or TRICARE Regional Office point-of-contact. Beneficiaries will be required to make their own travel arrangements unless the military treatment facility or TRICARE Regional Office point-of-contact arranges for government travel. Beneficiaries are required to coordinate their own lodging arrangements.
Upon completion of travel, the expenses need to be itemized on a SF 1164 or a DD1351-2 (travel voucher) and receipts are required for all expenses. The military treatment facility or TRICARE Regional Office point-of-contact will provide the beneficiary with specific instructions on how and where to submit his/her travel entitlement claim.
Traveling with a Non-medical Attendant:
The FY02 National Defense Authorization Act authorizes one parent, guardian or another adult family member to travel with a non-active duty Prime enrolled patient as a non-medical attendant. The non-medical attendant is authorized reimbursement of actual travel expenses. If the non-medical attendant family member is an active duty service member authorized by the military treatment facility or TRICARE Regional Office to accompany a non-active duty TRICARE Prime enrollee as a non-medical attendant, he/she is entitled to TDY allowances (per diem and mileage), not actual expenses.
If the non-medical attendant family member is a U.S. Government civilian assigned to TDY by their civilian organization, they may also be entitled to TDY allowances.
By statute, the non-medical attendant must be a parent, legal guardian or other adult family member. However, if the non-medical attendant isn’t the parent, the non-medical attendant must be at least 21 years of age. The non-medical attendant isn’t required to be enrolled in TRICARE Prime or to be TRICARE-eligible. The patient, however, must be enrolled in TRICARE Prime.
The uniformed services and the TRICARE Regional Offices have responsibility for implementing and managing the non-medical attendant provision. The non-medical attendant benefit is retroactive to December 28, 2001. Non-medical attendants that qualify for reimbursement under this entitlement should save their travel receipts.
For more information about the TRICARE Prime travel entitlement, please contact the local military treatment facility or TRICARE Regional Office beneficiary counseling and assistance coordinator or travel point-of-contact. Telephone numbers and addresses for BCACs are available on the TRICARE Web site at http://www.tricare.mil/contactus/.