Photo By Petty Officer 1st Class James Stenberg | The Health Benefits Office located on the first floor of Naval Hospital Pensacola’s...... read more read more
PENSACOLA, Fla. – With the conversion of Naval Hospital Pensacola’s Emergency Room into an Urgent Care Center, TRICARE beneficiaries need to understand their benefits when visiting a civilian ER.
Active duty service members and their families with TRICARE Prime still incur no cost when visiting a civilian ER, but most other TRICARE beneficiaries will incur a copay.
“A copay is the amount of money, fixed or percentage, that some patients are responsible to pay for any visit to a [civilian emergency room],” said Sally Rathbun, supervisor, Health Benefits Office. “The type of TRICARE coverage a patient has will determine the amount or percentage they will pay for the visit.”
For example, an ER visit by a non-active duty beneficiary or their family member with TRICARE Prime will cost $30 per visit while a TRICARE Standard member will pay 20-25 percent after their annual deductible is met. There are potential costs associated with other emergency services that non-active duty service members and their families may have to pay as well such as ambulance service, hospitalization and surgery to name to name a few.
To help understand the different costs that may be associated with an ER visit or health care benefits in general, NHP’s Health Benefits Office can answer any questions beneficiaries may have.
“The Health Benefits Office is here to help beneficiaries understand their TRICARE benefits,” said Rathbun. “We [provide support for] authorizations, claims, enrollments and any other information the patients need. If patients get a bill they do not understand, or just need clarification, they can call the Health Benefits Office and we will assist them.”
If TRICARE beneficiaries are not in need of emergent care, they should attempt to utilize NHP’s UCC or contact their Medical Home Port Team if enrolled at NHP. Both options are more cost efficient.
“Beneficiaries authorized for care at the UCC will not have any out of pocket expenses,” said Al Hijuelos, health systems manager, HUMANA.
The UCC is open seven days a week from 10 a.m. to 9 p.m. for all TRICARE beneficiaries. However, if a beneficiary believes they are having a medical condition that requires emergency care, they should immediately seek emergency assistance by calling 911 or visiting an ER. After visiting an ER, beneficiaries should contact their primary care manager for follow up and consultation.
For more information concerning costs sharing and copay, please call NHP’s Health Benefits Office at 850-505-6709 or visit www.TRICARE.com.
| Date Taken: | 06.06.2014 |
| Date Posted: | 06.06.2014 14:44 |
| Story ID: | 132340 |
| Location: | PENSACOLA, FL, US |
| Web Views: | 161 |
| Downloads: | 1 |
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