TRICARE-Approved Continuing Care Program
Transitional Health Coverage Overview
The TRICARE-Approved Continuing Care Program includes the Continued Health Care Benefit Program (CHCBP), which provides transitional health coverage after your TRICARE eligibility ends. This program is specifically designed for former uniformed service members, their family members, former spouses, adult children, and unmarried children by adoption or legal custody. Coverage under the CHCBP lasts between 18 to 36 months, depending on eligibility criteria [1].
This program offers access to health benefits comparable to TRICARE Select Group-B, ensuring that you have continued access to essential medical services and providers during your transition period.
| Coverage Duration | Eligibility |
|---|---|
| 18 months | Former service members who lost TRICARE eligibility |
| 36 months | Former spouses who have not remarried and qualified dependents |
Eligibility Criteria for CHCBP
To enroll in the CHCBP, certain conditions must be met. The service member must have lost TRICARE eligibility under circumstances other than adverse conditions, and the plan must have been established at least one day prior to the loss of benefits [2].
The following groups may be eligible for coverage:
- Former uniformed service members
- Dependents of former service members
- Former spouses who have not remarried
- Adult children and unmarried children by adoption or legal custody
Enrolling in the CHCBP must occur within 60 days of losing eligibility for TRICARE. It is important to understand that this premium-based program provides a safety net for individuals needing continued medical support during their recovery journey.
For additional support and services, consider exploring options available through insurance-based aftercare recovery program or aftercare therapy for long-term sobriety to ensure you receive the ongoing assistance needed in your recovery path.
Enrollment Process for CHCBP
The enrollment process for the Continued Health Care Benefit Program (CHCBP) is straightforward, but understanding premiums, coverage options, and the claims process is crucial for maximizing your benefits.
Premiums and Coverage Options
CHCBP offers two primary coverage plans: individual and family coverage. These plans must be purchased in 90-day increments. Below are the costs associated with each plan:
| Coverage Type | Premium per Quarter |
|---|---|
| Individual | $1,849 |
| Family | $4,621 |
Enrollees are responsible for an annual deductible and any cost-shares for covered services. The amount of cost-sharing depends on the enrollee’s sponsor status at the time of enrollment and the types of providers utilized during care. This information is important for budgeting your recovery expenses and ensuring you have comprehensive insurance coverage for ongoing support.
Filing Claims and Deadlines
When it comes to filing claims under CHCBP, it’s essential to follow proper procedures to avoid delays in reimbursement. To file a claim, you need to complete the Patient’s Request for Medical Payment (DD Form 2642). Here’s a breakdown of the necessary steps:
- Complete the Patient’s Request for Medical Payment (DD Form 2642).
- Include a copy of your CHCBP ID card.
- Attach the provider’s bill for the services rendered.
Timely submission of claims is vital. Claims for services provided in the United States and U.S. territories must be filed within one year, while claims for services rendered in overseas areas have a deadline of three years [3]. Keep this time frame in mind to ensure you receive the financial support necessary for your recovery journey.
Understanding these aspects of the CHCBP can provide you with the necessary tools to navigate your ongoing care and ensure you have support during your recovery. For further resources on insurance-based aftercare recovery programs and other related topics, explore our articles.
Limits and Exclusions
Understanding the limits and exclusions of the TRICARE-approved continuing care program is essential for effectively managing your post-rehab recovery. This section outlines the necessary information regarding network provider access and restrictions on military facilities.
Network Provider Access
In the TRICARE Continuation Coverage Program (CHCBP), only in-network providers may be utilized for non-emergency services. Enrollees should be aware that network providers file claims directly for their services, streamlining the reimbursement process. However, if you seek services from non-network, non-participating providers, you will need to pay upfront, and you’ll be responsible for filing your claims to receive reimbursement. Understanding this process is vital for ensuring that you receive the support you need without unexpected financial burdens.
| Provider Type | Claims Process |
|---|---|
| In-Network Providers | Claims filed by provider |
| Non-Network Providers | Pay upfront, file claims yourself |
For comprehensive information about available resources, consider visiting our articles on insurance-based alumni recovery support and affordable aftercare with insurance coverage.
Restrictions on Military Facilities
Due to the nature of the CHCBP, enrollees are generally restricted from using military hospitals and clinics, except in emergency situations. This restriction underscores the importance of securing care from approved civilian providers to ensure coverage under your TRICARE plan. If you require immediate care, be sure to follow established protocols to document your trip to a military facility to protect your coverage status.
As you navigate your recovery journey, understanding these limitations can help you plan your aftercare effectively. For more information on related services, explore our resources on insurance-covered post-rehab support and medicaid-covered post-rehab program.
Additional Coverage for Former Spouses
Duration and Qualifications
If you are a former spouse who has not remarried, you may qualify for the Continued Health Care Benefit Program (CHCBP) for up to 36 months. Additionally, certain former spouses who have not remarried before the age of 55 may qualify for coverage without a time limit [3]. This program provides coverage comparable to TRICARE Select Group-B, satisfying the minimum essential coverage required by the Affordable Care Act.
Dependent spouses and children who lose their eligibility for TRICARE or the Transitional Assistance Management Program (TAMP) may also qualify for CHCBP for up to 36 months. This includes children adopted or placed in the legal custody of a uniformed service sponsor, as well as children aged 21 to 25 who lose eligibility for TRICARE or TAMP. These older children may have the option to purchase Transitional Young Adult (TYA) coverage, which can extend their eligibility for CHCBP [1].
| Coverage Type | Duration |
|---|---|
| Unremarried Former Spouses | Up to 36 months |
| Unremarried Former Spouses (Age > 55) | Unlimited Coverage |
| Dependent Spouses and Children | Up to 36 months |
| Children (Ages 21-25) | Options for TYA coverage instead of CHCBP |
Contacting CHCBP Contractor
For assistance or any inquiries regarding CHCBP, it is advisable to directly contact the CHCBP contractor. They can provide specific information about eligibility, coverage options, and the enrollment process. The contractor will help guide you through any necessary steps to ensure you receive the benefits you are entitled to under the program.
You can find the contact information for the CHCBP contractor here. They will be able to assist you with any questions related to your potential coverage and fulfill your needs effectively. If you are looking for additional support in the recovery process, explore options like insurance-based alumni recovery support or aftercare therapy for long-term sobriety.
Special Cases and Considerations
Newborn Enrollment Process
If you lose your TRICARE eligibility after military separation, your newborn can still be enrolled in the Continued Health Care Benefit Program (CHCBP). It is vital to request a coverage card for your child once they have been born or adopted. Remember to provide this card to your healthcare provider to ensure they attach a copy to all claims for proper processing.
Newborns born or adopted after military separation cannot be added to the Defense Enrollment Eligibility Reporting System (DEERS). Instead, enrollment into the CHCBP is the required procedure to secure coverage for your newborn.
| Important Steps | Details |
|---|---|
| Request Coverage Card | After birth or adoption, immediately request a coverage card. |
| Provide to Provider | Ensure the provider receives the card for claim processing. |
| Enrollment Timing | Must enroll within the appropriate time frame post-separation. |
Service Member Separation Requirements
To qualify for the CHCBP, the service member’s previous healthcare plan must have been active at least one day before losing eligibility. Furthermore, the separation must be under “other than adverse conditions” to qualify for this ongoing benefit [2]. The CHCBP provides essential coverage, including access to insurance-based aftercare recovery programs and ongoing support crucial for your recovery journey.
The following conditions are necessary for enrollment:
| Enrollment Condition | Requirement |
|---|---|
| Active Healthcare Plan | Must have been in place at least one day before losing eligibility. |
| Separation Status | Must be under “other than adverse conditions.” |
Ensuring you meet these requirements will help facilitate a smoother transition to continued care and support following military service. You can find more information about related programs, such as insurance-verified recovery maintenance plans to assist in your ongoing recovery process.
Extended Benefits for Dependents
The TRICARE-Approved Continuing Care Program (CHCBP) provides essential support for dependents of uniformed service members. This section will cover the coverage options available for dependent spouses and children, as well as the Transitional Young Adult (TYA) option.
Coverage for Dependent Spouses and Children
Dependent spouses and children of sponsors can qualify for CHCBP coverage, which lasts up to 36 months. This includes children who were adopted or placed in the legal custody of a uniformed service sponsor. The CHCBP serves as a bridge, offering transitional health coverage for families after TRICARE eligibility ends. This coverage mirrors some of the essential benefits found in TRICARE programs.
| Dependent Type | Coverage Duration |
|---|---|
| Spouses | Up to 36 months |
| Children | Up to 36 months |
| Adult Children (ages 21-25) | Eligible for TYA coverage |
Former spouses who have not remarried can also qualify for coverage up to 36 months. Additionally, certain former spouses who have not remarried before the age of 55 may be eligible for unlimited coverage duration [3]. This ensures that eligible dependents have ongoing access to necessary medical services during their transition to civilian health plans.
Transitional Young Adult (TYA) Option
Children aged 21 to 25 who lose their eligibility for TRICARE or TAMP have the opportunity to purchase Transitional Young Adult (TYA) coverage. This option provides additional flexibility for young adults seeking to maintain health coverage during their transition to independence.
The TYA option allows young adults to extend their health coverage, offering the possibility to continue insurance through CHCBP. By purchasing TYA coverage, these individuals may also have the chance to extend their eligibility to buy CHCBP coverage thereafter. This ensures continued access to necessary healthcare services during a critical developmental time [1].
Understanding the options available for dependents under the CHCBP can significantly enhance recovery outcomes. If you seek comprehensive support for your post-rehab journey, explore programs like insurance-based aftercare recovery program or insurance-covered post-rehab support to ensure a sustained path to wellness.
