| Frequently Asked Questions |
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How does the US Family Health Plan compare to TRICARE Prime? top ^ The US Family Health Plan offers the same benefits and cost structure as TRICARE Prime. In addition, USFHP offers:
What will it cost to belong? top ^ While the US Family Health Plan offers the same benefits to all members, the costs for membership and for medical services are different depending on your beneficiary status. Some of you will have to pay an annual enrollment fee in order to belong to the US Family Health Plan. This is exactly the same fee you'd have to pay to join any TRICARE Prime plan, anywhere in the country, regardless of who is offering it. No more, no less. Here is the new fee structure:
How much will it cost for care? top ^ First, there are no deductibles to meet with US Family Health Plan, and no waiting periods. Your benefits take effect the first of month following the month you join if your application is received by the 20th of the month. After your enrollment fee, if any, your only costs are the relatively small copayments you pay when you receive medical services. How small? They are still small compared with the costs under TRICARE Standard, Extra or Medicare. However, it's important to note that many services - such as annual physical examinations, well child care, vision and hearing testing, require no copayments at all. The US Family Health Plan pharmacy benefit is excellent and, for many people offers significant savings over other plans. With traditional Medicare coverage, there are no outpatient pharmacy benefits. With Medicare HMOs, the pharmacy benefit is limited. What's more, if you think of what it might cost you in the time and trouble of filling out paperwork, you save here too: with the US Family Health Plan, there are no claim forms. Who is eligible for the US Family Health Plan? top ^ You're eligible for the plan if you are in any of the following categories:
Is my newborn or newly adopted child covered? top ^ Effective January 1, 2005, the newborn enrollment policy changed from a 120-day period to a 60-day period. You will now have 60 days to enroll your newborn or newly adoptive child into any of the TRICARE Prime options, including US Family Health Plan (USFHP). In order to enroll a newborn into USFHP the mother must be a current member. To enroll a newly adopted child into USFHP any family member must be a current member.
What happens if my military status changes during the middle of the plan year? top ^ When you retire and change your status from active duty to retiree, you will have to pay the applicable enrollment fee. The fee will be prorated based on the date of your retirement. Active duty sponsors who retire mid-plan year can join the USFHP at that time. Who can answer questions on eligibility, benefits or providers in the network? top ^ If you have questions regarding eligibility, benefits or providers in the network, call the Member Services Department at 1-800-241-4848. Member Services Representative are available to answer your questions Monday through Friday, 8:00 a.m. to 6:00 p.m. Bills or written inquires should be mailed to the address below. Only Physician / Provider claims and related information should be mailed to the address on the back of the ID Card: US Family Health Plan Member Services Saint Vincent Catholic Medical Centers 450 West 33rd St. 12th Floor New York, NY 10001 When will the enrollment fees be due, if applicable? top ^ All enrollees must pay their applicable enrollment fees in accordance with the government's fiscal year, which begins on October 1st and ends on September 30th of the following year. The enrollment fee, for retirees who do not pay for Medicare Part B coverage, is due by the first day of the new enrollment year (October 1st) for continuing members who chose to pay annually or by the first day of the enrollment quarter for those who choose to pay quarterly (October 1st, January 1st, April 1st and July 1st). If you are a new applicant, your initial payment for your enrollment fee should be sent with your application. How do I enroll? top ^ Enrollment is easy. You have several convenient options to obtain an application. 1) Click here to download an enrollment application 2) An application can be mailed to you by contacting Member Services by phone at 1-800-241-4848 or email us at usfamily@svcmcny.org to let us know your name and address. 3) Print an application via our web site. 4) Or attend one of the many briefings about the US Family Health Plan and make application then. You can enroll at any time. Who can I call to get additional information? top ^ Please feel free to call us Monday through Friday between 8 AM and 6 PM at 1-800-241-4848. |
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