|
|
| |
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:
-
Experience - Over twenty-five years of providing healthcare to military
beneficiaries
-
Quality - Comprehensive healthcare backed by the full resources of Saint
Vincent Catholic Medical Centers
-
Conveniences - Large network of healthcare providers with accessible
locations and hours. No forms to fill out and one payor for all your expenses
-
Choice - Members select physicians and healthcare sites
-
Access - Timely appointments with healthcare providers
-
Service - Personal attention from member services and healthcare
providers
-
Value - Minimal costs to members and lowest fees of all the TRICARE
options
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:
-
For active duty families, there are no enrollment fees
-
For military retirees and their eligible family members, the fee for the
12-month enrollment period is $230 per individual membership or $460 per family
membership. (2 or more family members). You may pay all at once or choose
quarterly with no additional charges. Your first enrollment fee payment is due
no later than the end of the first month of your membership.
-
For retirees 65 years of age or over, the USFHP enrollment fee is waived if you
have Medicare Part B coverage.
-
Enrollment is required to receive benefits under the plan.
-
The enrollment period is 12 months.
-
Re-enrollment is automatic.
-
Disenrollment requires written notification and will be effective upon anniversary date.
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:
- Eligible Family Members of Active Duty Uniformed Service Members
- Unmarried children up to age 21 or until their 23rd birthday if they are a
full-time student
- Retirees and their eligible family members
-
National Oceanic and Atmospheric Administration (NOAA) retirees and their
eligible family members
-
Un-remarried husbands and wives and qualified unmarried children of deceased
retired service members
-
Eligible family members of deceased or retired NOS members
- Retirees Over 65 with Medicare Part A only
- Retirees Over 65 with Medicare Part A and Part B
If you have questions about eligibility, please
call 1-800-241-4848.
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.
-
Obtaining a “Certificate of Live Birth” from the birthing facility or a Birth
Certificate
-
Contacting the Defense Enrollment Eligibility Reporting System (DEERS) and
enroll the newborn or newly adoptive child with these documents
-
Complete a USFHP application within 60 days from the date
of birth or adoption
Please note that if your newborn or newly adoptive child is not enrolled by the
61st day all future claims will be processed as TRICARE standard. All
applications received after the 60th day will be considered new. They will be
enrolled following the 20th of the month rule. If your newborn or newly
adoptive child is enrolled by the 60th day they will become effective as of
date of birth or date of adoption. To enroll your newborn or newly adoptive
child with USFHP you must complete the entire enrollment application form. This
includes selecting a Primary Care Manager. You can get this application and
select a Primary Care Manager on our website at www.usfhp.net.
You can also request this information by calling Member Services at
1-800-241-4848 Monday through Friday between the hours of 8:00am and 6:00pm.
The application must be received within the new 60-day period.
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.
|
|
|
