Volume 1 Unit 3 Part 1

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36 Questions

When hospitals were first established, who typically worked as nurses in the hospitals?

Wives or widows of military personnel.

When was the Act that led to Civilian Health and Medical program (CHAMPUS) signed into law?

1 October 1966

What was TRICARE designed to do?

Expand access to care, assure high-quality care, control healthcare costs, and improve medical readiness.

The three main benefit plan options are:

What are the two distinct types of care?

Direct care and purchased care.

What is a network provider?

A provider under contract with TRICARE regional office to provide care to beneficiaries.

What type of provider furnishes care to beneficiaries but does not sign agreements with regional contractors?

Non-Network provider

What is a non-network, non-participating provider?

One who provides care, but does not have an agreement with TRICARE and they do not accept the allowable charge as payment.

What providers are prohibited from balance billing?

Network and participating providers

What payments contribute to the catastrophic cap?

Deductibles, cost-shares, prescription co-payments and Prime enrollment fees.

Under what system do TRICARE beneficiaries receive a majority of their care?

Direct care system

Who has the highest priority for MTF care?

ADSMs and TRICARE Prime-enrolled active duty family members.

What is an Heath Maintenance Organization (HMO)?

It’s a health plan in which a member pays for medical care, and it usually includes primary and preventive care.

Who makes referrals for tests/specialty care, and monitor adequacy and continuity of needed care?

The PCM

What are the four geographic health service regions?

TRO-North, TRO-South, TRO-West, and TOP.

Where is the TRICARE overseas regional office headquartered?

DHA

What are the eleven different program options?

TRICARE Prime, TRICARE Prime Remote, TRICARE Prime Overseas, TRICARE Prime Remote Overseas, TRICARE Reserve Select, TRICARE Standard and Extra, TRICARE Standard Overseas, TRICARE for Life, TRICARE Young Adult, TRICARE Reserve and US Family Health Plan.

What plan offers the lowest out of pocket cost for beneficiaries, and is only available in the US Service Area?

TRICARE Prime

How does an active duty member receive care in TRICARE Prime Remote?

By enrolling with no fee required

Who is eligible for TRICARE Prime Overseas and TRICARE Remote Overseas?

Active duty service members and their family, and command-sponsored active duty family members

What is the catastrophic cap for active duty family members enrolled in TRICARE Standard and Extra?

Between $1,000 and $3,000 annually, depending on rank.

Who is eligible for TRICARE Reserve Select?

National Guard, Reserve members, and their family members

What is a voluntary, premium based program that extends TRICARE coverage to certain family members under the age of 26 who have (or will lose) their eligibility due to age?

TRICARE Young Adult.

What community-based, not-for-profit healthcare systems participate in Uniformed Service Family Health Plan? Johns Hopkins Medicine, Martin’s Point Healthcare, Brighton Marine Health Center, CHRISTUS Health, Pacific Medical Centers, and ...

TRICARE for Life is a program for what beneficiaries?

Dual TRICARE and Medicare beneficiaries.

Who does the DOD work with to offer cancer clinical trials for eligible TRICARE beneficiaries?

The National Cancer Institute

Who is eligible for the TRICARE Pharmacy Program?

All eligible uniformed service members, retirees, and family members, including beneficiaries age 65 and older.

When assisting beneficiaries with choosing the right TRICARE program for their family, what should you consider first?

Location

What website has all the information beneficiaries need to choose the right program for them?

TRICARE.mil

What site allows beneficiaries to access their appointments, prescriptions, and personal health information from a secure website?

TRICARE online (TOL)

Maintain TOL sustainment plan, oversee the activities of MTF TOL Team, and establish business practices to incorporate into newcomers briefings are whose responsibilities?

MTF TOL Project officer.

What is the function of the MTF TOL Systems Administrator?

This position is responsible for the technical aspect; interprets guidance, and understands the basic TOL features

What is a foundation for building a business strategy?

Marketing

What is one of the major goals of a marketing program?

Develop communication products that meet the customer needs

What marketing elements should marketing programs consider?

Briefings/presentations, enrollment packages, newspaper articles, public service advertising, and signage.

A provider that accepts TRICARE and agrees to the TRICARE allowable charge for their service is classified as what type of provider?

Test your knowledge on the history of nursing and the evolution of healthcare benefits. Explore the roles of nurses in early hospitals and the legislation that shaped modern healthcare programs such as CHAMPUS and TRICARE. Delve into benefit plan options, types of care, and network provider concepts.

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