Volume 1 Unit 3 Part 1

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:

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What are the two distinct types of care?

Direct care and purchased care. Signup and view all the answers

What is a network provider?

A provider under contract with TRICARE regional office to provide care to beneficiaries. Signup and view all the answers

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

Non-Network provider Signup and view all the answers

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. Signup and view all the answers

What providers are prohibited from balance billing?

Network and participating providers Signup and view all the answers

What payments contribute to the catastrophic cap?

Deductibles, cost-shares, prescription co-payments and Prime enrollment fees. Signup and view all the answers

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

Direct care system Signup and view all the answers

Who has the highest priority for MTF care?

ADSMs and TRICARE Prime-enrolled active duty family members. Signup and view all the answers

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. Signup and view all the answers

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

The PCM Signup and view all the answers

What are the four geographic health service regions?

TRO-North, TRO-South, TRO-West, and TOP. Signup and view all the answers

Where is the TRICARE overseas regional office headquartered?

DHA Signup and view all the answers

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. Signup and view all the answers

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

TRICARE Prime Signup and view all the answers

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

By enrolling with no fee required Signup and view all the answers

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 Signup and view all the answers

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. Signup and view all the answers

Who is eligible for TRICARE Reserve Select?

National Guard, Reserve members, and their family members Signup and view all the answers

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. Signup and view all the answers

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 ...

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TRICARE for Life is a program for what beneficiaries?

Dual TRICARE and Medicare beneficiaries. Signup and view all the answers

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

The National Cancer Institute Signup and view all the answers

Who is eligible for the TRICARE Pharmacy Program?

All eligible uniformed service members, retirees, and family members, including beneficiaries age 65 and older. Signup and view all the answers

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

Location Signup and view all the answers

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

TRICARE.mil Signup and view all the answers

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

TRICARE online (TOL) Signup and view all the answers

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. Signup and view all the answers

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 Signup and view all the answers

What is a foundation for building a business strategy?

Marketing Signup and view all the answers

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

Develop communication products that meet the customer needs Signup and view all the answers

What marketing elements should marketing programs consider?

Briefings/presentations, enrollment packages, newspaper articles, public service advertising, and signage. Signup and view all the answers

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

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Volume 1 Unit 3 Part 1

Questions and Answers

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

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

What was TRICARE designed to do?

The three main benefit plan options are:

What are the two distinct types of care?

What is a network provider?

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

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

What providers are prohibited from balance billing?

What payments contribute to the catastrophic cap?

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

Who has the highest priority for MTF care?

What is an Heath Maintenance Organization (HMO)?

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

What are the four geographic health service regions?

Where is the TRICARE overseas regional office headquartered?

What are the eleven different program options?

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

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

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

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

Who is eligible for TRICARE Reserve Select?

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?

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?

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

Who is eligible for the TRICARE Pharmacy Program?

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

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

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

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

What is the function of the MTF TOL Systems Administrator?

What is a foundation for building a business strategy?

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

What marketing elements should marketing programs consider?

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

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