Institutional claims topic to the CHAMPUS DRG-based reimbursement technique or a CHAMPUS-determined all-inclusive price reimbursement methodology, could also be submitted solely after the beneficiary has been discharged or transferred from the institutional provider’s facility or program. The most annual program 12 months Government cost-share per EHHC-eligible beneficiary for ECHO residence health care, together with EHHC respite care could not exceed the local wage-adjusted highest Medicare Resource Utilization Group (RUG-III) class cost for care in a TRICARE-authorized skilled nursing facility. The EHHC benefit provides coverage of residence health care companies and respite care services specified in this part. Public facility or Federal authorities. Rehabilitation and assistive technology companies or supplies could also be obtainable beneath the TRICARE Basic Program. Services offered by alcoholism rehabilitation counselors solely when rendered in a CHAMPUS-authorized treatment setting and only when the value of these providers is included in the facility’s CHAMPUS-determined allowable cost rate.

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A partner (as described in paragraph of this part besides former spouses) and baby (as described in paragraph of this section) of a member described in paragraph of this part can be eligible for TAMP advantages beneath TRICARE. CHAMPUS eligible dependents beneath this paragraph are these recognized in paragraphs and of this part. CHAMPUS eligible dependents of a Medal of Honor Recipient are these recognized in paragraphs of this part and of this part (except for a kid placed in legal custody of a Medal of Honor recipient underneath of this section).

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This term means a direct family member who has happy all the criteria that should be met earlier than the survivor is permitted for TRS coverage. Re-enrollment following termination. Absent a new qualifying occasion, members/survivors (subject to paragraph of this section) are not eligible to re-enroll in TRICARE Reserve Select until the following annual open season.

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