Medical Websites pertaining to Military Insurance Programs

U.S. Department of Defense Military Health System

Tricare Page: http://www.tricare.osd.mil/

This website has extensive information on all aspects of military health care. I would recommend going to the "Site Map" to navigate your way through the site easier. Here are just a few things of interest to cleft lip/palate:


  • Click here to view the Tricare Standard Handbook

  • Of interest: In the "Provider's Handbook" Section See: Non-Covered Dental Services:

     (Excerpt)

    Non-Covered Dental Services

    Preventive, routine, restorative, prosthodontic and emergency dental care
    Adding or modifying bridge work and dentures
    Orthodontics, except when directly related to correction of a cleft palate

    Note: Pre-authorization is needed for adjunctive dental care. Providers should contact the appropriate contractor.

    Note: The TRICARE Active-Duty Family Dental Plan is not part of the TRICARE medical benefits program. The Reserve Dental Plan and the Retiree Dental Plan are separate insurance programs administered by civilian contractors.


    Covered Oral Surgery

    • Surgery to correct accidental injury
    • Medically necessary surgery of accessory sinuses, salivary glands or ducts
    • Excision of tumors and cysts of the jaws, cheeks, lips, tongue, roof and floor of the mouth when the condition requires a pathological exam
    • External incision and drainage of cellulitis
    • Fractures of facial bones
    • Correction of cleft palate
    • Oral and facial cancer
    • Reduction of dislocations and the excision of the temporomandibular joints, when surgery is a necessary part of the reduction
    • Surgical intervention necessitated by physician-induced trauma
    Note: Covered oral surgical procedures that are essentially medical rather than dental may not require pre-authorization. Contact your claims processing contractor to determine whether a planned oral surgery procedure requires preauthorization.

    Plastic or Reconstructive Surgery (excerpted from that page)

    TRICARE Standard covers plastic, cosmetic and reconstructive surgery only in the following situations:


    A Look at TRICARE

    TRICARE: What Is It?

    TRICARE is the name of the Defense Department's new regional managed health care program for service families. Under TRICARE, you'll generally have three choices of ways in which to get your health care:

    Here's a brief look at each of the three options:

    TRICARE Prime

    This is a voluntary health maintenance organization-type (HMO) option. If you decide to get your health care through TRICARE Prime, you'll pay an annual enrollment fee (except for active-duty families, who may enroll free) and enroll for a year at a time. Normally, you'll receive your care from within the Prime network of civilian and military providersSee.

    You'll either choose or be assigned a Primary Care Manager (PCM) from within the contractor's network or at your nearest uniformed services medical facility, who will furnish most of your care and will manage all aspects of your care, including referrals to specialists. The Health Care Finder (HCF) assists in finding the appropriate specialty care for you.

    Covered services will be like those of regular CHAMPUS (now known as TRICARE Standard), plus additional preventive and primary care services that aren't covered under TRICARE Standard or TRICARE Extra. For example, periodic health promotion/disease prevention surveillance screenings (most people think of them as routine physical exams) are covered at no charge under TRICARE Prime. Prime also covers certain immunizations, as well as examinations for various cancers and infectious and cardiovascular diseases, and other screenings, with certain age and frequency limitations.

    Is TRICARE Prime the Right Plan For You?

    It depends. On the one hand, TRICARE Prime is the least costly of the three TRICARE options. You'll be able to predict your health care costs more exactly. As noted earlier, there's no enrollment fee for active-duty families-just modest co-payments when you get health care within the Prime network of civilian providers.

    Prime is easy to use. You'll have a Primary Care Manager (PCM) in the Prime provider network, from whom you'll get most of your care, and who will refer you to specialists within the network when necessary. Your local Health Care Finder (HCF) at the TRICARE Service Center (TSC) will make the arrangements for you to get the specialized care after you receive a referral from your PCM.

    The services of Health Care Finders are available to you 24 hours a day, seven days a week. And the various TRICARE Service Centers in the region served by your contractor will have representatives available during regular business hours to provide a variety of information about all aspects of your health benefits.

    There's less paperwork with Prime. When you get care from a provider who's part of the Prime network, you don't have to file claims (but if you should seek care from a non-network provider, you or the provider may have to file a claim with the regional TRICARE contractor).

    On the other hand, TRICARE Prime may not be your best bet if you have other health insurance that's your primary coverage. In such a case, Prime will only pay after your other insurance has paid whatever it's going to pay for your civilian care. Also, if you discontinue your other health insurance when you enroll in Prime, and later become ineligible for Prime, you might have difficulty getting your other insurance back.

    Or, if you travel out of your TRICARE Prime service area very often, Prime might not be your best choice. The reason: When you get civilian care outside your TRICARE Prime service area, Prime will only pay for emergency services-unless the care you receive has been authorized in advance by the Health Care Finder in your home service area.

    You might not want to enroll in TRICARE Prime if you don't want to be restricted to using only providers who are members of the Prime network. A better choice might be either the TRICARE Extra or TRICARE Standard (CHAMPUS) options, which are described later in this chapter.

    When you enroll in TRICARE Prime, your enrollment is for one year at a time. During the enrollment period, you're "locked in" to using only Prime (with the expensive exception of getting care under the "point-of-service" option-more about that later in this chapter) unless you become ineligible for TRICARE during the enrollment period, or unless you move from your local TRICARE Prime service area to a non-Prime area and have to disenroll from Prime as a result.

    Note:

    There are no pre-existing condition limitations for enrollment in TRICARE Prime or for use of the other two TRICARE health care options, Extra and Standard.

    TRICARE Extra

    In this option, you don't have to enroll or pay an annual fee. You do have to satisfy an annual deductible for outpatient care, just as you do under TRICARE Standard. (See the section on TRICARE Standard below, and also see the chapter titled "How Much Will It Cost?" for more information about the deductible under TRICARE Standard.) The deductible and cost-sharing works the same way under TRICARE Extra.

    On a visit-by-visit basis, you can seek care from a provider who's part of the TRICARE Extra network, get a discount on services, and have reduced cost-shares-five percent less than under TRICARE Standard. Also, you generally won't have to file any claim forms. You pay annual deductibles for outpatient care before government cost-sharing starts, as you do under TRICARE Standard. You can get a list of the TRICARE Extra providers by contacting one of the TRICARE service centers located in your region, or by calling the toll-free number established by the TRICARE contractor.

    TRICARE Standard

    This option is the regular CHAMPUS program with a new name. It pays a share of the cost of covered health care services that you obtain from an authorized non-network civilian health care provider. There's no enrollment in TRICARE Standard. You'll pay the normal TRICARE Standard deductibles for outpatient care, and your cost-sharing percentages will be the same as for regular CHAMPUS.


    TRICARE Regional Contacts

    If you have questions about your military health care benefits under TRICARE, there are many places to get answers. Each medical facility has a Health Benefits Advisor, Managed-Care Office or TRICARE Service Center. This should be your first contact for information. Additionally, below are telephone numbers for each region, where you can call and get information about TRICARE and your health care benefits.

    Check here for additional REGIONAL information

    Region 1
    Maine, New Hampshire, Vermont, Massachusetts, Connecticut, Rhode Island, Delaware, Maryland, New Jersey, New York, Pennsylvania, the District of Columbia, northern Virginia, and the northeast corner of West Virginia
    Expected operational mid 1998
    1-202-782-1486

    Region 2
    North Carolina and most of Virginia
    Expected operational mid 1998
    1-800-990-8272

    Region 3
    South Carolina, Georgia, and Florida excluding panhandle
    Operational July 1, 1996
    1-800-444-5445

    Region 4
    Florida panhandle, Alabama, Mississippi, Tennessee and eastern third of Louisiana
    Operational July 1, 1996
    1-800-444-5445

    Region 5
    Michigan, Wisconsin, Illinois, Indiana, Ohio, Kentucky, and West Virginia excluding the northeast corner
    Expected operational mid 1998
    1-513-255-9690

    Region 6
    Oklahoma, Arkansas, western two thirds of Lousiana, Texas, excluding southwest corner
    Operational November 1, 1995
    1-800-406-2832

    Region 7/8
    New Mexico, Arizona excluding Yuma, Nevada and southwest corner of Texas, including El Paso, Colorado, Utah, Wyoming, Montana, Idaho excluding northern Idaho, North Dakota, South Dakota, Nebraska, Kansas, Minnesota, Iowa and Missouri
    Operational April 1997
    1-888-TRIWEST (874-9378)

    Region 9
    Southern California and Yuma, Arizona
    Operational April 1, 1996
    1-800-242-6788

    Region 10
    Northern California
    Operational April 1, 1996
    1-800-242-6788

    Region 11
    Washington, Oregon, and northern Idaho
    Operational March 1, 1995
    1-800-404-0110

    Region 12
    Hawaii
    Operational April 1, 1996
    1-800-242-6788

    Europe
    Europe, Africa, Middle East, Azores, Iceland
    Operational October 1996
    011-49-6371-47-6230/6387

    Pacific
    Alaska, Hawaii, WESTPAC
    Expected operational October 1997
    1-808-433-6846

    Latin America
    Panama, Central America, South America
    Expected Operational Late 1997
    011-507-284-6977


    More Websites:

  • AMSUS on the Web (Association of Military Surgeons United States) http://www.amsus.org
  • Health Information Resources Service Home Page: http://www.hirs.osd.mil/home/

  • Websites for Specific Military Bases

    (Note: Click here for a more detailed listing of Uniformed Services Medical Facilities)

  • AIR FORCE
  • The Air Force Surgeon General's Advanced Desktop: http://usafsg.satx.disa.mil/

    AFMSA - Air Force Medical Support Agency: http://usafsg.satx.disa.mil:90/master.html

    Air Force Behavioral Science Corner: http://members.aol.com/AFBSC/index.html
    Information and Resources for Air Force Mental Health Professionals

    USAF School of Aerospace Medicine: http://wwwsam.brooks.af.mil/


    Andersen AFB, Guam. General Medical Info: http://www.andersen.af.mil/med.htm

    Andrews AFB, Maryland. 89th Medical Group: http://www.aon.af.mil/89med/89thmed.htm

    Altus AFB, Oklahoma. 97th Medical Group: http://www.lts.aetc.af.mil/pgmdg.html

    Barksdale AFB, Louisiana. 2nd Medical Group: http://131.10.254.80/2wg/2mdss/

    Beale AFB, California. 9th Medical Group: http://www.beale.af.mil/9mdg/index.htm

    Bolling AFB, Washington DC. 11th Medical Group: http://www.bolling.af.mil/medical/11mdg.htm

    Cannon AFB, New Mexico. 27th Medical Group: http://www.cannon.af.mil/mdg/

    Edwards AFB, California. 95th Medical Support Group: http://medwww.elan.af.mil/MDSS/mdss.html

    Elmendorf AFB, AK. 3rd Medical Group: http://yukla-27.topcover.af.mil/medgp/welcome.htm

    McGuire AFB, Ft Dix, New Jersey. 305th Medical Group: http://www.mcguire.af.mil/medgp/

    Onizuka Air Station, California. 750th Medical Squadron: http://saint.oafb.af.mil/750MDS/750tha.htm

    Patrick AFB, Florida. 45th Medical Group: http://www.pafb.af.mil/45MDG/45mdg.htm

    Travis AFB, California. 60th Medical Group: http://usafsg.satx.disa.mil/~dgmc/

    Wright-Patterson AFB, Ohio. 74th Medical Group: http://wpmc1.wpafb.af.mil/

  • ARMY
  • Army Surgeon General: http://www.medcom.amedd.army.mil/otsg/

    (USACHPPM) Medical Safety And Health Program 56:
    http://chppm-www.apgea.army.mil/Armyih/Pgms/hlth-haz.htm

    U. S. Army Center For Health Promotion & Preventive Medicine, Aberdeen Proving Ground, Maryland (USACHPPM) http://chppm-www.apgea.army.mil/

    US Army Dental Corps: http://www.dencom.army.mil/

    121st General Hospital, Korea: http://204.208.30.45/18sub121.htm
    94th General Hospital, Dallas, TX: http://www.cs.amedd.army.mil/94thgh/index.html
    Tripler Army Medical Center, Honolulu, Hawaii: http://www.tamc.amedd.army.mil/index.htm
    Walter Reed Army Medical Center, Washington D.C: http://www.wramc.amedd.army.mil/
    161 ASMB Alabama Army National Guard http://halyard.iar.net/~smithart

  • NAVY
  • Navy Surgeon General: http://support1.med.navy.mil/bumed/sg.htm
    Fleet Hospital Support Office, Alameda, California http://www.fhso.navy.mil/
    Naval Hospital Corps School http://support1.med.navy.mil/nhcsgl/
    Naval Health Research Center (NHRC) - Supports fleet operational readiness through RDT&E on the biomedical and psychological aspects of Navy and Marine Corps personnel health and performance. http://mac088.nhrc.navy.mil/
    Neural Human-System Interface (NHSI) Development - We are developing real-time objective alertness monitoring using EEG and eye-tracking technology. http://128.49.52.9/

  • MARINE CORPS

    United States Marine Corps Health Services Headquarters http://www.hqmc.usmc.mil/opages/health1.htm
  • COAST GUARD

  • Miscellaneous Military Links

    Search through these sites for additional information (Medical and more)

  • Sgt Mom's Military Family Support: http://www.sgtmoms.com
  • Air Force Link - Official web site of the United States Air Force: http://www.af.mil/
  • SITES Homepage Standard Installation Topic Exchange Service - Look up information on various bases:
    http://www.dmdc.osd.mil/

  • These page created by Kat Huck. If the links above don't work, or if you have links to add to this page, please email me. Thanks!

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