TRICARE partners with International SOS Government Services, Inc. (International SOS) to administer your benefit overseas. International SOS is your go-to resource for information and assistance overseas.
YOUR TRICARE OPTIONS BY SPONSOR STATUS
Your TRICARE health care options can change if you have a life event like moving, getting married, or having a status change (like a sponsor retiring from service). Use the following graphic to determine your options based on sponsor status.
|SPONSOR STATUS||HEALTH CARE OPTIONS|
Active Duty Includes National guard and Reserve members called or ordered to active duty for more than 30days for a prepianned mission or in support of a contingency operation
||Family member options:
Separatedfrom Service non-retirement
|sponsor and Family member options:
After separating from service (non-retirement), the Sponser and family members lose TRICARE eligibillity, you may quality for a period of continued coveratge under the:
||Family member options:
TOP Prime and TOP Prime Remote
TOP Prime and TOP Prime Remote are health care options for active duty service members (ADSMs) and their eligible, command-sponsored family members. TOP Prime and TOP Prime Remote are similar to a managed-care or health maintenance organization option, which means you get most of your care from a primary care manager (PCM).
COSTS FOR COVERED CARE
You have no out-of-pocket costs when you get covered health care services from your PCM or when you have a referral and pre-authorization for care from a purchased care sector provider, also called a civilian provider.
When seeing nonparticipating non-network providers, expect to pay the full cost of care up front and file a claim to get money back. Outside the U.S. and U.S. territories, there may be no limit to the amount that nonparticipating non-network providers may bill, and you’re responsible for paying any amount that exceeds the TRICARE-allowable charge. For up-to-date costs, go to www.tricare.mil/costs.
SEEING A PROVIDER WITHOUT A REFERRAL: THE POINT-OF-SERVICE OPTION
The point-of-service (POS) option allows TOP Prime and TOP Prime Remote family members to see any TRICARE-authorized provider without a referral. This means you pay more up front to get nonemergency health care from any TRICARE-authorized provider without a referral. Costs you pay under the POS option don’t count toward your yearly catastrophic cap.
TOP Select is an option for eligible non-ADSMs living overseas. TOP Select works like the stateside TRICARE Select program with similar benefits, requirements, and costs. Premium-based plans that work like TRICARE Select are also available: TRICARE Reserve Select (TRS) and TRICARE Retired Reserve (TRR), which are discussed later.
Health Care Costs
There is no yearly enrollment fee for ADFMs. Retirees, their families, and others pay enrollment fees. In TOP Select, you pay a yearly deductible and per-visit copayments or cost-shares. You should expect to pay up front for care and file your own claims to get money back. Visit www.tricare.mil/costs for more information and current costs.
Private Insurance for Civilian
- 100% out of pocket payment
- File a claim with your insurance company for reimbursement
- International healthcare team will provide you with an English receipt
TRICARE OVERSEAS PROGRAM
IMPORTANT FACTS TO REMEMBER WHEN VISITING NETWORK PROVIDERS IN KOREA
Many of the hospitals in Korea have helpful International Departments that cater to the needs of patients visiting from other countries.
If you need assistance, ask the hospital staff directly so they can put you in touch with someone who can best assist you.
- Obtain an authorization prior to receiving care AND please take a copy of the authorization with you when you go to the facility for your medical appointment. To obtain an authorization please see your Primary Care Manager (PCM) and ask for a referral to receive care from the overseas civilian provider.
- Remember to leave plenty of time to arrive to your appointment. The extra time will help. If you need to search for a parking space or navigate to your scheduled appointment location. Punctuality is key.
- Bring your Military ID or TRICARE Overseas Enrollment Card to the appointment for verification and registration purposes.
- Take any necessary medical records or reports to your appointment. This will assist the provider in making sure your personal information is up-to-date, including your medical condition(s), and also avoids duplicate ordering of diagnostic tests/imaging.
- Remember to pack personal items such as toiletries (soap, toothpaste, hairbrush) should you be admitted for an inpatient stay
- Be mindful of cultural differences in South Korea. Please understand that Korean hospitals have different custodial care*, and that you many need to request caregiving from one of your family members/colleagues or make arrangements for caregivers to provide bedside assistance during an inpatient stay. Custodial care is NOT considered a TRICARE covered benefit, and will not be paid by TRICARE. *Custodial Care (also known as activities or essentials of daily living) is non-skilled personal care needed to perform basic day-to-day tasks—this includes help with eating, dressing, getting in or out of a bed or chair, moving around, and using the bathroom to name a few.
- If any of the instructions provided by the hospital staff are unclear, please be sure to contact the International Department Assistance Desk directly or contact your International SOS TOP Regional Call Center for assistance (See “Information and Language Assistance” box for contact details).
- Do not be late for your medical appointment. If you arrive late, you cannot be seen by the provider right away, even with an appointment. If you need to cancel your appointment, notify International SOS or the provider as soon as possible. “No shows” can be one of the biggest causes of damaging a good relationship with providers in Korea.
- Do not raise your voice or yell.
- Do not point fingers at people.
- Do not record or take photos in the hospital or clinic
INFORMATION AND LANGUAGE ASSISTANCE
If you have any TRICARE benefit coverage questions or need language assistance
call the International TOP Regional Assistance Center
24/7/365 for over-the-phone Korean-to-English interpretation services.
Press Option 1 to request real-time telephonic language assistance.
Overseas contact information is available at www,tricareoverseas.com/contact-us
- Korean Customer Service Toll-free : 080-429-0880
- Medical Assistance Toll-free : 080-591-880
Process for Patients
- Out patient clinic process for US military
* Active duty and their family member(Tricare prime)
- Visit TMC & Consult with provider
- Providers put in a referral & Yong-san 121 hospital will review your referral
- Tricare Singapore office will review your referral lastly and issue an authorization form
- YUMC international clinic will call and make an appointment
- Visit international Healthcare Service Center at YUMC for your appointment
- Consultation Evaluation and Examination Treatment(Medication, Injection, Physical Therapy)