1. Stay at the Civilian Network Facility

TRICARE has a new pilot program. It lets you decide if you want to be in a military or a civilian hospital. Under the pilot, you can choose to: 1. Stay at the civilian network facility 2. Transfer to your local military treatment facility, Wright-Patterson Medical Center

If you want to transfer to Wright-Patterson Medical Center for inpatient care, let the hospital staff at the civilian network facility know you would like to be considered for transfer. Your provider teams will decide whether you’re stable enough for the transfer and the military hospital staff will confirm if there is a bed available for you at Wright-Patterson Medical Center. Note: Members on active duty for more than 30 continuous days who are stable are asked to agree to transfer, or may be ordered to transfer to the closest military hospital, as long as the needed care is available. This pilot does not apply to those in the US Family Health Plan. WHY SHOULD I THINK ABOUT CHANGING HOSPITALS? The decision is yours to make, but here are some reasons you may want to consider:  Continuity of Care – the ability to see your primary care manager or return to a facility where you have been treated.  Possibility of lower out-of-pocket costs. Please see the cost information below. STUDY YOUR OPTIONS Please read the below tables to learn about inpatient costs, catastrophic caps, and costs for ambulance services. HOSPITAL COSTS TRICARE plan Beneficiary category Military hospital Civilian hospital Active duty service member $0 TRICARE Prime Active duty family members $0 TRICARE Young Adult – Retired service members Prime Option Retiree family members, survivors and $11 per day ($25 minimum charge) $18 per day others Active duty service member TRICARE Prime Remote $0 $0 Active duty family members Active duty family members $18 per day $18 per day ($25 minimum charge) Network: $250 per day or 25% of billed charges for institutional services, whichever is less, plus TRICARE Standard 20% cost-share for separately billed services Retired service members $0 TRICARE Young Adult – Non-network: $810 per day or 25% of billed Standard Option charges for institutional services, whichever is less, plus 25% cost-share for separately billed Retiree family members, survivors and services $18 per day others TRICARE Reserve Select members $0 TRICARE Reserve Select TRICARE Reserve Select members family $18 per day ($25 minimum charge) $18 per day members Network: $250 per day or 25% of billed charges TRICARE Retired Reserve members $0 for institutional services, whichever is less, plus 20% cost-share for separately billed services

TRICARE Retired Reserve Non-network: $810 per day or 25% of billed TRICARE Retired Reserve family charges for institutional services, whichever is $18 per day members less, plus 25% cost-share for separately billed services CATASTROPHIC CAPS If you choose to stay at the civilian hospital, your TRICARE catastrophic cap still applies. The catastrophic cap is the most you or your family pays for covered services each fiscal year (Oct. 1–Sept. 30). The catastrophic cap is:  Active duty family members and TRICARE Reserve Select members: $1,000 per family  Retirees, their family members, TRICARE Retired Reserve and all others: $3,000 per family

YOUR AMBULANCE COSTS FOR TRANSFERRING TO THE MILITARY HOSPITAL The military hospital and civilian hospitals will work together to decide how you’ll get to the military hospital. Ambulance costs vary based on your TRICARE plan and beneficiary category. TRICARE plan Beneficiary category Copay or cost share Active duty service member $0 TRICARE Prime Active duty family members TRICARE Young Adult – Prime Option Retired service members, their family members, $20 copay per transport survivors and others Active duty service member TRICARE Prime Remote $0 Active duty family members Network: 15% of the negotiated rate Active duty family members Non-network: 20% of the TRICARE-allowable charge TRICARE Standard TRICARE Young Adult – Standard Option Network: 20% of the negotiated rate Retired service members, their family members, Non-network: 25% of the TRICARE-allowable survivors and others charge

TRICARE Reserve Select Network: 15% of the negotiated rate TRICARE Reserve Select members and their TRS- Non-network: 20% of the TRICARE-allowable covered family members charge TRICARE Retired Reserve Network: 20% of the negotiated rate TRICARE Retired Reserve members and their TRR- Non-network: 25% of the TRICARE-allowable covered family members charge

OTHER HEALTH INSURANCE AND MEDICARE Think about how your other health insurance (OHI) or Medicare coverage affects your care and costs. If you choose to stay at the civilian hospital, you have to follow your OHI’s or Medicare’s rules. What you pay for inpatient care may be different from what is in the hospital costs table. Remember, TRICARE processes your claims after your OHI and Medicare. OHI and Medicare usually only cover ambulance transport to the nearest appropriate medical setting. If you choose to transfer to the military hospital, and your OHI or Medicare denies your claim, TRICARE then pays as primary. You have to pay your TRICARE annual deductible and cost- shares or copayments. The military hospital may bill your OHI for its services, but won’t charge you for what OHI or Medicare doesn't pay on the claim. READY TO TRANSFER TO THE MILITARY HOSPITAL?

Just let the hospital staff know to contact Wright-Patterson Medical Center to begin the transfer process.

If you have questions pertaining to your beneficiary status, you may contact WPMC at (937) 257-9166 or (937) 522-3165 from 0730-1630, Monday through Friday or Health Net Federal Services anytime at 1-877-TRICARE (874-2273)