Tricare Standard: Beneficiary Analysis

Brief description of your activities This week I began my 6-week internship at Blue Cross Blue Shield of Nebraska (BCBSNE). The first day was a common orientation for all new employees, internally denoted to as the “onboarding process” where all employees are told they matter. This full-day session communicates the core mission, vision and goals of BCBSNE, organizational structure, operating objectives, and workplace culture. BCBSNE is a not-for-profit health insurance company that is focused on collaboration to find the best solution for their customers; in other words, they are customer-focused. Since the implementation of the Affordable Care Act (ACA), many changes to the health insurance market required a change in the organizational structure and culture of BCBSNE. Through partnerships with providers, the goals of BCBSNE are to be responsive, accountable, minimize errors, and decrease costs – all components of the ACA. BCBSNE has strategically aligned their goals to those of the government-mandated goals, and implemented them at all levels of the organization, making them competitive in the health insurance market. I found this very fascinating: I was very excited after day one!

The five most important characteristics for a healthcare provider is honesty, patience, empathy, responsibility, and a team player. I picked honesty because for me honesty is important because if I was the patient I would like for the nurses and doctors be completely honest with me. To be honest you have trustful. Patients should be able to always have faith in you. You always have to be honest with the patients no matter what. Honesty has a lot to do with the healthcare industry.

Tricare Standard - An option that provides flexible coverage for eligible beneficiaries. It allows beneficiaries to choose an authorized Tricare provider they desire. However; this option isn't available for active military members. Eligible participants include: family members of active military, retired military and their family, survivors, authorized past spouses, and

Vision statement of a business is very imperative in summarizing the strategic path of the business. The vision of a business should summarize what precisely the business is encompassed in and what the business plan to develop into in future. The vision of the business should highlight what precisely the business plans to do for its shareholders. Summarizing I could say visions should be the communication approaches through which the business communicates with its workforces regarding the planned leadership of the business. Proverbs 29:18 states, “Where there is no prophetic vision the people cast off restraint, but blessed is he who keeps the law” (NKJ). In order for persons to perform well, individuals should know God’s practices and sustain his

Tricare Prime is a managed care plan similar to an HMO. This plan has Tricare Prime Remote, Tricare Prime Overseas and Tricare Global Remote Overseas. Tricare Extra is an alternative managed care plan for individuals who want to receive services primarily from civilian facilities and physicians rather than from military treatment facilities. Tricare for Life is a plan for beneficiaries who are both Medicare and Tricare eligible. Tricare Reserve Select is a premium based health plan available for purchase by certain members of the National Guard and Reserve activated on or after September 11,2001. Tricare Young Adult is a plan that can be purchased by qualified adult children after their regular Tricare coverage ends at age of twenty-one. Tricare is a secondary payer in almost all circumstances except Medicaid. The Civilian Health and Medical Program of the Department of Veteran Affairs (CHAMPVA) is the government’s health insurance program for the families of veterans with hundred percent service related disabilities. CHAMPVA provides coverage for most medically necessary services such as surgical procedures, anesthesia, chemotherapy, physical therapy, speech therapy, mental healthcare, prescription medications, maternity care, family planning, immunizations, durable medical equipment, hospice services and much more. CHAMPVA is usually the secondary payer except Medicaid and supplemental policy.

Standard- a fee for service plan that offers a lot of flexibility but you may have to pay at the time for service and then file to get reimbursement. You also pay a higher out of pocket cost verse the other plans but you can choose any authorized provider for the services you need this is one of the biggest advantages to choosing standard Tricare.

TRICARE is formerly known as the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), and is a health care program of the US Department of Defense Military Health System. Following WWII and the Korean War, access to care in military facilities became less available by civilians and active-duty personnel due to a lack of resources, or a constraint of them, and growing demands on the system, and “space-available basis” was first addressed. As a solution, Congress passed the Dependents Medical Care Act in 1956 and the Military Medical Benefits Amendments in 1966. Such acts allowed the Secretary of Defense to work with civilian health care providers and contract their services. This health civilian health care program became known as the CHAMPUS in 1966. The responsibility of maintaining the health care initiative within the Military lies upon the U.S. Department of Defense Military Health System, which organized the Tricare Management Activity (TMA). The TMA consists of a contract-structure between several large health insurance corporations to provide claims processing, customer service and other administrative functions to the TRICARE

Long-Term Care Reimbursement Who Covers Reimbursement for Long-Term Care Long-term care has many funding sources which includes government funding, privet insurance, out-of-pocket payments, and any combination of any of these programs. Privet insurance includes insurance for long-term care and managed care (HMO, PPO, POS). While government funding includes Supplemental security income, Department

HCS 405 week 1 Health Care Financial Terms Worksheet Paper Introduction The HCS 405 week 1 financial terms worksheet throws light on some of the most basic concepts of the healthcare business. Understanding health care financial terms is a prerequisite for both academic and professional success. The health care business helps the

Available Tri-Care Coverage Plans Tri-Care medical coverage doesn't feature just one overarching plan: there are multiple different plans available for people interested in drug rehabilitation. These plans

Tricare or CHAMPUS is a health insurance program that is for spouses and dependents of active duty military personnel as well as retired military and their family.

On October 1, 2015, Ms. Booth was approved for Medicaid coverage through the BCC program. It was determined by the Mississippi State Department of Health that Ms. Heigle was eligible to receive Medicaid coverage for two (2) years or during the course of her treatment for breast cancer. The Office of Eligibility issued a Notice of Adverse Action on September 5, 2017, informing Ms. Booth that her eligibility would terminate on September 30, 2017, because her two (2) year treatment period was ending.

What is TRICARE? A question that many of us really do not know how to answer. TRICARE is a major part of the Military Health System, its purpose is to combine the resources of military hospitals and clinics with civilian health care networks, provides access to high-quality health care, supports military operations and readiness. In order to participate in TRICARE benefits, beneficiaries must be enrolled in the Defense Enrollment Eligibility Reporting System (DEERS) before you can reap these benefits.

While researching I learned that all three agencies shared the same covered services. The services covered included nursing care, medical social services, home health aide, and therapies like physical, occupational, and speech. Neither of the three showed what types of services were not covered. To add, the quality of patient care star rating for the compared home health agencies summarizes 9 of the 29 quality measures reported on Home Health Compare (Medicare, n.d.). The star ratings go as followed:

Tricare, which was formerly known as the Civilian Health and Medical Program of the Uniformed Services, is a health care program of the United States Department of Defense Military Health System. Tricare provides civilian health benefits for U.S Armed Forces military personnel, military retirees, and their dependents, including some members of the Reserve Component. There are three types of medical plans with Tricare: Standard, Extra, and Prime.