Getting the most from your healthcare coverage

  • Published
  • By Teri Nelson
  • 5th Medical Group
An opportunity exists at the 5th Medical Group that will benefit patients and the 5th MDG facility. It's called the Third Party Collection (TCP) Program. Everyone's cooperation in this program will help collect reasonable costs of providing healthcare.

The key to this program's success is the patient and the third party health insurance coverage that a beneficiary and their spouse may be paying for, but not using. The only thing that we ask to be done is fill out a DD Form 2569 (Record of Other Health Insurance) for each non-active duty dependant in the family (including retirees and their dependants) once a year. This needs to be done whether the beneficiary has other health insurance besides TRICARE or not. Once the beneficiary fills out the 2569 and turns it in he will be issued a blue Third Party Collection Card (TPC CARD) which will need to be carried with the person and presented at all clinic and pharmacy visits here at the 5th Medical Group. All non-active duty dependants and spouses ages 18 years or older need to sign their own forms (sponsors cannot sign for them). If the beneficiary or his dependants have other health insurance, we will then bill the insurance company directly. The benefit is enhanced healthcare at no extra cost. The money recovered from third-party payers goes directly to our facility, so the high level of healthcare beneficiaries have come to expect from us will continue without costing any more money. In fact, this program could end up saving the beneficiary money if he was to seek care from a civilian provider. The beneficiary's annual deductible could be satisfied by visits to the clinic without any out-of-pocket expenses, resulting in an average savings of over $500.

The Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 established the TCP Program. Under this federal program, Military Medical Treatment Facilities are authorized and obligated to bill health insurance carriers (like Blue Cross or Mail Handlers) for the cost of medical care furnished to military retirees and family members who are covered by other health insurance policies. Laws also provide for a fine of up to $10,000 and up to 5 years imprisonment for not disclosing insurance information. We, as a military facility must comply with these laws and we need your help to make this program a success.

A Department of Defense Form 2569 (Record of Other Health Insurance)can be obtained from any of the clinics, Lab, Radiology, Pharmacy, or the TPC office located on the 3rd floor, room 3J7 at the 5th Medical Group or call the TPC/OHI Specialist at 723-5171.