미군 가족 의료 혜택_Tricare Select Details

Tricare 종류

앞서 알아봤듯이 Tricare에는 크게 Tricare Prime과 Tricare Select가 있다.
남편과 떨어져 사는 나는 Tricare Select에 해당될 듯싶다.
그래서 트라이케어 셀렉트에 대해 자세히 알아보고자 한다.

Tricare Select는 진료 때마다 요금을 지불하며 아무 병원에나 가도 된다.
만약 network doctor에게 가면 copay(본인 부담금)을 적게 내고
만약 non-network doctor에게 가면 일단 모든 비용을 지불한 후에
트라이케어에 reimbursement를 요구하면 된다.

Tricare Groups

일단 트라이케어에는 두 그룹이 있다.
그룹 A: 2018/1/1 이전에 입대
그룹 B: 그 이후에 입대

Enrollment Fee

현역 군인과 그의 가족들은 신청 비용이 없다.
그룹 A: $50 Individual, $300 for a family
그룹 B: $474 individual, $948 for a family

Deductible

그룹 A:

• Active duty family members - sponsor rank E-4 and below:
  • $50 Individual
  • $100 Family
• Active duty family members - sponsor rank E-5 and above:
  • $150 Individual
  • $300 Family
• Retirees:
  • $150 Individual
  • $300 Family

그룹 B:

• Active duty family members - sponsor rank E-4 and below:
  • $52 Individual
  • $105 Family
• Active duty family members - sponsor rank E-5 and above:
  • $156 Individual
  • $313 Family
• Group A Retirees:
  • $158 Individual
  • $300 Family
• Group B Retirees:
  • $158 Individual
  • $317 Family

Catastrophic Cap

Catastrophic Cap: 최대 자기 부담 비용

• Active Duty Group A: $1,000
• Active Duty Group B: $1,058
• Retired Group A: $3,500
• Retired Group B: $3,703

Copay Amounts

Service	그룹 A	그룹 B
Primary Care	Active Duty Family: $22 Retirees: $30	Active Duty Family: $15 Retirees: $26
Specialist	Active Duty Family: $34 Retirees: $34	Active Duty Family: $26 Retirees: $26
Ambulance	Active Duty Family: $70 Retirees: $93	Active Duty Family: $15 Retirees: $63
Emergency Room	Active Duty Family: $93 Retirees: $125	Active Duty Family: $42 Retirees: $84
Hospital	Active Duty Family: $20.15/day Retirees: $250/day	Active Duty Family: $63 Retirees: $185

Copay와 deductible의 차이

Copays are a fixed fee you pay when you receive covered care like an office visit or pick up prescription drugs. A deductible is the amount of money you must pay out-of-pocket toward covered benefits before your health insurance company starts paying. In most cases your copay will not go toward your deductible.
출처: eHealth

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출처 : https://www.military.com/benefits/tricare/tricare-select/tricare-select-details.html

Tricare Select Details

관련 글 :
https://www.militaryonesource.mil/health-wellness/healthcare/tricare-101-military-health-benefits-basics-in-five-minutes-or-less/

트라이케어 홈페이지:
https://www.tricare.mil/

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