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Reserve Component members with approved line of duty care won’t show as eligible in the Defense Enrollment Eligibility Reporting System or in the contractor’s system.
- Reserve component members will have approved authorizations for the line of duty care.
- The regional contractor’s system will reflect authorizations.
Line of Duty Coverage and Other Health Insurance
- TRICARE pays as the only claims processer for approved line of duty care.
- The care must match the authorization.
- Reserve Component members won’t have a co-payment or cost-share.
Claims
Although the Reserve Component member won’t show eligible, you must file the claim with the appropriate contractor. We can’t make payments for claims which aren’t in the system. They may deny initially due to ineligibility, but we will initiate a claim reimbursement adjudication.
If you’re experiencing issues with electronic claims filing, please contact your managed care support contractor.
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Last Updated: November 21, 2023