Tricare Terminology

2. Refers to the patients ability to obtain medical care
3. an annual amount a patient must pay out of pocket before TRICARE begins to pay
4. Often referred to as the "Gatekeeper"
7. A network of health care providers who provide services at discounted rates
9. civilian provider with no TRICARE contract but agrees to file claims
10. Requires the patient to have prior approval before seeking care
13. Provider who has a contractual relationship with TRICARE
14. an option for beneficiaries to seek and receive services without requesting a referral from their PCM
15. The amount a beneficiary will pay as the remainder of an expense after TRICARE

1. controlling cost by closely supervising and reviewing the delivery of care
5. Fixed amount a TRICARE Prime retiree will pay for care in the civilian network
6. providers who have not agreed to accept the TRICARE allowable charge
8. Any person who is eligible for care in a MTF
11. Refers to the total number of covered persons in a health plan
12. A health plan to which you pay a fixed premium for medical services