Frequently Asked Questions (FAQs)

According to Health Affairs Policy 97-052, only Active Duty Family Members (ADFMs) who meet the Joint Federal Travel Regulation (JFTR) definition of Command Sponsored are eligible for enrollment into TRICARE Overseas Program (TOP) Prime. Command sponsorship is annotated on your assignment orders. The TRICARE enrollment clerks must verify command sponsorship from your official orders in order to enroll your family in TOP Prime.

We have several families who are on a joint domicile assignment in Korea. If the dual-Active Duty couple has accompanying children, one of the service members must have the children listed as command sponsored on their assignment orders in order for the children to be eligible to enroll in TOP Prime.

No. You must transfer your enrollment to your new duty location whenever you move. Visit your local TRICARE Office with assignment orders annotating command sponsorship to fill out an enrollment form.

Non-command-sponsored Active Duty Family Members, who reside overseas, are eligible for TRICARE Overseas Program (TOP) Standard only. The TOP Standard option is similar to the TRICARE Standard program offered stateside, with the same cost-shares and deductibles. Your family members can obtain their primary care from one of the military treatment facilities on the Korean Peninsula. Any care or services not available with in the MTFs will be referred out to one of the hospitals we have an agreement with (called "MOU" facilities) to provide care to our beneficiaries. Although TRICARE Standard patients stateside do not require a referral for care, we encourage TOP Standard patients to have their care to host nation hospitals referred by their primary care provider and arranged by the TRICARE Service Center to avoid having to pay the entire bill up front.

Many host nation providers expect payment at the time services are provided, often in local currency instead of U.S. dollars. Most host nation facilities will accept a U.S. bank credit card, especially in the larger metropolitan areas.

• If you are enrolled in TOP Prime, you will not be required to pay up front for care in one of our host nation partnership hospitals and clinics. If you have to obtain care in facility that is not one of our host nation partnership hospitals or clinics because of an emergency, you will be required to pay up front and file a claim with Wisconsin Physician Services (WPS), the TRICARE Overseas claims processor. Your local TRICARE Benefits Counselor can assist you with any claims paperwork needed for reimbursement.
• If you are TOP Standard and you have been referred by a MTF provider, your care will be arranged by the TRICARE Service Center and your cost-share will be annotated so that the host nation partnership hospital or clinic only collects that portion at the time the services are provided. If you have to obtain care in a facility that is not one of our host nation partnership hospitals or clinics because of an emergency, you will be required to pay up front and file a claim with WPS, the TRICARE Overseas claims processor. You will be reimbursed for all but your cost-share and deductible. Your local TRICARE Benefits Counselor can assist you with any claims paperwork needed for reimbursement.
• If family members visit Korea who are enrolled in a stateside TRICARE Region, but need care not available in the MTF, they must call their stateside regional office for care authorization, pay up front for the care, then file a claim with their TRICARE Region for reimbursement. TRICARE information for all regions is located on www.tricare.mil. Your local TRICARE Benefits Counselor can assist you with any claims paperwork needed for reimbursement.

Your college-age daughter can obtain care when available within the MTF. If care is not available, she will be referred to one of our host nation partnership hospitals or clinics. She will need to call her stateside TRICARE Region for care authorization, pay up front for the care at the time services are provided, and then file a claim with her TRICARE Region for reimbursement. If she does not obtain authorization for the care, she may incur higher point-of-service (POS) charges. See the TRICARE for College Students FACT SHEET on www.tricare.mil. We encourage her to obtain any necessary routine care where she is enrolled. If she is referred out for emergency care, the TRICARE Benefits Counselor will assist with notification of her TRICARE Region and payment arrangements.

Obstetrical (OB) care is available to Active Duty Service Members, Retirees, DoD Employees, and Family Members, throughout Korea. To obtain OB care, patients should first report to the nearest Military Treatment Facility (MTF) for confirmation of their pregnancy. If the local MTF cannot provide the necessary care, then the provider will either refer the patient to a Brian Allgood Army Community Hospital provider, or to a local TRICARE-accepting host nation partnership hospital. However, if the patient is determined to have a high risk pregnancy, or if the patient prefers to utilize a host nation hospital due to traveling distance, the OB provider may refer the patients to TRICARE in order for the patient to obtain an approved referral to one of the host nation partnership hospitals.

TRICARE Standard patients (retirees and non-command sponsored family members primarily) are highly encouraged to obtain an approved referral, signed by a MTF provider and approved by the TRICARE Service Center, before going to a host nation partnership hospital in order to avoid full, up front, out-of-pocket payments (and the requirement to file for reimbursement later).

TRICARE Standard patients are required to pay their annual deductible one time per fiscal year and cost-share for each visit at MOU facilities, up to the catastrophic cap for the year. Once the family has met the cap ($1000 for Active Duty Families and $3000 for Retirees and their families), they will not incur any other costs for the rest of the fiscal year for TRICARE covered benefits. Non-command-sponsored families should be prepared to pay up to $1000 per fiscal year for medical care while they are in Korea.

You can expect a high level of care, and a multidisciplinary team approach to medicine, involving nursing and medical staff to include your primary care provider and internists. Most of our host nation hospitals are University hospitals where they approach medicine with a team approach using multiple individuals to ensure you receive the best of care.

During your stay you can expect mainly Korean food served at your meals. Some of the larger and more modern host nation partnership hospitals have western style food as well, available upon request. In the Korean culture, the family is very much involved with the patients? care and stay with them until he/she is discharged from the hospital. We understand that many of our beneficiaries are here without family and encourage unit support of those admitted. The nursing staff is wonderful and compassionate, and will be available to assist you with all your needs during your stay at the hospital.

YES. Translators are available either through the host nation hospital or through the Brian Allgood Army Community Hospital/121 hospital ER, as they have a roster of translators on duty to assist.

Your medical records will be provided to you in order for you to give them to your primary care provider for review and to update your profile at your follow up appointment. In most cases, a copy of your medical records will be delivered to the TRICARE Service Center. Once the results are received, they will be scanned into your electronic medical record and the hard copy will be maintained in your medical record in Patient Administration.

Depending upon your situation, you may need to follow up with the doctor that cared for you at the host nation partnership hospital. You will also need to make a follow up appointment with your primary care provider in order to have your records updated and to keep your provider informed of your medical condition.

You may be notified several days in advance or simply a couple of hours before they need you at the hospital. It will depend upon availability of the surgeon and the availability of patient beds.

The local hospitals are very busy and take care of a very large population of people. It may not always be possible to have a private room, and private rooms are very limited, depending upon the facility. Generally, TRICARE and other commercial insurance do not pay for private rooms upon request; if a semi-private room is unavailable, TRICARE will pay for a private room until a semi-private room becomes available. Sharing a room with one or more other persons is quite realistic and should be expected.

We recommend you bring your own toiletries and bath towels. Some of the medical facilities will supply an admission packet that includes basic personal items, but not all. Post surgical supplies should be made available upon discharge. Please be advised that the cost of medical supplies will be added to your final bill.

Yes. Although they have a different approach on managing pain, the host nation partnership hospital will accommodate your needs to the best of their ability. If your pain level is intolerable, please inform the Nurse Case Manager or Patient Liaison when they come visit you during your admission.

It will depend upon the surgery or care that you received and the recommendation from the treating physician at the host nation partnership hospital. You should always make a follow up appointment with your primary care provider in to have your profile updated with your current medical status and condition with recommendations for future care.

You will need to coordinate your own transportation upon discharge from the hospital, and will be given ample time to make such arrangements. If you're being discharged Monday through Friday, between the hours of 0730-1600, the TRICARE courtesy van may be available, depending upon the time of day and location.

If it is a true emergency that without medical attention would result in a threat to life, or eyesight, go to the nearest emergency room. You will most likely be required to pay up front and file a claim with WPS, the TRICARE Overseas claims processor. The TRICARE Benefit Counselor can assist you with any claims paperwork needed for reimbursement. If you go to one of our network providers for emergency care, they will contact TRICARE personnel at Yongsan to verify eligibility and arrange for payment. If you're an Active Duty Service Member or a command sponsored family member enrolled in TOP Prime and you're seen at one of our host nation partnership hospitals, you will not be required to pay up front for your medical care. If you are TOP Standard, you will be responsible for paying your annual deductible and cost-share at the time medical care is provided.

The TRICARE Service Center is located within the Brian Allgood Army Community Hospital (BDAACH), Managed Care Division, Room 1150 on Yongsan Garrison, across from the Asian Garden, Brian Allgood Army Community Hospital. The TRICARE Service Center offers the following services to Active Duty Service Members, command and non-command sponsored family members, retirees, DoD Civilians and Contractors throughout the peninsula:

• Educates all beneficiaries about TRICARE options in Korea.
• Enrolls or transfers enrollment for eligible beneficiaries in the appropriate TRICARE health plan.
• Assists with claims resolution and debt collection.
• Coordinates healthcare with one of our host nation partnership hospitals and clinics when a provider enters consults for services that cannot be provided internally; contacts hospital and schedules appointments for beneficiaries.
• Educates beneficiaries on co-payment, cost shares and deductibles for services rendered at one of our host nation partnership hospitals or clinics; coordinates care if/when necessary or requested.
• Provides healthcare finder services when patients need to be transferred from the MTF to a host nation partnership hospital or clinic.
• Provides courtesy transportation to/from some of our host nation partnership hospital or clinic on a first come, first serve basis.
• Please contact the TRICARE Service Center with any questions. DSN 737-1433, or 0503-337-1433 from a civilian phone.

If you have a referral from a Military Treatment Facility provider, the TRICARE Service Center can arrange for your care at one of our host nation partnership hospitals or clinics across the peninsula and you will only pay your deductible (if not already met for the year) and your 25% cost share at the time of your appointment.

The next time you need care at a host nation facility,

• Visit your MTF provider for a referral. If care is not available within the MTF, the provider will put a referral in the system for TRICARE.
• A representative from TRICARE will call you with an appointment date and time. If you do not receive a phone call from a TRICARE staff member after 72 hours after the referral was requested by a provider, please contact your local TRICARE Office for assistance.
• The TRICARE Service Center will inform the host nation medical facility of your payment responsibilities. (Note: If you have Other Health Insurance, you will need to pay the entire bill up front and file claims with your insurance company and TRICARE. TRICARE is the second payer.)
• The TRICARE Service Center will ensure the host nation hospital does not charge you for the remainder of the bill.
• Contact the TRICARE Service Center with any questions at DSN 737-1433, or 0503-337-1433 from a civilian phone, or visit the Yongsan TRICARE Service Center, Building 7005, Room 1150 inside Brian Allgood Army Community Hospital across from the Asian Garden.

Certainly! However, you also have the option of filing the claim yourself and tracking it through the TRICARE4u website. Visit www.tricare4u.com to see all of the services available to you.

Because TRICARE is the second payer and most other health insurance companies do not pay host nation facilities directly, you will be required to pay the entire bill up front, file a claim with your other insurance company first, then file a claim with TRICARE for the remainder of the bill. You will be reimbursed for all but your deductible, if not met for the year, and your cost-share for that visit after the other insurance reimburses you for their covered portion.

There are many information options for you.

• The TRICARE Website at http://www.tricare-overseas.com. This website provides specific information on TRICARE Overseas Program.
• The TRICARE website at www.tricare.mil has information on TRICARE in general, for different beneficiary categories, as well as specific Fact Sheets for overseas.
• The TRICARE Service Center and your military treatment facility have several TRICARE Overseas booklets available to you.
• You can also contact the TRICARE Service Center on Yongsan Garrison at DSN 736-7236, or 0505-736-7236 from a civilian phone, or visit the Yongsan TRICARE Service Center, Building 7005, Room 1150, inside Brian Allgood Army Community across from the Asian Garden.