Tricare/CHAMPVA Coverage purchased by ineligible person

It is rare, but we occasionally have someone purchase coverage even though they are not eligible – they are not a military retiree covered under a TRICARE plan.  It is more likely to happen when coverage is purchased through an employer’s corporate plan.

 

Here is what you should do if you get a call from an employee who thinks they purchased coverage but are not eligible for it:

 

  1. Send email to Twanna Tilghman  & Yolonda Roulette (MIP Client Management) and copy Jutta Hiley noting the following:
    1. Primary Insured’s name
    2. Company/Client Name and Client Number
    3. The Inspro Policy Number (P00xxxxxxx)

                                                               i.      If there is no record in Inspro, check ImageNow for application and effective date

    1. Their policy effective date
    2. Their policy paid to date
    3. Any specifics about why they are not eligible (ex:  not a military retiree, not covered under a TRICARE plan)
  1. Let the caller know we will research their policy and advise if termination is possible and if so, what their termination date would be
  2. Please DO NOT promise or tell them that we will terminate their coverage based on this call
    1. Tell them we will get back to them as soon as possible 
  3. Jutta Hiley, Twanna Tilighman and Yolonda will email you with a resolution or ask you to get additional information from the caller. 

 




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