INPATIENT

The coverage provided under the inpatient benefit of the supplement plan is limited to 

30 inpatient treatment days per plan year for persons age 19 and older … or …

45 inpatient treatment days per plan year for persons under age 19.

This inpatient limit is based on the number of days TRICARE normally provides each plan year for such confinements. In rare instances, TRICARE extends these daily limits. If this occurs, we will limit the number of days that we provide for such confinement to the lesser of: a) the number of days TRICARE pays for such inpatient treatment during the plan year; or b) 90 inpatient days per plan year.

OUTPATIENT

TRICARE: There is no longer a $500 limit on mental, nervous and emotional disorders.

CHAMPVA: The coverage provided under the outpatient benefit of the supplement plan is limited to $500 during any plan year for all such disorders. THIS CLAIM WILL BE CODED AS "12"

Verbiage: Your plan allows for $500.00 of covered benefits in each plan year. Once the benefit amount is exceeded those claims are not covered.