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Military Health System Health Care Glossary serves as the official repository and consolidated reference (as a secondary source) for terms and definitions used within the MHS. Some terms may have multiple and varying definitions based on the context and primary source of authority. Note that certain definitions may be approved only for limited use in a single primary reference document, while others may have broad applicability in multiple contexts and issuances. To determine the most appropriate definition in a particular context, consult all relevant source documents. Any disparities between this Glossary and primary sources are unintentional, and the primary source shall control.
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An health maintenance organization (HMO)-like option, provided as part of the TRICARE program in accordance with section 199.17 of Title 32, Code of Federal Regulations, where MHS beneficiaries elect to enroll in a voluntary enrollment program, which provides TRICARE Standard benefits and enhanced primary and preventive benefits with nominal beneficiary c...
An agreement that defines the legal position of a visiting military force deployed in the territory of a friendly state. The NATO SOFA, as referenced in this instruction, does not apply to care in U.S. territories or possessions unless the foreign materiel program (FMP) are stationed in the 50 U.S. States and is traveling from there to a U.S. territory or...
The practice of a provider billing a beneficiary the difference between the TRICARE allowed amount and the billed charges on a claim. Participating providers and network providers may not collect from all sources an amount that exceeds the TRICARE allowed amount. Non-participating providers may not collect an amount that exceeds the balance billing limit,...
A plan that qualified adult children can purchase after eligibility for “regular” TRICARE coverage ends at age 21 (or 23 if enrolled in college).
The point of service option allows an eligible beneficiary enrolled in TRICARE Prime to receive non-emergency, TRICARE-covered services from any TRICARE authorized provider without requesting a referral from their primary care manager, resulting in higher out of pocket costs.
Any service that directly assists an individual with a disability in the selection, acquisition, or use of an AT device. Services may include needs assessments, acquisition, integration, coordination of services with rehabilitation plans, training, and technical assistance.
A system of support and advocacy to guide and assist the wounded, ill, and injured Service members and family or designated caregiver through treatment, rehabilitation, return to duty, or military retirement into the civilian community. Each Military Department has a unique wounded warrior program that addresses its Service members’ needs. Thi...
A program under the authority of the DODHRA that provides AT to increase access to computer and telecommunication systems by employees with disabilities within the DOD and federal partner agencies, and Service members with cognitive, communication, dexterity, hearing, or vision impairments.
Technology that provides individuals with disabilities equal access to computer and telecommunication work environments. It does not include durable medical equipment and is divided into two categories: devices and services.
Any item, piece of equipment, or product system, whether acquired commercially, modified, or customized, that is used to increase, maintain, or improve the functional capabilities of individuals with disabilities. The devices help individuals access computer and telecommunication systems and gain improved access to care and decision making. Ex...
A planned and systemic pattern of all actions necessary to provide confidence that requirements are established; products and services conform to established laws, regulations, and policy; and satisfactory performance is achieved.
The joint DOD-Department of Veterans Affairs process by which DOD determines whether ill or injured service members are fit for continued military service. The DOD and VA determine appropriate benefits for those service members who are separated or retired for disability.
An independent body within the military organization concerned, separate from the disability evaluation system processes.
A body composed of Department of Defense representatives charged with developing constructed cases for standardized consistency reviews and assessing the results of consistency reviews.
A scoring mechanism, such as a checklist, that uses agreed criteria and an agreed evaluation scale and process that is used as a common basis for evaluating disability evaluation system cases across multiple evaluators.
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